hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|CO,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Rio Grande Hospital,2024-04-29,2.0.0,"310 Country Road 14 Del Norte, CO 81132",Rio Grande Hospital,841276376,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,modifiers,standard_charge|AETNA|COMMERCIAL|negotiated_dollar,standard_charge|AETNA|COMMERCIAL|negotiated_percentage,standard_charge|AETNA|COMMERCIAL|negotiated_algorithm,estimated_amount|AETNA|COMMERCIAL,standard_charge|AETNA|COMMERCIAL|methodology,additional_payer_notes|AETNA|COMMERCIAL,standard_charge|AETNA|MEDICAL RENTAL COFINITY|negotiated_dollar,standard_charge|AETNA|MEDICAL RENTAL COFINITY|negotiated_percentage,standard_charge|AETNA|MEDICAL RENTAL COFINITY|negotiated_algorithm,estimated_amount|AETNA|MEDICAL RENTAL COFINITY,standard_charge|AETNA|MEDICAL RENTAL COFINITY|methodology,additional_payer_notes|AETNA|MEDICAL RENTAL COFINITY,standard_charge|AETNA|MEDICARE|negotiated_dollar,standard_charge|AETNA|MEDICARE|negotiated_percentage,standard_charge|AETNA|MEDICARE|negotiated_algorithm,estimated_amount|AETNA|MEDICARE,standard_charge|AETNA|MEDICARE|methodology,additional_payer_notes|AETNA|MEDICARE,standard_charge|APOSTROPHE|MEDICARE|negotiated_dollar,standard_charge|APOSTROPHE|MEDICARE|negotiated_percentage,standard_charge|APOSTROPHE|MEDICARE|negotiated_algorithm,estimated_amount|APOSTROPHE|MEDICARE,standard_charge|APOSTROPHE|MEDICARE|methodology,additional_payer_notes|APOSTROPHE|MEDICARE,standard_charge|BLUE CROSS|COMMERCIAL|negotiated_dollar,standard_charge|BLUE CROSS|COMMERCIAL|negotiated_percentage,standard_charge|BLUE CROSS|COMMERCIAL|negotiated_algorithm,estimated_amount|BLUE CROSS|COMMERCIAL,standard_charge|BLUE CROSS|COMMERCIAL|methodology,additional_payer_notes|BLUE CROSS|COMMERCIAL,standard_charge|BLUE CROSS|MEDICARE|negotiated_dollar,standard_charge|BLUE CROSS|MEDICARE|negotiated_percentage,standard_charge|BLUE CROSS|MEDICARE|negotiated_algorithm,estimated_amount|BLUE CROSS|MEDICARE,standard_charge|BLUE CROSS|MEDICARE|methodology,additional_payer_notes|BLUE CROSS|MEDICARE,standard_charge|CIGNA|COMMERCIAL|negotiated_dollar,standard_charge|CIGNA|COMMERCIAL|negotiated_percentage,standard_charge|CIGNA|COMMERCIAL|negotiated_algorithm,estimated_amount|CIGNA|COMMERCIAL,standard_charge|CIGNA|COMMERCIAL|methodology,additional_payer_notes|CIGNA|COMMERCIAL,standard_charge|COFINITY|COMMERCIAL|negotiated_dollar,standard_charge|COFINITY|COMMERCIAL|negotiated_percentage,standard_charge|COFINITY|COMMERCIAL|negotiated_algorithm,estimated_amount|COFINITY|COMMERCIAL,standard_charge|COFINITY|COMMERCIAL|methodology,additional_payer_notes|COFINITY|COMMERCIAL,standard_charge|HUMANA|CHOICECARE|negotiated_dollar,standard_charge|HUMANA|CHOICECARE|negotiated_percentage,standard_charge|HUMANA|CHOICECARE|negotiated_algorithm,estimated_amount|HUMANA|CHOICECARE,standard_charge|HUMANA|CHOICECARE|methodology,additional_payer_notes|HUMANA|CHOICECARE,standard_charge|HUMANA|MEDICARE PFFS|negotiated_dollar,standard_charge|HUMANA|MEDICARE PFFS|negotiated_percentage,standard_charge|HUMANA|MEDICARE PFFS|negotiated_algorithm,estimated_amount|HUMANA|MEDICARE PFFS,standard_charge|HUMANA|MEDICARE PFFS|methodology,additional_payer_notes|HUMANA|MEDICARE PFFS,standard_charge|HUMANA|MEDICARE PPO|negotiated_dollar,standard_charge|HUMANA|MEDICARE PPO|negotiated_percentage,standard_charge|HUMANA|MEDICARE PPO|negotiated_algorithm,estimated_amount|HUMANA|MEDICARE PPO,standard_charge|HUMANA|MEDICARE PPO|methodology,additional_payer_notes|HUMANA|MEDICARE PPO,standard_charge|MEDICARE|MEDICARE|negotiated_dollar,standard_charge|MEDICARE|MEDICARE|negotiated_percentage,standard_charge|MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|MEDICARE|MEDICARE,standard_charge|MEDICARE|MEDICARE|methodology,additional_payer_notes|MEDICARE|MEDICARE,standard_charge|SLVHMO FRIDAY|COMMERCIAL|negotiated_dollar,standard_charge|SLVHMO FRIDAY|COMMERCIAL|negotiated_percentage,standard_charge|SLVHMO FRIDAY|COMMERCIAL|negotiated_algorithm,estimated_amount|SLVHMO FRIDAY|COMMERCIAL,standard_charge|SLVHMO FRIDAY|COMMERCIAL|methodology,additional_payer_notes|SLVHMO FRIDAY|COMMERCIAL,standard_charge|UHC|COMMERCIAL|negotiated_dollar,standard_charge|UHC|COMMERCIAL|negotiated_percentage,standard_charge|UHC|COMMERCIAL|negotiated_algorithm,estimated_amount|UHC|COMMERCIAL,standard_charge|UHC|COMMERCIAL|methodology,additional_payer_notes|UHC|COMMERCIAL,standard_charge|min,standard_charge|max,additional_generic_notes
Anesthesia for Reconstructive Procedures of Eyelid,2,CDM,964,RC,103,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Reconstructive Procedures of Eyelid,3,CDM,964,RC,103,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Reconstructive Procedures of Eyelid,4,CDM,964,RC,103,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia on eye-Pterygium,5,CDM,964,RC,140,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia on eye-Pterygium,6,CDM,964,RC,140,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia on eye-Pterygium,7,CDM,964,RC,140,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Lens Surgery,8,CDM,964,RC,142,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,51.69,
Anesthesia for Lens Surgery,9,CDM,964,RC,142,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,51.69,
"Anesthesia for skin,ms,head neck back",10,CDM,964,RC,300,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,51.69,
Anesthesia for breast I&D,11,CDM,964,RC,400,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for breast I&D,12,CDM,964,RC,400,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anes procedures Spine or Spinal cord/unit,13,CDM,964,RC,600,HCPCS,outpatient,,,114.24,85.68,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,102.82,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,102.82,102.82,
Anes procedures Spine or Spinal cord/unit,14,CDM,964,RC,600,HCPCS,outpatient,,,114.24,85.68,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,102.82,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,102.82,102.82,
ANES Lumbar procedure NOS,15,CDM,964,RC,630,HCPCS,outpatient,,,114.24,85.68,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,102.82,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,102.82,102.82,
Lumbar Punc  diag or thera,16,CDM,964,RC,635,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,51.69,
Anesthesia for Upper GI Endoscopic Procedures,17,CDM,964,RC,731,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,250,100,,,case rate,100% of case rate,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,250,
Anesthesia for Upper GI Endoscopic Procedures,18,CDM,964,RC,731,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,250,100,,,case rate,100% of case rate,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,250,
Anesthesia for Colonoscopy,19,CDM,964,RC,811,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,250,100,,,case rate,100% of case rate,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,250,
Anesthesia for Colonoscopy-screening,20,CDM,964,RC,812,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,250,100,,,case rate,100% of case rate,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,250,
"Anesthesia for combined EGD,colonscopy",21,CDM,964,RC,813,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,250,100,,,case rate,100% of case rate,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,250,
Anesthesia for Extraperitoneal Procedures,22,CDM,964,RC,860,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Extraperitoneal Procedures,23,CDM,964,RC,860,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Extraperitoneal Procedures,24,CDM,964,RC,860,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Lithotripsy without water,25,CDM,964,RC,873,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Lithotripsy without water,26,CDM,964,RC,873,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Lithotripsy without water,27,CDM,964,RC,873,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Transurethral Procedures,28,CDM,964,RC,910,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Transurethral Procedures,29,CDM,964,RC,910,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Transurethral Procedures,30,CDM,964,RC,910,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia Transurethral Resection Prostate,31,CDM,964,RC,914,HCPCS,outpatient,,,14.05,10.54,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,12.65,
Anesthesia Transurethral Resection Prostate,32,CDM,964,RC,914,HCPCS,outpatient,,,14.05,10.54,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,12.65,
Anesthesia Transurethral Resection Prostate,33,CDM,964,RC,914,HCPCS,outpatient,,,14.05,10.54,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,12.65,
Anesthesia for Male External Genitalia,34,CDM,964,RC,920,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Male External Genitalia,35,CDM,964,RC,920,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Male External Genitalia,36,CDM,964,RC,920,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Undescended Testis,37,CDM,964,RC,924,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Undescended Testis,38,CDM,964,RC,924,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Undescended Testis,39,CDM,964,RC,924,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for penis amputataion,40,CDM,964,RC,932,HCPCS,outpatient,,,14.05,10.54,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,12.65,
Anesthesia for penis amputataion,41,CDM,964,RC,932,HCPCS,outpatient,,,14.05,10.54,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,12.65,
Anesthesia for Vaginal Procedures,42,CDM,964,RC,940,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Vaginal Procedures,43,CDM,964,RC,940,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Vaginal Procedures,44,CDM,964,RC,940,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anes open procedure SI joint,45,CDM,964,RC,1170,HCPCS,outpatient,,,114.24,85.68,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,102.82,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,102.82,102.82,
Anesthesia diagnostic artho knee,46,CDM,964,RC,1382,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia diagnostic artho knee,47,CDM,964,RC,1382,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anes open procedures tib/fib/pat,48,CDM,964,RC,1392,HCPCS,outpatient,,,114.44,85.83,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103,103,
"Anesthesia arthro knee, unspecified",49,CDM,964,RC,1400,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
"Anesthesia arthro knee, unspecified",50,CDM,964,RC,1400,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia Total Knee,51,CDM,964,RC,1402,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia Total Knee,52,CDM,964,RC,1402,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
"Anesthesia for procedure lower leg, foot",53,CDM,964,RC,1470,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
"Anesthesia for procedure lower leg, foot",54,CDM,964,RC,1470,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
"Anesthesia for procedure lower leg, foot",55,CDM,964,RC,1470,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Open Procedure-Bone,56,CDM,964,RC,1480,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Open Procedure-Bone,57,CDM,964,RC,1480,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for Open Procedure-Bone,58,CDM,964,RC,1480,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
"Anesthesia for Nerves, Muscles, Tendons, etc. Shoulder",59,CDM,964,RC,1610,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
"Anesthesia for Nerves, Muscles, Tendons, etc. Shoulder",60,CDM,964,RC,1610,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
"Anesthesia for Nerves, Muscles, Tendons, etc. Shoulder",61,CDM,964,RC,1610,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia Upper arm or elbow,62,CDM,964,RC,1710,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for tenotomy elbow to shoulder,63,CDM,964,RC,1712,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for tenotomy elbow to shoulder,64,CDM,964,RC,1712,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
Anesthesia for tenotomy elbow to shoulder,65,CDM,964,RC,1712,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,103.37,103.37,
"Anesthesia for Nerves, Muscles, Tendons, etc. Wrist, Hand",66,CDM,964,RC,1810,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,51.69,
"Anesthesia for Nerves, Muscles, Tendons, etc. Wrist, Hand",67,CDM,964,RC,1810,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,51.69,
"Anesthesia for Nerves, Muscles, Tendons, etc. Wrist, Hand",68,CDM,964,RC,1810,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,51.69,
"Anesthesia closed procedures on wrist,hand",69,CDM,964,RC,1820,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,51.69,
"Anesthesia closed procedures on wrist,hand",70,CDM,964,RC,1820,HCPCS,outpatient,,,57.43,43.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,51.69,51.69,
Anethesia open hand surgery,71,CDM,964,RC,1830,HCPCS,outpatient,,,14.05,10.54,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,12.65,
Anethesia open hand surgery,72,CDM,964,RC,1830,HCPCS,outpatient,,,14.05,10.54,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,12.65,
Anethesia open hand surgery,73,CDM,964,RC,1830,HCPCS,outpatient,,,14.05,10.54,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.65,12.65,
* venipuncture -  requiring MD or CRNA>3,74,CDM,964,RC,36410,HCPCS,outpatient,,,56.3,42.23,,12.79,130,,,fee schedule,130% of fee schedule,12.79,130,,,fee schedule,130% of fee schedule,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,11.6,119,,,fee schedule,119% of fee schedule,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,100% of fee schedule,50.67,90,,,percent of total billed charges,90% of total billed charges,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,14.37,100,,,fee schedule,100% of fee schedule,9.16,100,,,fee schedule,100% of fee schedule,9.16,50.67,
Anesthesia Technical Level for Eye surgery,75,CDM,370,RC,40000,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
Anesthesia Technical Level I 1-29 min,76,CDM,370,RC,41111,HCPCS,outpatient,,,303.49,227.62,,273.14,90,,,percent of total billed charges,90% of total billed charges,282.25,93,,,percent of total billed charges,93% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,247.04,81.4,,,percent of total billed charges,81.4% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,227.62,75,,,percent of total billed charges,75% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,282.25,
Anesthesia Technical Level I 1-29 min,77,CDM,370,RC,41111,HCPCS,outpatient,,,303.49,227.62,,273.14,90,,,percent of total billed charges,90% of total billed charges,282.25,93,,,percent of total billed charges,93% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,247.04,81.4,,,percent of total billed charges,81.4% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,227.62,75,,,percent of total billed charges,75% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,282.25,
Anesthesia Technical Level I 1-29 min,78,CDM,370,RC,41111,HCPCS,outpatient,,,303.49,227.62,,273.14,90,,,percent of total billed charges,90% of total billed charges,282.25,93,,,percent of total billed charges,93% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,247.04,81.4,,,percent of total billed charges,81.4% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,227.62,75,,,percent of total billed charges,75% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,282.25,
Anesthesia Technical Level III >60 min,79,CDM,370,RC,41111,HCPCS,outpatient,,,918.96,689.22,,827.06,90,,,percent of total billed charges,90% of total billed charges,854.63,93,,,percent of total billed charges,93% of total billed charges,349.2,38,,,percent of total billed charges,38% of total billed charges,349.2,38,,,percent of total billed charges,38% of total billed charges,781.12,85,,,percent of total billed charges,85% of total billed charges,349.2,38,,,percent of total billed charges,38% of total billed charges,748.03,81.4,,,percent of total billed charges,81.4% of total billed charges,827.06,90,,,percent of total billed charges,90% of total billed charges,827.06,90,,,percent of total billed charges,90% of total billed charges,349.2,38,,,percent of total billed charges,38% of total billed charges,349.2,38,,,percent of total billed charges,38% of total billed charges,349.2,38,,,percent of total billed charges,38% of total billed charges,689.22,75,,,percent of total billed charges,75% of total billed charges,781.12,85,,,percent of total billed charges,85% of total billed charges,349.2,854.63,
Anesthesia Technical Level II 30 to 60 min,80,CDM,370,RC,42222,HCPCS,outpatient,,,603.46,452.6,,543.11,90,,,percent of total billed charges,90% of total billed charges,561.22,93,,,percent of total billed charges,93% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,512.94,85,,,percent of total billed charges,85% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,491.22,81.4,,,percent of total billed charges,81.4% of total billed charges,543.11,90,,,percent of total billed charges,90% of total billed charges,543.11,90,,,percent of total billed charges,90% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,452.6,75,,,percent of total billed charges,75% of total billed charges,512.94,85,,,percent of total billed charges,85% of total billed charges,229.31,561.22,
"ANES epidural, C or T w/o imaging",81,CDM,964,RC,62320,HCPCS,outpatient,,,788.32,591.24,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,119,,,fee schedule,119% of fee schedule,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,100% of fee schedule,709.49,90,,,percent of total billed charges,90% of total billed charges,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,101.05,100,,,fee schedule,100% of fee schedule,101.05,709.49,
"ANES epidural, C or T w/o imaging",82,CDM,964,RC,62320,HCPCS,outpatient,,,788.32,591.24,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,119,,,fee schedule,119% of fee schedule,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,100% of fee schedule,709.49,90,,,percent of total billed charges,90% of total billed charges,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,101.05,100,,,fee schedule,100% of fee schedule,101.05,709.49,
"ANES epidural, C or T w/o imaging",83,CDM,964,RC,62320,HCPCS,outpatient,,,788.32,591.24,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,119,,,fee schedule,119% of fee schedule,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,100% of fee schedule,709.49,90,,,percent of total billed charges,90% of total billed charges,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,101.05,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,101.05,100,,,fee schedule,100% of fee schedule,101.05,709.49,
ANES Epidural Steroid Inj. LS w/o images-Fac,84,CDM,360,RC,62322,HCPCS,outpatient,,,563.07,422.3,,506.76,90,,,percent of total billed charges,90% of total billed charges,523.66,93,,,percent of total billed charges,93% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,478.61,85,,,percent of total billed charges,85% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,458.34,81.4,,,percent of total billed charges,81.4% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,422.3,75,,,percent of total billed charges,75% of total billed charges,478.61,85,,,percent of total billed charges,85% of total billed charges,213.97,523.66,
Mod sedation-other <5yr 15min-PRO,85,CDM,964,RC,99155,HCPCS,outpatient,,,394.16,295.62,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,82.2,100,,,fee schedule,Pays 100% Medicare OPPS,82.2,100,,,fee schedule,Pays 100% Medicare OPPS,103.95,119,,,fee schedule,119% of fee schedule,82.2,100,,,fee schedule,Pays 100% Medicare OPPS,82.2,100,,,fee schedule,100% of fee schedule,354.74,90,,,percent of total billed charges,90% of total billed charges,82.2,100,,,fee schedule,Pays 100% Medicare OPPS,82.2,100,,,fee schedule,Pays 100% Medicare OPPS,82.2,100,,,fee schedule,Pays 100% Medicare OPPS,82.2,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,82.2,100,,,fee schedule,100% of fee schedule,82.2,354.74,
Mod sedation -other 5+yrs 15 min-PRO,86,CDM,964,RC,99156,HCPCS,outpatient,,,394.16,295.62,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,75.64,100,,,fee schedule,Pays 100% Medicare OPPS,75.64,100,,,fee schedule,Pays 100% Medicare OPPS,95.32,119,,,fee schedule,119% of fee schedule,75.64,100,,,fee schedule,Pays 100% Medicare OPPS,75.64,100,,,fee schedule,100% of fee schedule,354.74,90,,,percent of total billed charges,90% of total billed charges,75.64,100,,,fee schedule,Pays 100% Medicare OPPS,75.64,100,,,fee schedule,Pays 100% Medicare OPPS,75.64,100,,,fee schedule,Pays 100% Medicare OPPS,75.64,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,75.64,100,,,fee schedule,100% of fee schedule,75.64,354.74,
Mod sedation-other addt 15 min-PRO,87,CDM,964,RC,99157,HCPCS,outpatient,,,281.54,211.16,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,62.26,100,,,fee schedule,Pays 100% Medicare OPPS,62.26,100,,,fee schedule,Pays 100% Medicare OPPS,78.03,119,,,fee schedule,119% of fee schedule,62.26,100,,,fee schedule,Pays 100% Medicare OPPS,62.26,100,,,fee schedule,100% of fee schedule,253.39,90,,,percent of total billed charges,90% of total billed charges,62.26,100,,,fee schedule,Pays 100% Medicare OPPS,62.26,100,,,fee schedule,Pays 100% Medicare OPPS,62.26,100,,,fee schedule,Pays 100% Medicare OPPS,62.26,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,62.26,100,,,fee schedule,100% of fee schedule,62.26,253.39,
Blood/Blood Products Administration,88,CDM,391,RC,36430,HCPCS,outpatient,,,548.39,411.29,,493.55,90,,,percent of total billed charges,90% of total billed charges,510,93,,,percent of total billed charges,93% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,466.13,85,,,percent of total billed charges,85% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,446.39,81.4,,,percent of total billed charges,81.4% of total billed charges,493.55,90,,,percent of total billed charges,90% of total billed charges,493.55,90,,,percent of total billed charges,90% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,411.29,75,,,percent of total billed charges,75% of total billed charges,466.13,85,,,percent of total billed charges,85% of total billed charges,208.39,510,
"PRBC, Leuko Reduced -tranfuse",89,CDM,390,RC,P9016,HCPCS,outpatient,,,895.24,671.43,,805.72,90,,,percent of total billed charges,90% of total billed charges,832.57,93,,,percent of total billed charges,93% of total billed charges,340.19,38,,,percent of total billed charges,38% of total billed charges,340.19,38,,,percent of total billed charges,38% of total billed charges,760.95,85,,,percent of total billed charges,85% of total billed charges,340.19,38,,,percent of total billed charges,38% of total billed charges,728.73,81.4,,,percent of total billed charges,81.4% of total billed charges,805.72,90,,,percent of total billed charges,90% of total billed charges,805.72,90,,,percent of total billed charges,90% of total billed charges,340.19,38,,,percent of total billed charges,38% of total billed charges,340.19,38,,,percent of total billed charges,38% of total billed charges,340.19,38,,,percent of total billed charges,38% of total billed charges,671.43,75,,,percent of total billed charges,75% of total billed charges,760.95,85,,,percent of total billed charges,85% of total billed charges,340.19,832.57,
Fresh Frozen Plasma - Administer,90,CDM,390,RC,P9017,HCPCS,outpatient,,,162.87,122.15,,146.58,90,,,percent of total billed charges,90% of total billed charges,151.47,93,,,percent of total billed charges,93% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,132.58,81.4,,,percent of total billed charges,81.4% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,122.15,75,,,percent of total billed charges,75% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,151.47,
Platelets apher irradiated -administer,91,CDM,390,RC,P9036,HCPCS,outpatient,,,1005.87,754.4,,905.28,90,,,percent of total billed charges,90% of total billed charges,935.46,93,,,percent of total billed charges,93% of total billed charges,382.23,38,,,percent of total billed charges,38% of total billed charges,382.23,38,,,percent of total billed charges,38% of total billed charges,854.99,85,,,percent of total billed charges,85% of total billed charges,382.23,38,,,percent of total billed charges,38% of total billed charges,818.78,81.4,,,percent of total billed charges,81.4% of total billed charges,905.28,90,,,percent of total billed charges,90% of total billed charges,905.28,90,,,percent of total billed charges,90% of total billed charges,382.23,38,,,percent of total billed charges,38% of total billed charges,382.23,38,,,percent of total billed charges,38% of total billed charges,382.23,38,,,percent of total billed charges,38% of total billed charges,754.4,75,,,percent of total billed charges,75% of total billed charges,854.99,85,,,percent of total billed charges,85% of total billed charges,382.23,935.46,
"PRBC, LR  Irradiated -transfused",92,CDM,390,RC,P9040,HCPCS,outpatient,,,988.96,741.72,,890.06,90,,,percent of total billed charges,90% of total billed charges,919.73,93,,,percent of total billed charges,93% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,840.62,85,,,percent of total billed charges,85% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,805.01,81.4,,,percent of total billed charges,81.4% of total billed charges,890.06,90,,,percent of total billed charges,90% of total billed charges,890.06,90,,,percent of total billed charges,90% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,741.72,75,,,percent of total billed charges,75% of total billed charges,840.62,85,,,percent of total billed charges,85% of total billed charges,375.8,919.73,
Pulmonary Rehabilitation,93,CDM,948,RC,94626,HCPCS,outpatient,,,92,69,,82.8,90,,,percent of total billed charges,90% of total billed charges,85.56,93,,,percent of total billed charges,93% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,78.2,85,,,percent of total billed charges,85% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,74.89,81.4,,,percent of total billed charges,81.4% of total billed charges,82.8,90,,,percent of total billed charges,90% of total billed charges,82.8,90,,,percent of total billed charges,90% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,69,75,,,percent of total billed charges,75% of total billed charges,78.2,85,,,percent of total billed charges,85% of total billed charges,34.96,85.56,
CT Head w/o contrast,96,CDM,350,RC,70450,HCPCS,outpatient,,,1333.48,1000.11,,1200.13,90,,,percent of total billed charges,90% of total billed charges,1240.14,93,,,percent of total billed charges,93% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,506.72,38,,,percent of total billed charges,38% of total billed charges,1085.45,81.4,,,percent of total billed charges,81.4% of total billed charges,1200.13,90,,,percent of total billed charges,90% of total billed charges,1200.13,90,,,percent of total billed charges,90% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,1000.11,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1240.14,
CT Head w/ contrast,97,CDM,350,RC,70460,HCPCS,outpatient,,,1488.17,1116.13,,1339.35,90,,,percent of total billed charges,90% of total billed charges,1384,93,,,percent of total billed charges,93% of total billed charges,565.5,38,,,percent of total billed charges,38% of total billed charges,565.5,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,565.5,38,,,percent of total billed charges,38% of total billed charges,1211.37,81.4,,,percent of total billed charges,81.4% of total billed charges,1339.35,90,,,percent of total billed charges,90% of total billed charges,1339.35,90,,,percent of total billed charges,90% of total billed charges,565.5,38,,,percent of total billed charges,38% of total billed charges,565.5,38,,,percent of total billed charges,38% of total billed charges,565.5,38,,,percent of total billed charges,38% of total billed charges,1116.13,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1384,
"CT Head w, w/o",98,CDM,350,RC,70470,HCPCS,outpatient,,,1786.96,1340.22,,1608.26,90,,,percent of total billed charges,90% of total billed charges,1661.87,93,,,percent of total billed charges,93% of total billed charges,679.04,38,,,percent of total billed charges,38% of total billed charges,679.04,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,679.04,38,,,percent of total billed charges,38% of total billed charges,1454.59,81.4,,,percent of total billed charges,81.4% of total billed charges,1608.26,90,,,percent of total billed charges,90% of total billed charges,1608.26,90,,,percent of total billed charges,90% of total billed charges,679.04,38,,,percent of total billed charges,38% of total billed charges,679.04,38,,,percent of total billed charges,38% of total billed charges,679.04,38,,,percent of total billed charges,38% of total billed charges,1340.22,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1661.87,
CT IAC/MID/INNER EAR WO,99,CDM,350,RC,70480,HCPCS,outpatient,,,1279.58,959.69,,1151.62,90,,,percent of total billed charges,90% of total billed charges,1190.01,93,,,percent of total billed charges,93% of total billed charges,486.24,38,,,percent of total billed charges,38% of total billed charges,486.24,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,486.24,38,,,percent of total billed charges,38% of total billed charges,1041.58,81.4,,,percent of total billed charges,81.4% of total billed charges,1151.62,90,,,percent of total billed charges,90% of total billed charges,1151.62,90,,,percent of total billed charges,90% of total billed charges,486.24,38,,,percent of total billed charges,38% of total billed charges,486.24,38,,,percent of total billed charges,38% of total billed charges,486.24,38,,,percent of total billed charges,38% of total billed charges,959.69,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,486.24,1209,
CT ORBIT/SELLA/OUTER-M,100,CDM,350,RC,70481,HCPCS,outpatient,,,1619.39,1214.54,,1457.45,90,,,percent of total billed charges,90% of total billed charges,1506.03,93,,,percent of total billed charges,93% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,615.37,38,,,percent of total billed charges,38% of total billed charges,1318.18,81.4,,,percent of total billed charges,81.4% of total billed charges,1457.45,90,,,percent of total billed charges,90% of total billed charges,1457.45,90,,,percent of total billed charges,90% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,1214.54,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1506.03,
"CT IAC/mid-inner ear, w/wo",101,CDM,350,RC,70482,HCPCS,outpatient,,,1516.29,1137.22,,1364.66,90,,,percent of total billed charges,90% of total billed charges,1410.15,93,,,percent of total billed charges,93% of total billed charges,576.19,38,,,percent of total billed charges,38% of total billed charges,576.19,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,576.19,38,,,percent of total billed charges,38% of total billed charges,1234.26,81.4,,,percent of total billed charges,81.4% of total billed charges,1364.66,90,,,percent of total billed charges,90% of total billed charges,1364.66,90,,,percent of total billed charges,90% of total billed charges,576.19,38,,,percent of total billed charges,38% of total billed charges,576.19,38,,,percent of total billed charges,38% of total billed charges,576.19,38,,,percent of total billed charges,38% of total billed charges,1137.22,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1410.15,
CT Max/Fac w/o contrast,102,CDM,350,RC,70486,HCPCS,outpatient,,,1394.41,1045.81,,1254.97,90,,,percent of total billed charges,90% of total billed charges,1296.8,93,,,percent of total billed charges,93% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,529.88,38,,,percent of total billed charges,38% of total billed charges,1135.05,81.4,,,percent of total billed charges,81.4% of total billed charges,1254.97,90,,,percent of total billed charges,90% of total billed charges,1254.97,90,,,percent of total billed charges,90% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,1045.81,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1296.8,
CT Sinus w/o contrast,103,CDM,350,RC,70486,HCPCS,outpatient,,,1394.41,1045.81,,1254.97,90,,,percent of total billed charges,90% of total billed charges,1296.8,93,,,percent of total billed charges,93% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,529.88,38,,,percent of total billed charges,38% of total billed charges,1135.05,81.4,,,percent of total billed charges,81.4% of total billed charges,1254.97,90,,,percent of total billed charges,90% of total billed charges,1254.97,90,,,percent of total billed charges,90% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,529.88,38,,,percent of total billed charges,38% of total billed charges,1045.81,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1296.8,
CT Max/Fac w/ contrast,104,CDM,350,RC,70487,HCPCS,outpatient,,,1573.7,1180.28,,1416.33,90,,,percent of total billed charges,90% of total billed charges,1463.54,93,,,percent of total billed charges,93% of total billed charges,598.01,38,,,percent of total billed charges,38% of total billed charges,598.01,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,598.01,38,,,percent of total billed charges,38% of total billed charges,1280.99,81.4,,,percent of total billed charges,81.4% of total billed charges,1416.33,90,,,percent of total billed charges,90% of total billed charges,1416.33,90,,,percent of total billed charges,90% of total billed charges,598.01,38,,,percent of total billed charges,38% of total billed charges,598.01,38,,,percent of total billed charges,38% of total billed charges,598.01,38,,,percent of total billed charges,38% of total billed charges,1180.28,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1463.54,
"CT Max/Fac w, w/o contrast",105,CDM,350,RC,70488,HCPCS,outpatient,,,1887.74,1415.81,,1698.97,90,,,percent of total billed charges,90% of total billed charges,1755.6,93,,,percent of total billed charges,93% of total billed charges,717.34,38,,,percent of total billed charges,38% of total billed charges,717.34,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,717.34,38,,,percent of total billed charges,38% of total billed charges,1536.62,81.4,,,percent of total billed charges,81.4% of total billed charges,1698.97,90,,,percent of total billed charges,90% of total billed charges,1698.97,90,,,percent of total billed charges,90% of total billed charges,717.34,38,,,percent of total billed charges,38% of total billed charges,717.34,38,,,percent of total billed charges,38% of total billed charges,717.34,38,,,percent of total billed charges,38% of total billed charges,1415.81,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1755.6,
CT Soft Tissue Neck w/o contrast,106,CDM,350,RC,70490,HCPCS,outpatient,,,1409.65,1057.24,,1268.69,90,,,percent of total billed charges,90% of total billed charges,1310.97,93,,,percent of total billed charges,93% of total billed charges,535.67,38,,,percent of total billed charges,38% of total billed charges,535.67,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,535.67,38,,,percent of total billed charges,38% of total billed charges,1147.46,81.4,,,percent of total billed charges,81.4% of total billed charges,1268.69,90,,,percent of total billed charges,90% of total billed charges,1268.69,90,,,percent of total billed charges,90% of total billed charges,535.67,38,,,percent of total billed charges,38% of total billed charges,535.67,38,,,percent of total billed charges,38% of total billed charges,535.67,38,,,percent of total billed charges,38% of total billed charges,1057.24,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1310.97,
CT Soft Tissue Neck w/ contrast,107,CDM,320,RC,70491,HCPCS,outpatient,,,1619.39,1214.54,,1457.45,90,,,percent of total billed charges,90% of total billed charges,1506.03,93,,,percent of total billed charges,93% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,1376.48,85,,,percent of total billed charges,85% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,1318.18,81.4,,,percent of total billed charges,81.4% of total billed charges,1457.45,90,,,percent of total billed charges,90% of total billed charges,1457.45,90,,,percent of total billed charges,90% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,615.37,38,,,percent of total billed charges,38% of total billed charges,1214.54,75,,,percent of total billed charges,75% of total billed charges,1376.48,85,,,percent of total billed charges,85% of total billed charges,615.37,1506.03,
CT Soft Tissue Neck w/wo contrast,108,CDM,350,RC,70492,HCPCS,outpatient,,,1939.3,1454.48,,1745.37,90,,,percent of total billed charges,90% of total billed charges,1803.55,93,,,percent of total billed charges,93% of total billed charges,736.93,38,,,percent of total billed charges,38% of total billed charges,736.93,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,736.93,38,,,percent of total billed charges,38% of total billed charges,1578.59,81.4,,,percent of total billed charges,81.4% of total billed charges,1745.37,90,,,percent of total billed charges,90% of total billed charges,1745.37,90,,,percent of total billed charges,90% of total billed charges,736.93,38,,,percent of total billed charges,38% of total billed charges,736.93,38,,,percent of total billed charges,38% of total billed charges,736.93,38,,,percent of total billed charges,38% of total billed charges,1454.48,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1803.55,
CT Angio of the Brain (COW),109,CDM,350,RC,70496,HCPCS,outpatient,,,1847.88,1385.91,,1663.09,90,,,percent of total billed charges,90% of total billed charges,1718.53,93,,,percent of total billed charges,93% of total billed charges,702.19,38,,,percent of total billed charges,38% of total billed charges,702.19,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,702.19,38,,,percent of total billed charges,38% of total billed charges,1504.17,81.4,,,percent of total billed charges,81.4% of total billed charges,1663.09,90,,,percent of total billed charges,90% of total billed charges,1663.09,90,,,percent of total billed charges,90% of total billed charges,702.19,38,,,percent of total billed charges,38% of total billed charges,702.19,38,,,percent of total billed charges,38% of total billed charges,702.19,38,,,percent of total billed charges,38% of total billed charges,1385.91,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1718.53,
CT Angio of Carotids,110,CDM,350,RC,70498,HCPCS,outpatient,,,1975.62,1481.72,,1778.06,90,,,percent of total billed charges,90% of total billed charges,1837.33,93,,,percent of total billed charges,93% of total billed charges,750.74,38,,,percent of total billed charges,38% of total billed charges,750.74,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,750.74,38,,,percent of total billed charges,38% of total billed charges,1608.15,81.4,,,percent of total billed charges,81.4% of total billed charges,1778.06,90,,,percent of total billed charges,90% of total billed charges,1778.06,90,,,percent of total billed charges,90% of total billed charges,750.74,38,,,percent of total billed charges,38% of total billed charges,750.74,38,,,percent of total billed charges,38% of total billed charges,750.74,38,,,percent of total billed charges,38% of total billed charges,1481.72,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1837.33,
CT Thorax w/o contrast,111,CDM,350,RC,71250,HCPCS,outpatient,,,1914.67,1436,,1723.2,90,,,percent of total billed charges,90% of total billed charges,1780.64,93,,,percent of total billed charges,93% of total billed charges,727.57,38,,,percent of total billed charges,38% of total billed charges,727.57,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,727.57,38,,,percent of total billed charges,38% of total billed charges,1558.54,81.4,,,percent of total billed charges,81.4% of total billed charges,1723.2,90,,,percent of total billed charges,90% of total billed charges,1723.2,90,,,percent of total billed charges,90% of total billed charges,727.57,38,,,percent of total billed charges,38% of total billed charges,727.57,38,,,percent of total billed charges,38% of total billed charges,727.57,38,,,percent of total billed charges,38% of total billed charges,1436,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1780.64,
CT high resolution THorax w/o,112,CDM,350,RC,71250,HCPCS,outpatient,,,2122.42,1591.82,,1910.18,90,,,percent of total billed charges,90% of total billed charges,1973.85,93,,,percent of total billed charges,93% of total billed charges,806.52,38,,,percent of total billed charges,38% of total billed charges,806.52,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,806.52,38,,,percent of total billed charges,38% of total billed charges,1727.65,81.4,,,percent of total billed charges,81.4% of total billed charges,1910.18,90,,,percent of total billed charges,90% of total billed charges,1910.18,90,,,percent of total billed charges,90% of total billed charges,806.52,38,,,percent of total billed charges,38% of total billed charges,806.52,38,,,percent of total billed charges,38% of total billed charges,806.52,38,,,percent of total billed charges,38% of total billed charges,1591.82,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1973.85,
CT Thorax w/ contrast,113,CDM,350,RC,71260,HCPCS,outpatient,,,2198.25,1648.69,,1978.43,90,,,percent of total billed charges,90% of total billed charges,2044.37,93,,,percent of total billed charges,93% of total billed charges,835.34,38,,,percent of total billed charges,38% of total billed charges,835.34,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,835.34,38,,,percent of total billed charges,38% of total billed charges,1789.38,81.4,,,percent of total billed charges,81.4% of total billed charges,1978.43,90,,,percent of total billed charges,90% of total billed charges,1978.43,90,,,percent of total billed charges,90% of total billed charges,835.34,38,,,percent of total billed charges,38% of total billed charges,835.34,38,,,percent of total billed charges,38% of total billed charges,835.34,38,,,percent of total billed charges,38% of total billed charges,1648.69,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,2044.37,
**CT PE Study,114,CDM,350,RC,71260,HCPCS,outpatient,,,2934.12,2200.59,,2640.71,90,,,percent of total billed charges,90% of total billed charges,2728.73,93,,,percent of total billed charges,93% of total billed charges,1114.97,38,,,percent of total billed charges,38% of total billed charges,1114.97,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,1114.97,38,,,percent of total billed charges,38% of total billed charges,2388.37,81.4,,,percent of total billed charges,81.4% of total billed charges,2640.71,90,,,percent of total billed charges,90% of total billed charges,2640.71,90,,,percent of total billed charges,90% of total billed charges,1114.97,38,,,percent of total billed charges,38% of total billed charges,1114.97,38,,,percent of total billed charges,38% of total billed charges,1114.97,38,,,percent of total billed charges,38% of total billed charges,2200.59,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,2728.73,
"CT Thorax w, w/o contrast",115,CDM,350,RC,71270,HCPCS,outpatient,,,2643.53,1982.65,,2379.18,90,,,percent of total billed charges,90% of total billed charges,2458.48,93,,,percent of total billed charges,93% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,1004.54,38,,,percent of total billed charges,38% of total billed charges,2151.83,81.4,,,percent of total billed charges,81.4% of total billed charges,2379.18,90,,,percent of total billed charges,90% of total billed charges,2379.18,90,,,percent of total billed charges,90% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,1982.65,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,2458.48,
CT Low dose screening for lung cancer,116,CDM,350,RC,71271,HCPCS,outpatient,,,1126.16,844.62,,1013.54,90,,,percent of total billed charges,90% of total billed charges,1047.33,93,,,percent of total billed charges,93% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,427.94,38,,,percent of total billed charges,38% of total billed charges,916.69,81.4,,,percent of total billed charges,81.4% of total billed charges,1013.54,90,,,percent of total billed charges,90% of total billed charges,1013.54,90,,,percent of total billed charges,90% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,844.62,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,427.94,1209,
CT Angio Chest - Chest Disection of Aorta Protocol,117,CDM,350,RC,71275,HCPCS,outpatient,,,2464.24,1848.18,,2217.82,90,,,percent of total billed charges,90% of total billed charges,2291.74,93,,,percent of total billed charges,93% of total billed charges,936.41,38,,,percent of total billed charges,38% of total billed charges,936.41,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,936.41,38,,,percent of total billed charges,38% of total billed charges,2005.89,81.4,,,percent of total billed charges,81.4% of total billed charges,2217.82,90,,,percent of total billed charges,90% of total billed charges,2217.82,90,,,percent of total billed charges,90% of total billed charges,936.41,38,,,percent of total billed charges,38% of total billed charges,936.41,38,,,percent of total billed charges,38% of total billed charges,936.41,38,,,percent of total billed charges,38% of total billed charges,1848.18,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,2291.74,
CTA-PE study,118,CDM,350,RC,71275,HCPCS,outpatient,,,2935.24,2201.43,,2641.72,90,,,percent of total billed charges,90% of total billed charges,2729.77,93,,,percent of total billed charges,93% of total billed charges,1115.39,38,,,percent of total billed charges,38% of total billed charges,1115.39,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,1115.39,38,,,percent of total billed charges,38% of total billed charges,2389.29,81.4,,,percent of total billed charges,81.4% of total billed charges,2641.72,90,,,percent of total billed charges,90% of total billed charges,2641.72,90,,,percent of total billed charges,90% of total billed charges,1115.39,38,,,percent of total billed charges,38% of total billed charges,1115.39,38,,,percent of total billed charges,38% of total billed charges,1115.39,38,,,percent of total billed charges,38% of total billed charges,2201.43,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,2729.77,
CT C-Spine w/o contrast,119,CDM,350,RC,72125,HCPCS,outpatient,,,1385.05,1038.79,,1246.55,90,,,percent of total billed charges,90% of total billed charges,1288.1,93,,,percent of total billed charges,93% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,526.32,38,,,percent of total billed charges,38% of total billed charges,1127.43,81.4,,,percent of total billed charges,81.4% of total billed charges,1246.55,90,,,percent of total billed charges,90% of total billed charges,1246.55,90,,,percent of total billed charges,90% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,1038.79,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1288.1,
CT T-Spine w/o contrast,120,CDM,350,RC,72128,HCPCS,outpatient,,,1385.05,1038.79,,1246.55,90,,,percent of total billed charges,90% of total billed charges,1288.1,93,,,percent of total billed charges,93% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,526.32,38,,,percent of total billed charges,38% of total billed charges,1127.43,81.4,,,percent of total billed charges,81.4% of total billed charges,1246.55,90,,,percent of total billed charges,90% of total billed charges,1246.55,90,,,percent of total billed charges,90% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,1038.79,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1288.1,
CT L-Spine w/o contrast,121,CDM,350,RC,72131,HCPCS,outpatient,,,1385.05,1038.79,,1246.55,90,,,percent of total billed charges,90% of total billed charges,1288.1,93,,,percent of total billed charges,93% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,526.32,38,,,percent of total billed charges,38% of total billed charges,1127.43,81.4,,,percent of total billed charges,81.4% of total billed charges,1246.55,90,,,percent of total billed charges,90% of total billed charges,1246.55,90,,,percent of total billed charges,90% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,526.32,38,,,percent of total billed charges,38% of total billed charges,1038.79,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1288.1,
CT Angio PEL - AAA Protocol,122,CDM,350,RC,72191,HCPCS,outpatient,,,1531.51,1148.63,,1378.36,90,,,percent of total billed charges,90% of total billed charges,1424.3,93,,,percent of total billed charges,93% of total billed charges,581.97,38,,,percent of total billed charges,38% of total billed charges,581.97,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,581.97,38,,,percent of total billed charges,38% of total billed charges,1246.65,81.4,,,percent of total billed charges,81.4% of total billed charges,1378.36,90,,,percent of total billed charges,90% of total billed charges,1378.36,90,,,percent of total billed charges,90% of total billed charges,581.97,38,,,percent of total billed charges,38% of total billed charges,581.97,38,,,percent of total billed charges,38% of total billed charges,581.97,38,,,percent of total billed charges,38% of total billed charges,1148.63,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1424.3,
"CT Pelvis, w/o contrast",123,CDM,350,RC,72192,HCPCS,outpatient,,,1162.41,871.81,,1046.17,90,,,percent of total billed charges,90% of total billed charges,1081.04,93,,,percent of total billed charges,93% of total billed charges,441.72,38,,,percent of total billed charges,38% of total billed charges,441.72,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,441.72,38,,,percent of total billed charges,38% of total billed charges,946.2,81.4,,,percent of total billed charges,81.4% of total billed charges,1046.17,90,,,percent of total billed charges,90% of total billed charges,1046.17,90,,,percent of total billed charges,90% of total billed charges,441.72,38,,,percent of total billed charges,38% of total billed charges,441.72,38,,,percent of total billed charges,38% of total billed charges,441.72,38,,,percent of total billed charges,38% of total billed charges,871.81,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,441.72,1209,
"CT Pelvis, w/ contrast",124,CDM,350,RC,72193,HCPCS,outpatient,,,1333.48,1000.11,,1200.13,90,,,percent of total billed charges,90% of total billed charges,1240.14,93,,,percent of total billed charges,93% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,506.72,38,,,percent of total billed charges,38% of total billed charges,1085.45,81.4,,,percent of total billed charges,81.4% of total billed charges,1200.13,90,,,percent of total billed charges,90% of total billed charges,1200.13,90,,,percent of total billed charges,90% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,506.72,38,,,percent of total billed charges,38% of total billed charges,1000.11,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1240.14,
"CT Upper Ext, w/o contrast",125,CDM,350,RC,73200,HCPCS,outpatient,,,992.5,744.38,,893.25,90,,,percent of total billed charges,90% of total billed charges,923.03,93,,,percent of total billed charges,93% of total billed charges,377.15,38,,,percent of total billed charges,38% of total billed charges,377.15,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,377.15,38,,,percent of total billed charges,38% of total billed charges,807.9,81.4,,,percent of total billed charges,81.4% of total billed charges,893.25,90,,,percent of total billed charges,90% of total billed charges,893.25,90,,,percent of total billed charges,90% of total billed charges,377.15,38,,,percent of total billed charges,38% of total billed charges,377.15,38,,,percent of total billed charges,38% of total billed charges,377.15,38,,,percent of total billed charges,38% of total billed charges,744.38,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,377.15,1209,
"CT Upper Ext, w/ contrast",126,CDM,350,RC,73201,HCPCS,outpatient,,,1141.31,855.98,,1027.18,90,,,percent of total billed charges,90% of total billed charges,1061.42,93,,,percent of total billed charges,93% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,433.7,38,,,percent of total billed charges,38% of total billed charges,929.03,81.4,,,percent of total billed charges,81.4% of total billed charges,1027.18,90,,,percent of total billed charges,90% of total billed charges,1027.18,90,,,percent of total billed charges,90% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,855.98,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,433.7,1209,
CT Angio Upper Extremitiy w/ cont,127,CDM,350,RC,73206,HCPCS,outpatient,,,1556.11,1167.08,,1400.5,90,,,percent of total billed charges,90% of total billed charges,1447.18,93,,,percent of total billed charges,93% of total billed charges,591.32,38,,,percent of total billed charges,38% of total billed charges,591.32,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,591.32,38,,,percent of total billed charges,38% of total billed charges,1266.67,81.4,,,percent of total billed charges,81.4% of total billed charges,1400.5,90,,,percent of total billed charges,90% of total billed charges,1400.5,90,,,percent of total billed charges,90% of total billed charges,591.32,38,,,percent of total billed charges,38% of total billed charges,591.32,38,,,percent of total billed charges,38% of total billed charges,591.32,38,,,percent of total billed charges,38% of total billed charges,1167.08,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1447.18,
"CT Lower Ext, w/o contrast",128,CDM,350,RC,73700,HCPCS,outpatient,,,706.58,529.94,,635.92,90,,,percent of total billed charges,90% of total billed charges,657.12,93,,,percent of total billed charges,93% of total billed charges,268.5,38,,,percent of total billed charges,38% of total billed charges,268.5,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,268.5,38,,,percent of total billed charges,38% of total billed charges,575.16,81.4,,,percent of total billed charges,81.4% of total billed charges,635.92,90,,,percent of total billed charges,90% of total billed charges,635.92,90,,,percent of total billed charges,90% of total billed charges,268.5,38,,,percent of total billed charges,38% of total billed charges,268.5,38,,,percent of total billed charges,38% of total billed charges,268.5,38,,,percent of total billed charges,38% of total billed charges,529.94,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,268.5,1209,
"CT Lower Ext, w/ contrast",129,CDM,350,RC,73701,HCPCS,outpatient,,,1137.79,853.34,,1024.01,90,,,percent of total billed charges,90% of total billed charges,1058.14,93,,,percent of total billed charges,93% of total billed charges,432.36,38,,,percent of total billed charges,38% of total billed charges,432.36,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,432.36,38,,,percent of total billed charges,38% of total billed charges,926.16,81.4,,,percent of total billed charges,81.4% of total billed charges,1024.01,90,,,percent of total billed charges,90% of total billed charges,1024.01,90,,,percent of total billed charges,90% of total billed charges,432.36,38,,,percent of total billed charges,38% of total billed charges,432.36,38,,,percent of total billed charges,38% of total billed charges,432.36,38,,,percent of total billed charges,38% of total billed charges,853.34,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,432.36,1209,
CT Angio Lower Extrem w/ cont,130,CDM,350,RC,73706,HCPCS,outpatient,,,1237.4,928.05,,1113.66,90,,,percent of total billed charges,90% of total billed charges,1150.78,93,,,percent of total billed charges,93% of total billed charges,470.21,38,,,percent of total billed charges,38% of total billed charges,470.21,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,470.21,38,,,percent of total billed charges,38% of total billed charges,1007.24,81.4,,,percent of total billed charges,81.4% of total billed charges,1113.66,90,,,percent of total billed charges,90% of total billed charges,1113.66,90,,,percent of total billed charges,90% of total billed charges,470.21,38,,,percent of total billed charges,38% of total billed charges,470.21,38,,,percent of total billed charges,38% of total billed charges,470.21,38,,,percent of total billed charges,38% of total billed charges,928.05,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,470.21,1209,
"CT Abd, w/o contrast",131,CDM,350,RC,74150,HCPCS,outpatient,,,1476.45,1107.34,,1328.81,90,,,percent of total billed charges,90% of total billed charges,1373.1,93,,,percent of total billed charges,93% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,561.05,38,,,percent of total billed charges,38% of total billed charges,1201.83,81.4,,,percent of total billed charges,81.4% of total billed charges,1328.81,90,,,percent of total billed charges,90% of total billed charges,1328.81,90,,,percent of total billed charges,90% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,1107.34,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1373.1,
"CT Abd, w/ contrast",132,CDM,350,RC,74160,HCPCS,outpatient,,,1700.25,1275.19,,1530.23,90,,,percent of total billed charges,90% of total billed charges,1581.23,93,,,percent of total billed charges,93% of total billed charges,646.1,38,,,percent of total billed charges,38% of total billed charges,646.1,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,646.1,38,,,percent of total billed charges,38% of total billed charges,1384,81.4,,,percent of total billed charges,81.4% of total billed charges,1530.23,90,,,percent of total billed charges,90% of total billed charges,1530.23,90,,,percent of total billed charges,90% of total billed charges,646.1,38,,,percent of total billed charges,38% of total billed charges,646.1,38,,,percent of total billed charges,38% of total billed charges,646.1,38,,,percent of total billed charges,38% of total billed charges,1275.19,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1581.23,
"CT ABD w, w/o contrast",133,CDM,350,RC,74170,HCPCS,outpatient,,,3084.1,2313.08,,2775.69,90,,,percent of total billed charges,90% of total billed charges,2868.21,93,,,percent of total billed charges,93% of total billed charges,1171.96,38,,,percent of total billed charges,38% of total billed charges,1171.96,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,1171.96,38,,,percent of total billed charges,38% of total billed charges,2510.46,81.4,,,percent of total billed charges,81.4% of total billed charges,2775.69,90,,,percent of total billed charges,90% of total billed charges,2775.69,90,,,percent of total billed charges,90% of total billed charges,1171.96,38,,,percent of total billed charges,38% of total billed charges,1171.96,38,,,percent of total billed charges,38% of total billed charges,1171.96,38,,,percent of total billed charges,38% of total billed charges,2313.08,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,2868.21,
CT ANGIO ABD/PELVIS,134,CDM,350,RC,74174,HCPCS,outpatient,,,1071,803.25,,963.9,90,,,percent of total billed charges,90% of total billed charges,996.03,93,,,percent of total billed charges,93% of total billed charges,406.98,38,,,percent of total billed charges,38% of total billed charges,406.98,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,406.98,38,,,percent of total billed charges,38% of total billed charges,871.79,81.4,,,percent of total billed charges,81.4% of total billed charges,963.9,90,,,percent of total billed charges,90% of total billed charges,963.9,90,,,percent of total billed charges,90% of total billed charges,406.98,38,,,percent of total billed charges,38% of total billed charges,406.98,38,,,percent of total billed charges,38% of total billed charges,406.98,38,,,percent of total billed charges,38% of total billed charges,803.25,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,406.98,1209,
CT Angio ABD  - AAA Protocol,135,CDM,350,RC,74175,HCPCS,outpatient,,,2057.64,1543.23,,1851.88,90,,,percent of total billed charges,90% of total billed charges,1913.61,93,,,percent of total billed charges,93% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,781.9,38,,,percent of total billed charges,38% of total billed charges,1674.92,81.4,,,percent of total billed charges,81.4% of total billed charges,1851.88,90,,,percent of total billed charges,90% of total billed charges,1851.88,90,,,percent of total billed charges,90% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,1543.23,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,1913.61,
"CT Abd/Pelvis, w/o contrast",136,CDM,350,RC,74176,HCPCS,outpatient,,,2560.33,1920.25,,2304.3,90,,,percent of total billed charges,90% of total billed charges,2381.11,93,,,percent of total billed charges,93% of total billed charges,972.93,38,,,percent of total billed charges,38% of total billed charges,972.93,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,972.93,38,,,percent of total billed charges,38% of total billed charges,2084.11,81.4,,,percent of total billed charges,81.4% of total billed charges,2304.3,90,,,percent of total billed charges,90% of total billed charges,2304.3,90,,,percent of total billed charges,90% of total billed charges,972.93,38,,,percent of total billed charges,38% of total billed charges,972.93,38,,,percent of total billed charges,38% of total billed charges,972.93,38,,,percent of total billed charges,38% of total billed charges,1920.25,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,2381.11,
"CT Abd/Pelvis, w/contrast",137,CDM,350,RC,74177,HCPCS,outpatient,,,2804.05,2103.04,,2523.65,90,,,percent of total billed charges,90% of total billed charges,2607.77,93,,,percent of total billed charges,93% of total billed charges,1065.54,38,,,percent of total billed charges,38% of total billed charges,1065.54,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,1065.54,38,,,percent of total billed charges,38% of total billed charges,2282.5,81.4,,,percent of total billed charges,81.4% of total billed charges,2523.65,90,,,percent of total billed charges,90% of total billed charges,2523.65,90,,,percent of total billed charges,90% of total billed charges,1065.54,38,,,percent of total billed charges,38% of total billed charges,1065.54,38,,,percent of total billed charges,38% of total billed charges,1065.54,38,,,percent of total billed charges,38% of total billed charges,2103.04,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,2607.77,
"CT Abd/Pelvis, w/wo contrast",138,CDM,350,RC,74178,HCPCS,outpatient,,,3658.28,2743.71,,3292.45,90,,,percent of total billed charges,90% of total billed charges,3402.2,93,,,percent of total billed charges,93% of total billed charges,1390.15,38,,,percent of total billed charges,38% of total billed charges,1390.15,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,1390.15,38,,,percent of total billed charges,38% of total billed charges,2977.84,81.4,,,percent of total billed charges,81.4% of total billed charges,3292.45,90,,,percent of total billed charges,90% of total billed charges,3292.45,90,,,percent of total billed charges,90% of total billed charges,1390.15,38,,,percent of total billed charges,38% of total billed charges,1390.15,38,,,percent of total billed charges,38% of total billed charges,1390.15,38,,,percent of total billed charges,38% of total billed charges,2743.71,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,3402.2,
CT Urogram,139,CDM,350,RC,74178,HCPCS,outpatient,,,3941.57,2956.18,,3547.41,90,,,percent of total billed charges,90% of total billed charges,3665.66,93,,,percent of total billed charges,93% of total billed charges,1497.8,38,,,percent of total billed charges,38% of total billed charges,1497.8,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,1497.8,38,,,percent of total billed charges,38% of total billed charges,3208.44,81.4,,,percent of total billed charges,81.4% of total billed charges,3547.41,90,,,percent of total billed charges,90% of total billed charges,3547.41,90,,,percent of total billed charges,90% of total billed charges,1497.8,38,,,percent of total billed charges,38% of total billed charges,1497.8,38,,,percent of total billed charges,38% of total billed charges,1497.8,38,,,percent of total billed charges,38% of total billed charges,2956.18,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,500,3665.66,
Oxygen titrate 94-99%  per hr,140,CDM,271,RC,22271,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Oxygen titrate 94-99%  per hr[CLONE],141,CDM,271,RC,22271,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Oxygen titrate 88-94%  per hr,142,CDM,271,RC,22272,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Oxygen Heat, High Flow HFNC protocol per hr",143,CDM,271,RC,22273,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Oxygen high flow/hr,144,CDM,271,RC,,,outpatient,,,27.06,20.3,,24.35,90,,,percent of total billed charges,90% of total billed charges,25.17,93,,,percent of total billed charges,93% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,22.03,81.4,,,percent of total billed charges,81.4% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,20.3,75,,,percent of total billed charges,75% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,25.17,
Oxygen per hr,145,CDM,271,RC,,,outpatient,,,21.65,16.24,,19.49,90,,,percent of total billed charges,90% of total billed charges,20.13,93,,,percent of total billed charges,93% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,18.4,85,,,percent of total billed charges,85% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,17.62,81.4,,,percent of total billed charges,81.4% of total billed charges,19.49,90,,,percent of total billed charges,90% of total billed charges,19.49,90,,,percent of total billed charges,90% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,16.24,75,,,percent of total billed charges,75% of total billed charges,18.4,85,,,percent of total billed charges,85% of total billed charges,8.23,20.13,
Injection Morton's neuroma-anes-Fac,146,CDM,510,RC,64450,HCPCS,outpatient,,,249.7,187.28,,224.73,90,,,percent of total billed charges,90% of total billed charges,232.22,93,,,percent of total billed charges,93% of total billed charges,94.89,38,,,percent of total billed charges,38% of total billed charges,94.89,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,94.89,38,,,percent of total billed charges,38% of total billed charges,203.26,81.4,,,percent of total billed charges,81.4% of total billed charges,224.73,90,,,percent of total billed charges,90% of total billed charges,224.73,90,,,percent of total billed charges,90% of total billed charges,94.89,38,,,percent of total billed charges,38% of total billed charges,94.89,38,,,percent of total billed charges,38% of total billed charges,94.89,38,,,percent of total billed charges,38% of total billed charges,187.28,75,,,percent of total billed charges,75% of total billed charges,212.25,85,,,percent of total billed charges,85% of total billed charges,94.89,232.22,
DERM ACNE SURGERY - FAC,147,CDM,761,RC,10040,HCPCS,outpatient,,,116.73,87.55,,105.06,90,,,percent of total billed charges,90% of total billed charges,108.56,93,,,percent of total billed charges,93% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,44.36,38,,,percent of total billed charges,38% of total billed charges,95.02,81.4,,,percent of total billed charges,81.4% of total billed charges,105.06,90,,,percent of total billed charges,90% of total billed charges,105.06,90,,,percent of total billed charges,90% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,87.55,75,,,percent of total billed charges,75% of total billed charges,99.22,85,,,percent of total billed charges,85% of total billed charges,44.36,108.56,
DERM I&D ABCESS SIMPLE OR SINGLE - FAC,148,CDM,761,RC,10060,HCPCS,outpatient,,,302.44,226.83,,272.2,90,,,percent of total billed charges,90% of total billed charges,281.27,93,,,percent of total billed charges,93% of total billed charges,114.93,38,,,percent of total billed charges,38% of total billed charges,114.93,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,114.93,38,,,percent of total billed charges,38% of total billed charges,246.19,81.4,,,percent of total billed charges,81.4% of total billed charges,272.2,90,,,percent of total billed charges,90% of total billed charges,272.2,90,,,percent of total billed charges,90% of total billed charges,114.93,38,,,percent of total billed charges,38% of total billed charges,114.93,38,,,percent of total billed charges,38% of total billed charges,114.93,38,,,percent of total billed charges,38% of total billed charges,226.83,75,,,percent of total billed charges,75% of total billed charges,257.07,85,,,percent of total billed charges,85% of total billed charges,114.93,281.27,
DERM I&D COMPLEX POST OP - FAC,149,CDM,761,RC,10180,HCPCS,outpatient,,,4244.83,3183.62,,3820.35,90,,,percent of total billed charges,90% of total billed charges,3947.69,93,,,percent of total billed charges,93% of total billed charges,1613.04,38,,,percent of total billed charges,38% of total billed charges,1613.04,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,1613.04,38,,,percent of total billed charges,38% of total billed charges,3455.29,81.4,,,percent of total billed charges,81.4% of total billed charges,3820.35,90,,,percent of total billed charges,90% of total billed charges,3820.35,90,,,percent of total billed charges,90% of total billed charges,1613.04,38,,,percent of total billed charges,38% of total billed charges,1613.04,38,,,percent of total billed charges,38% of total billed charges,1613.04,38,,,percent of total billed charges,38% of total billed charges,3183.62,75,,,percent of total billed charges,75% of total billed charges,3608.11,85,,,percent of total billed charges,85% of total billed charges,1613.04,3947.69,
DERM BIOPSY-TANGENTIAL (SCRAPE) - FAC,150,CDM,761,RC,11102,HCPCS,outpatient,,,53.06,39.8,,47.75,90,,,percent of total billed charges,90% of total billed charges,49.35,93,,,percent of total billed charges,93% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,20.16,38,,,percent of total billed charges,38% of total billed charges,43.19,81.4,,,percent of total billed charges,81.4% of total billed charges,47.75,90,,,percent of total billed charges,90% of total billed charges,47.75,90,,,percent of total billed charges,90% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,39.8,75,,,percent of total billed charges,75% of total billed charges,45.1,85,,,percent of total billed charges,85% of total billed charges,20.16,49.35,
DERM BIOPSY TANGENTIAL EA ADD - FAC,151,CDM,761,RC,11103,HCPCS,outpatient,,,55.18,41.39,,49.66,90,,,percent of total billed charges,90% of total billed charges,51.32,93,,,percent of total billed charges,93% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,20.97,38,,,percent of total billed charges,38% of total billed charges,44.92,81.4,,,percent of total billed charges,81.4% of total billed charges,49.66,90,,,percent of total billed charges,90% of total billed charges,49.66,90,,,percent of total billed charges,90% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,41.39,75,,,percent of total billed charges,75% of total billed charges,46.9,85,,,percent of total billed charges,85% of total billed charges,20.97,51.32,
DERM BIOPSY PUNCH SINGLE - FAC,152,CDM,761,RC,11104,HCPCS,outpatient,,,106.12,79.59,,95.51,90,,,percent of total billed charges,90% of total billed charges,98.69,93,,,percent of total billed charges,93% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,40.33,38,,,percent of total billed charges,38% of total billed charges,86.38,81.4,,,percent of total billed charges,81.4% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,79.59,75,,,percent of total billed charges,75% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,98.69,
DERM BIOPSY PUNCH EA ADD - FAC,153,CDM,761,RC,11105,HCPCS,outpatient,,,63.67,47.75,,57.3,90,,,percent of total billed charges,90% of total billed charges,59.21,93,,,percent of total billed charges,93% of total billed charges,24.19,38,,,percent of total billed charges,38% of total billed charges,24.19,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,24.19,38,,,percent of total billed charges,38% of total billed charges,51.83,81.4,,,percent of total billed charges,81.4% of total billed charges,57.3,90,,,percent of total billed charges,90% of total billed charges,57.3,90,,,percent of total billed charges,90% of total billed charges,24.19,38,,,percent of total billed charges,38% of total billed charges,24.19,38,,,percent of total billed charges,38% of total billed charges,24.19,38,,,percent of total billed charges,38% of total billed charges,47.75,75,,,percent of total billed charges,75% of total billed charges,54.12,85,,,percent of total billed charges,85% of total billed charges,24.19,59.21,
"DERM SHAVE-BENIGN, SKIN TAGS 1-15 - FAC",154,CDM,761,RC,11200,HCPCS,outpatient,,,36.08,27.06,,32.47,90,,,percent of total billed charges,90% of total billed charges,33.55,93,,,percent of total billed charges,93% of total billed charges,13.71,38,,,percent of total billed charges,38% of total billed charges,13.71,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,13.71,38,,,percent of total billed charges,38% of total billed charges,29.37,81.4,,,percent of total billed charges,81.4% of total billed charges,32.47,90,,,percent of total billed charges,90% of total billed charges,32.47,90,,,percent of total billed charges,90% of total billed charges,13.71,38,,,percent of total billed charges,38% of total billed charges,13.71,38,,,percent of total billed charges,38% of total billed charges,13.71,38,,,percent of total billed charges,38% of total billed charges,27.06,75,,,percent of total billed charges,75% of total billed charges,30.67,85,,,percent of total billed charges,85% of total billed charges,13.71,33.55,
"DERM SHAVE, BENIGN; EACH ADDITIONAL 10 - FAC",155,CDM,761,RC,11201,HCPCS,outpatient,,,21.23,15.92,,19.11,90,,,percent of total billed charges,90% of total billed charges,19.74,93,,,percent of total billed charges,93% of total billed charges,8.07,38,,,percent of total billed charges,38% of total billed charges,8.07,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,8.07,38,,,percent of total billed charges,38% of total billed charges,17.28,81.4,,,percent of total billed charges,81.4% of total billed charges,19.11,90,,,percent of total billed charges,90% of total billed charges,19.11,90,,,percent of total billed charges,90% of total billed charges,8.07,38,,,percent of total billed charges,38% of total billed charges,8.07,38,,,percent of total billed charges,38% of total billed charges,8.07,38,,,percent of total billed charges,38% of total billed charges,15.92,75,,,percent of total billed charges,75% of total billed charges,18.05,85,,,percent of total billed charges,85% of total billed charges,8.07,19.74,
"Derm Shave/benigh(tr,a,l)05.cm &less FAC",156,CDM,761,RC,11300,HCPCS,outpatient,,,104.04,78.03,,93.64,90,,,percent of total billed charges,90% of total billed charges,96.76,93,,,percent of total billed charges,93% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,39.54,38,,,percent of total billed charges,38% of total billed charges,84.69,81.4,,,percent of total billed charges,81.4% of total billed charges,93.64,90,,,percent of total billed charges,90% of total billed charges,93.64,90,,,percent of total billed charges,90% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,78.03,75,,,percent of total billed charges,75% of total billed charges,88.43,85,,,percent of total billed charges,85% of total billed charges,39.54,96.76,
"Derm Shave/benigh(tr,a,l)05.cm &less PRO",157,CDM,982,RC,11300,HCPCS,outpatient,,,72.83,54.62,,40.38,130,,,fee schedule,130% of fee schedule,40.38,130,,,fee schedule,130% of fee schedule,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,42.73,119,,,fee schedule,119% of fee schedule,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,100% of fee schedule,65.55,90,,,percent of total billed charges,90% of total billed charges,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,34.42,100,,,fee schedule,100% of fee schedule,34.42,71.86,
"Derm Shave/Benign(tr,a,l).6-1cm-Fac",158,CDM,761,RC,11301,HCPCS,outpatient,,,176.87,132.65,,159.18,90,,,percent of total billed charges,90% of total billed charges,164.49,93,,,percent of total billed charges,93% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,67.21,38,,,percent of total billed charges,38% of total billed charges,143.97,81.4,,,percent of total billed charges,81.4% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,132.65,75,,,percent of total billed charges,75% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,164.49,
"Derm Shave/Benign(tr,a,l).6-1cm-PRO",159,CDM,982,RC,11301,HCPCS,outpatient,,,104.04,78.03,,68.85,130,,,fee schedule,130% of fee schedule,68.85,130,,,fee schedule,130% of fee schedule,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,64.77,119,,,fee schedule,119% of fee schedule,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,100% of fee schedule,93.64,90,,,percent of total billed charges,90% of total billed charges,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,51.85,100,,,fee schedule,100% of fee schedule,51.85,107.79,
"Derm Shave/Benign(tr,a,l).6-1cm-Global",160,CDM,761,RC,11301,HCPCS,outpatient,,,280.91,210.68,,252.82,90,,,percent of total billed charges,90% of total billed charges,261.25,93,,,percent of total billed charges,93% of total billed charges,106.75,38,,,percent of total billed charges,38% of total billed charges,106.75,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,106.75,38,,,percent of total billed charges,38% of total billed charges,228.66,81.4,,,percent of total billed charges,81.4% of total billed charges,252.82,90,,,percent of total billed charges,90% of total billed charges,252.82,90,,,percent of total billed charges,90% of total billed charges,106.75,38,,,percent of total billed charges,38% of total billed charges,106.75,38,,,percent of total billed charges,38% of total billed charges,106.75,38,,,percent of total billed charges,38% of total billed charges,210.68,75,,,percent of total billed charges,75% of total billed charges,238.77,85,,,percent of total billed charges,85% of total billed charges,106.75,261.25,
DERM SKIN RMV: SHAVE OVER 2.0CM - FAC,161,CDM,761,RC,11303,HCPCS,outpatient,,,116.73,87.55,,105.06,90,,,percent of total billed charges,90% of total billed charges,108.56,93,,,percent of total billed charges,93% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,44.36,38,,,percent of total billed charges,38% of total billed charges,95.02,81.4,,,percent of total billed charges,81.4% of total billed charges,105.06,90,,,percent of total billed charges,90% of total billed charges,105.06,90,,,percent of total billed charges,90% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,87.55,75,,,percent of total billed charges,75% of total billed charges,99.22,85,,,percent of total billed charges,85% of total billed charges,44.36,108.56,
DERM SHAVE SKIN LESION 004CM/< - FAC,162,CDM,761,RC,11305,HCPCS,outpatient,,,212.24,159.18,,191.02,90,,,percent of total billed charges,90% of total billed charges,197.38,93,,,percent of total billed charges,93% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,80.65,38,,,percent of total billed charges,38% of total billed charges,172.76,81.4,,,percent of total billed charges,81.4% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,159.18,75,,,percent of total billed charges,75% of total billed charges,180.4,85,,,percent of total billed charges,85% of total billed charges,80.65,197.38,
"DERM SHAVE LESION EPID, DERM - FAC",163,CDM,761,RC,11311,HCPCS,outpatient,,,318.36,238.77,,286.52,90,,,percent of total billed charges,90% of total billed charges,296.07,93,,,percent of total billed charges,93% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,120.98,38,,,percent of total billed charges,38% of total billed charges,259.15,81.4,,,percent of total billed charges,81.4% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,238.77,75,,,percent of total billed charges,75% of total billed charges,270.61,85,,,percent of total billed charges,85% of total billed charges,120.98,296.07,
"DERM EXCISION BENIGN (TR,A,L); 1.1-2C - FAC",164,CDM,761,RC,11402,HCPCS,outpatient,,,636.72,477.54,,573.05,90,,,percent of total billed charges,90% of total billed charges,592.15,93,,,percent of total billed charges,93% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,241.95,38,,,percent of total billed charges,38% of total billed charges,518.29,81.4,,,percent of total billed charges,81.4% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,477.54,75,,,percent of total billed charges,75% of total billed charges,541.21,85,,,percent of total billed charges,85% of total billed charges,241.95,592.15,
"DERM EXCISION BENIGN (TR, A, L): 2.1-3.0CM - FAC",165,CDM,761,RC,11403,HCPCS,outpatient,,,848.97,636.73,,764.07,90,,,percent of total billed charges,90% of total billed charges,789.54,93,,,percent of total billed charges,93% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,322.61,38,,,percent of total billed charges,38% of total billed charges,691.06,81.4,,,percent of total billed charges,81.4% of total billed charges,764.07,90,,,percent of total billed charges,90% of total billed charges,764.07,90,,,percent of total billed charges,90% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,636.73,75,,,percent of total billed charges,75% of total billed charges,721.62,85,,,percent of total billed charges,85% of total billed charges,322.61,789.54,
"DERM Excise B9(sc,n,ha,fe,g);.5cm or<-FAC",166,CDM,761,RC,11420,HCPCS,outpatient,,,157.66,118.25,,141.89,90,,,percent of total billed charges,90% of total billed charges,146.62,93,,,percent of total billed charges,93% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,59.91,38,,,percent of total billed charges,38% of total billed charges,128.34,81.4,,,percent of total billed charges,81.4% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,118.25,75,,,percent of total billed charges,75% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,146.62,
"DERM EXCIS BENIGN (SC,N,HA,FE,G); 0.6 TO 1.0CM - FAC",167,CDM,761,RC,11421,HCPCS,outpatient,,,318.36,238.77,,286.52,90,,,percent of total billed charges,90% of total billed charges,296.07,93,,,percent of total billed charges,93% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,120.98,38,,,percent of total billed charges,38% of total billed charges,259.15,81.4,,,percent of total billed charges,81.4% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,238.77,75,,,percent of total billed charges,75% of total billed charges,270.61,85,,,percent of total billed charges,85% of total billed charges,120.98,296.07,
"DERM EXC BENIGN (HEAD, NECK, EXT, GEN) 1.1-2CM - FAC",168,CDM,761,RC,11422,HCPCS,outpatient,,,583.66,437.75,,525.29,90,,,percent of total billed charges,90% of total billed charges,542.8,93,,,percent of total billed charges,93% of total billed charges,221.79,38,,,percent of total billed charges,38% of total billed charges,221.79,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,221.79,38,,,percent of total billed charges,38% of total billed charges,475.1,81.4,,,percent of total billed charges,81.4% of total billed charges,525.29,90,,,percent of total billed charges,90% of total billed charges,525.29,90,,,percent of total billed charges,90% of total billed charges,221.79,38,,,percent of total billed charges,38% of total billed charges,221.79,38,,,percent of total billed charges,38% of total billed charges,221.79,38,,,percent of total billed charges,38% of total billed charges,437.75,75,,,percent of total billed charges,75% of total billed charges,496.11,85,,,percent of total billed charges,85% of total billed charges,221.79,542.8,
"DERM EXCIS BENIGN (SC, N, HA, FE, G); 2.1 TO 3.0CM - FAC",169,CDM,761,RC,11423,HCPCS,outpatient,,,2440.78,1830.59,,2196.7,90,,,percent of total billed charges,90% of total billed charges,2269.93,93,,,percent of total billed charges,93% of total billed charges,927.5,38,,,percent of total billed charges,38% of total billed charges,927.5,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,927.5,38,,,percent of total billed charges,38% of total billed charges,1986.79,81.4,,,percent of total billed charges,81.4% of total billed charges,2196.7,90,,,percent of total billed charges,90% of total billed charges,2196.7,90,,,percent of total billed charges,90% of total billed charges,927.5,38,,,percent of total billed charges,38% of total billed charges,927.5,38,,,percent of total billed charges,38% of total billed charges,927.5,38,,,percent of total billed charges,38% of total billed charges,1830.59,75,,,percent of total billed charges,75% of total billed charges,2074.66,85,,,percent of total billed charges,85% of total billed charges,927.5,2269.93,
DERM Excis B9 Face .5cm/<-FAC,170,CDM,761,RC,11440,HCPCS,outpatient,,,168.92,126.69,,152.03,90,,,percent of total billed charges,90% of total billed charges,157.1,93,,,percent of total billed charges,93% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,64.19,38,,,percent of total billed charges,38% of total billed charges,137.5,81.4,,,percent of total billed charges,81.4% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,126.69,75,,,percent of total billed charges,75% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,157.1,
DERM EXCIS BENIGN (FACE);0.6-1.0CM - FAC,171,CDM,761,RC,11441,HCPCS,outpatient,,,318.36,238.77,,286.52,90,,,percent of total billed charges,90% of total billed charges,296.07,93,,,percent of total billed charges,93% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,120.98,38,,,percent of total billed charges,38% of total billed charges,259.15,81.4,,,percent of total billed charges,81.4% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,238.77,75,,,percent of total billed charges,75% of total billed charges,270.61,85,,,percent of total billed charges,85% of total billed charges,120.98,296.07,
DERM EXCIS BENIGN (FACE); 1.1-2.0CM - FAC,172,CDM,761,RC,11442,HCPCS,outpatient,,,318.36,238.77,,286.52,90,,,percent of total billed charges,90% of total billed charges,296.07,93,,,percent of total billed charges,93% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,120.98,38,,,percent of total billed charges,38% of total billed charges,259.15,81.4,,,percent of total billed charges,81.4% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,238.77,75,,,percent of total billed charges,75% of total billed charges,270.61,85,,,percent of total billed charges,85% of total billed charges,120.98,296.07,
Derm Excis B9 (Face); 2.1-3cm - FAC,173,CDM,761,RC,11443,HCPCS,outpatient,,,848.97,636.73,,764.07,90,,,percent of total billed charges,90% of total billed charges,789.54,93,,,percent of total billed charges,93% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,322.61,38,,,percent of total billed charges,38% of total billed charges,691.06,81.4,,,percent of total billed charges,81.4% of total billed charges,764.07,90,,,percent of total billed charges,90% of total billed charges,764.07,90,,,percent of total billed charges,90% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,636.73,75,,,percent of total billed charges,75% of total billed charges,721.62,85,,,percent of total billed charges,85% of total billed charges,322.61,789.54,
"DERM EXC, SKIN, MAL - (TR, A, L); 0.6-1.0CM - FAC",174,CDM,761,RC,11601,HCPCS,outpatient,,,848.97,636.73,,764.07,90,,,percent of total billed charges,90% of total billed charges,789.54,93,,,percent of total billed charges,93% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,322.61,38,,,percent of total billed charges,38% of total billed charges,691.06,81.4,,,percent of total billed charges,81.4% of total billed charges,764.07,90,,,percent of total billed charges,90% of total billed charges,764.07,90,,,percent of total billed charges,90% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,636.73,75,,,percent of total billed charges,75% of total billed charges,721.62,85,,,percent of total billed charges,85% of total billed charges,322.61,789.54,
"DERM EXC, SKIN, MAL - (TR, A, L); 1.1-2.0CM - FAC",175,CDM,761,RC,11602,HCPCS,outpatient,,,212.24,159.18,,191.02,90,,,percent of total billed charges,90% of total billed charges,197.38,93,,,percent of total billed charges,93% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,80.65,38,,,percent of total billed charges,38% of total billed charges,172.76,81.4,,,percent of total billed charges,81.4% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,159.18,75,,,percent of total billed charges,75% of total billed charges,180.4,85,,,percent of total billed charges,85% of total billed charges,80.65,197.38,
"DERM EXCISION, MAL (TR,A,L);2.1-3.0 - FAC",176,CDM,761,RC,11603,HCPCS,outpatient,,,636.72,477.54,,573.05,90,,,percent of total billed charges,90% of total billed charges,592.15,93,,,percent of total billed charges,93% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,241.95,38,,,percent of total billed charges,38% of total billed charges,518.29,81.4,,,percent of total billed charges,81.4% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,477.54,75,,,percent of total billed charges,75% of total billed charges,541.21,85,,,percent of total billed charges,85% of total billed charges,241.95,592.15,
DERM EXC MAL INC MARG (TR/EXT) - FAC,177,CDM,761,RC,11604,HCPCS,outpatient,,,902.03,676.52,,811.83,90,,,percent of total billed charges,90% of total billed charges,838.89,93,,,percent of total billed charges,93% of total billed charges,342.77,38,,,percent of total billed charges,38% of total billed charges,342.77,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,342.77,38,,,percent of total billed charges,38% of total billed charges,734.25,81.4,,,percent of total billed charges,81.4% of total billed charges,811.83,90,,,percent of total billed charges,90% of total billed charges,811.83,90,,,percent of total billed charges,90% of total billed charges,342.77,38,,,percent of total billed charges,38% of total billed charges,342.77,38,,,percent of total billed charges,38% of total billed charges,342.77,38,,,percent of total billed charges,38% of total billed charges,676.52,75,,,percent of total billed charges,75% of total billed charges,766.73,85,,,percent of total billed charges,85% of total billed charges,342.77,838.89,
Derm Exc mal lesion tr/A/L>4cm-Fac,178,CDM,761,RC,11606,HCPCS,outpatient,,,2096.1,1572.08,,1886.49,90,,,percent of total billed charges,90% of total billed charges,1949.37,93,,,percent of total billed charges,93% of total billed charges,796.52,38,,,percent of total billed charges,38% of total billed charges,796.52,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,796.52,38,,,percent of total billed charges,38% of total billed charges,1706.23,81.4,,,percent of total billed charges,81.4% of total billed charges,1886.49,90,,,percent of total billed charges,90% of total billed charges,1886.49,90,,,percent of total billed charges,90% of total billed charges,796.52,38,,,percent of total billed charges,38% of total billed charges,796.52,38,,,percent of total billed charges,38% of total billed charges,796.52,38,,,percent of total billed charges,38% of total billed charges,1572.08,75,,,percent of total billed charges,75% of total billed charges,1781.69,85,,,percent of total billed charges,85% of total billed charges,796.52,1949.37,
"DERM LESION RMV; MALIG (SC, NE, FE, HA, GEN); 0.6-1.0CM - FAC",179,CDM,761,RC,11622,HCPCS,outpatient,,,212.24,159.18,,191.02,90,,,percent of total billed charges,90% of total billed charges,197.38,93,,,percent of total billed charges,93% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,80.65,38,,,percent of total billed charges,38% of total billed charges,172.76,81.4,,,percent of total billed charges,81.4% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,159.18,75,,,percent of total billed charges,75% of total billed charges,180.4,85,,,percent of total billed charges,85% of total billed charges,80.65,197.38,
"DERM EXC, MAL LESION INC MARG (S/N/H/F/L) - FAC",180,CDM,761,RC,11623,HCPCS,outpatient,,,955.09,716.32,,859.58,90,,,percent of total billed charges,90% of total billed charges,888.23,93,,,percent of total billed charges,93% of total billed charges,362.93,38,,,percent of total billed charges,38% of total billed charges,362.93,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,362.93,38,,,percent of total billed charges,38% of total billed charges,777.44,81.4,,,percent of total billed charges,81.4% of total billed charges,859.58,90,,,percent of total billed charges,90% of total billed charges,859.58,90,,,percent of total billed charges,90% of total billed charges,362.93,38,,,percent of total billed charges,38% of total billed charges,362.93,38,,,percent of total billed charges,38% of total billed charges,362.93,38,,,percent of total billed charges,38% of total billed charges,716.32,75,,,percent of total billed charges,75% of total billed charges,811.83,85,,,percent of total billed charges,85% of total billed charges,362.93,888.23,
"DERM EXC MAL LESION Inc MARGINS, S, NE, H, F, G - FAC",181,CDM,761,RC,11624,HCPCS,outpatient,,,2228.54,1671.41,,2005.69,90,,,percent of total billed charges,90% of total billed charges,2072.54,93,,,percent of total billed charges,93% of total billed charges,846.85,38,,,percent of total billed charges,38% of total billed charges,846.85,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,846.85,38,,,percent of total billed charges,38% of total billed charges,1814.03,81.4,,,percent of total billed charges,81.4% of total billed charges,2005.69,90,,,percent of total billed charges,90% of total billed charges,2005.69,90,,,percent of total billed charges,90% of total billed charges,846.85,38,,,percent of total billed charges,38% of total billed charges,846.85,38,,,percent of total billed charges,38% of total billed charges,846.85,38,,,percent of total billed charges,38% of total billed charges,1671.41,75,,,percent of total billed charges,75% of total billed charges,1894.26,85,,,percent of total billed charges,85% of total billed charges,846.85,2072.54,
"DERM EXCIS, MAL LESION (SC, N, HA, FE, G); 0.6-1.0CM - FAC",182,CDM,761,RC,11641,HCPCS,outpatient,,,265.3,198.98,,238.77,90,,,percent of total billed charges,90% of total billed charges,246.73,93,,,percent of total billed charges,93% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,100.81,38,,,percent of total billed charges,38% of total billed charges,215.95,81.4,,,percent of total billed charges,81.4% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,198.98,75,,,percent of total billed charges,75% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,100.81,246.73,
"DERM - EXCIS, MAL LESIONS (SC, N, HA, FE, G); 1.1-2.0CM - FAC",183,CDM,761,RC,11642,HCPCS,outpatient,,,339.59,254.69,,305.63,90,,,percent of total billed charges,90% of total billed charges,315.82,93,,,percent of total billed charges,93% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,129.04,38,,,percent of total billed charges,38% of total billed charges,276.43,81.4,,,percent of total billed charges,81.4% of total billed charges,305.63,90,,,percent of total billed charges,90% of total billed charges,305.63,90,,,percent of total billed charges,90% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,254.69,75,,,percent of total billed charges,75% of total billed charges,288.65,85,,,percent of total billed charges,85% of total billed charges,129.04,315.82,
Derm EXC mal+mar 2.1-3 f/e/e/n/l-PRO,184,CDM,982,RC,11643,HCPCS,outpatient,,,459,344.25,,312.72,130,,,fee schedule,130% of fee schedule,312.72,130,,,fee schedule,130% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,283.32,119,,,fee schedule,119% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,100% of fee schedule,413.1,90,,,percent of total billed charges,90% of total billed charges,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,431.16,100,,,fee schedule,100% of fee schedule,230.83,100,,,fee schedule,100% of fee schedule,230.83,431.16,
Derm EXC mal+mar 2.1-3 f/e/e/n/l - FAC,185,CDM,761,RC,11643,HCPCS,outpatient,,,2448,1836,,2203.2,90,,,percent of total billed charges,90% of total billed charges,2276.64,93,,,percent of total billed charges,93% of total billed charges,930.24,38,,,percent of total billed charges,38% of total billed charges,930.24,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,930.24,38,,,percent of total billed charges,38% of total billed charges,1992.67,81.4,,,percent of total billed charges,81.4% of total billed charges,2203.2,90,,,percent of total billed charges,90% of total billed charges,2203.2,90,,,percent of total billed charges,90% of total billed charges,930.24,38,,,percent of total billed charges,38% of total billed charges,930.24,38,,,percent of total billed charges,38% of total billed charges,930.24,38,,,percent of total billed charges,38% of total billed charges,1836,75,,,percent of total billed charges,75% of total billed charges,2080.8,85,,,percent of total billed charges,85% of total billed charges,930.24,2276.64,
Derm EXC mal+mar 2.1-3f/e/e/n/l Global,186,CDM,982,RC,11643,HCPCS,outpatient,,,2448,1836,,312.72,130,,,fee schedule,130% of fee schedule,312.72,130,,,fee schedule,130% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,283.32,119,,,fee schedule,119% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,100% of fee schedule,2203.2,90,,,percent of total billed charges,90% of total billed charges,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,431.16,100,,,fee schedule,100% of fee schedule,230.83,100,,,fee schedule,100% of fee schedule,230.83,2203.2,
DERM TX OF LESIONS; INJ. UP TO 7 LESIONS - FAC,187,CDM,761,RC,11900,HCPCS,outpatient,,,37.14,27.86,,33.43,90,,,percent of total billed charges,90% of total billed charges,34.54,93,,,percent of total billed charges,93% of total billed charges,14.11,38,,,percent of total billed charges,38% of total billed charges,14.11,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,14.11,38,,,percent of total billed charges,38% of total billed charges,30.23,81.4,,,percent of total billed charges,81.4% of total billed charges,33.43,90,,,percent of total billed charges,90% of total billed charges,33.43,90,,,percent of total billed charges,90% of total billed charges,14.11,38,,,percent of total billed charges,38% of total billed charges,14.11,38,,,percent of total billed charges,38% of total billed charges,14.11,38,,,percent of total billed charges,38% of total billed charges,27.86,75,,,percent of total billed charges,75% of total billed charges,31.57,85,,,percent of total billed charges,85% of total billed charges,14.11,34.54,
"DERM INJECTION, INTRALESIONAL; UP TO AND INCLUDING 7 LESIONS - FAC",188,CDM,761,RC,11901,HCPCS,outpatient,,,339.59,254.69,,305.63,90,,,percent of total billed charges,90% of total billed charges,315.82,93,,,percent of total billed charges,93% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,129.04,38,,,percent of total billed charges,38% of total billed charges,276.43,81.4,,,percent of total billed charges,81.4% of total billed charges,305.63,90,,,percent of total billed charges,90% of total billed charges,305.63,90,,,percent of total billed charges,90% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,254.69,75,,,percent of total billed charges,75% of total billed charges,288.65,85,,,percent of total billed charges,85% of total billed charges,129.04,315.82,
DERM LAC REPAIR INTERMED. NONFACE; 2.5CM OR < - FAC,189,CDM,761,RC,12031,HCPCS,outpatient,,,636.72,477.54,,573.05,90,,,percent of total billed charges,90% of total billed charges,592.15,93,,,percent of total billed charges,93% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,241.95,38,,,percent of total billed charges,38% of total billed charges,518.29,81.4,,,percent of total billed charges,81.4% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,477.54,75,,,percent of total billed charges,75% of total billed charges,541.21,85,,,percent of total billed charges,85% of total billed charges,241.95,592.15,
DERM LAC REPAIR INTERMED. NONFACE; 2.6-7 - FAC,190,CDM,761,RC,12032,HCPCS,outpatient,,,318.36,238.77,,286.52,90,,,percent of total billed charges,90% of total billed charges,296.07,93,,,percent of total billed charges,93% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,120.98,38,,,percent of total billed charges,38% of total billed charges,259.15,81.4,,,percent of total billed charges,81.4% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,238.77,75,,,percent of total billed charges,75% of total billed charges,270.61,85,,,percent of total billed charges,85% of total billed charges,120.98,296.07,
DERM LAC REPAIR INTERMED. NONFACE; 7.6-12.5CM - FAC,191,CDM,761,RC,12034,HCPCS,outpatient,,,443.59,332.69,,399.23,90,,,percent of total billed charges,90% of total billed charges,412.54,93,,,percent of total billed charges,93% of total billed charges,168.56,38,,,percent of total billed charges,38% of total billed charges,168.56,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,168.56,38,,,percent of total billed charges,38% of total billed charges,361.08,81.4,,,percent of total billed charges,81.4% of total billed charges,399.23,90,,,percent of total billed charges,90% of total billed charges,399.23,90,,,percent of total billed charges,90% of total billed charges,168.56,38,,,percent of total billed charges,38% of total billed charges,168.56,38,,,percent of total billed charges,38% of total billed charges,168.56,38,,,percent of total billed charges,38% of total billed charges,332.69,75,,,percent of total billed charges,75% of total billed charges,377.05,85,,,percent of total billed charges,85% of total billed charges,168.56,412.54,
DERM LAC REPAIR INTERMED. HEAD/FACE; 2.5CM OR < - FAC,192,CDM,761,RC,12041,HCPCS,outpatient,,,530.6,397.95,,477.54,90,,,percent of total billed charges,90% of total billed charges,493.46,93,,,percent of total billed charges,93% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,201.63,38,,,percent of total billed charges,38% of total billed charges,431.91,81.4,,,percent of total billed charges,81.4% of total billed charges,477.54,90,,,percent of total billed charges,90% of total billed charges,477.54,90,,,percent of total billed charges,90% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,397.95,75,,,percent of total billed charges,75% of total billed charges,451.01,85,,,percent of total billed charges,85% of total billed charges,201.63,493.46,
DERM LAC REPAIR INTERMED. HEAD/FACE; 2.6-7.5CM - FAC,193,CDM,761,RC,12042,HCPCS,outpatient,,,328.97,246.73,,296.07,90,,,percent of total billed charges,90% of total billed charges,305.94,93,,,percent of total billed charges,93% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,125.01,38,,,percent of total billed charges,38% of total billed charges,267.78,81.4,,,percent of total billed charges,81.4% of total billed charges,296.07,90,,,percent of total billed charges,90% of total billed charges,296.07,90,,,percent of total billed charges,90% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,246.73,75,,,percent of total billed charges,75% of total billed charges,279.62,85,,,percent of total billed charges,85% of total billed charges,125.01,305.94,
DERM LAC REPAIR INTERMED. HEAD/FACE; 7.6-12.5CM - FAC,194,CDM,761,RC,12044,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
DERM LAC REPAIR INTERMED. FACE; 2.5CM OR < - FAC,195,CDM,761,RC,12051,HCPCS,outpatient,,,312,234,,280.8,90,,,percent of total billed charges,90% of total billed charges,290.16,93,,,percent of total billed charges,93% of total billed charges,118.56,38,,,percent of total billed charges,38% of total billed charges,118.56,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,118.56,38,,,percent of total billed charges,38% of total billed charges,253.97,81.4,,,percent of total billed charges,81.4% of total billed charges,280.8,90,,,percent of total billed charges,90% of total billed charges,280.8,90,,,percent of total billed charges,90% of total billed charges,118.56,38,,,percent of total billed charges,38% of total billed charges,118.56,38,,,percent of total billed charges,38% of total billed charges,118.56,38,,,percent of total billed charges,38% of total billed charges,234,75,,,percent of total billed charges,75% of total billed charges,265.2,85,,,percent of total billed charges,85% of total billed charges,118.56,290.16,
DERM LAC REPAIR INTERMED. FACE; 2.6-5.0CM - FAC,196,CDM,761,RC,12052,HCPCS,outpatient,,,159.18,119.39,,143.26,90,,,percent of total billed charges,90% of total billed charges,148.04,93,,,percent of total billed charges,93% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,60.49,38,,,percent of total billed charges,38% of total billed charges,129.57,81.4,,,percent of total billed charges,81.4% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,119.39,75,,,percent of total billed charges,75% of total billed charges,135.3,85,,,percent of total billed charges,85% of total billed charges,60.49,148.04,
DERM LAC REPAIR INTERMED. FACE; 5.1-7.5CM - FAC,197,CDM,761,RC,12053,HCPCS,outpatient,,,636.72,477.54,,573.05,90,,,percent of total billed charges,90% of total billed charges,592.15,93,,,percent of total billed charges,93% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,241.95,38,,,percent of total billed charges,38% of total billed charges,518.29,81.4,,,percent of total billed charges,81.4% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,477.54,75,,,percent of total billed charges,75% of total billed charges,541.21,85,,,percent of total billed charges,85% of total billed charges,241.95,592.15,
Derm Lac Repair int f7.6-12.3cPRO,198,CDM,988,RC,12054,HCPCS,outpatient,,,530.6,397.95,,304.1,130,,,fee schedule,130% of fee schedule,304.1,130,,,fee schedule,130% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,273.77,119,,,fee schedule,119% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,100% of fee schedule,477.54,90,,,percent of total billed charges,90% of total billed charges,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,222.73,100,,,fee schedule,100% of fee schedule,222.73,477.54,
Derm Lac Repair int f7.6-12.3c,199,CDM,761,RC,12054,HCPCS,outpatient,,,328.97,246.73,,296.07,90,,,percent of total billed charges,90% of total billed charges,305.94,93,,,percent of total billed charges,93% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,125.01,38,,,percent of total billed charges,38% of total billed charges,267.78,81.4,,,percent of total billed charges,81.4% of total billed charges,296.07,90,,,percent of total billed charges,90% of total billed charges,296.07,90,,,percent of total billed charges,90% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,246.73,75,,,percent of total billed charges,75% of total billed charges,279.62,85,,,percent of total billed charges,85% of total billed charges,125.01,305.94,
DERM LAC REPAIR CMPLX. TRUNK; 1.1-2C - FAC,200,CDM,761,RC,13100,HCPCS,outpatient,,,530.6,397.95,,477.54,90,,,percent of total billed charges,90% of total billed charges,493.46,93,,,percent of total billed charges,93% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,201.63,38,,,percent of total billed charges,38% of total billed charges,431.91,81.4,,,percent of total billed charges,81.4% of total billed charges,477.54,90,,,percent of total billed charges,90% of total billed charges,477.54,90,,,percent of total billed charges,90% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,397.95,75,,,percent of total billed charges,75% of total billed charges,451.01,85,,,percent of total billed charges,85% of total billed charges,201.63,493.46,
"DERM REPAIR COMPX LAC FACE/NECK EXT, GEN 2.6C-7.5C - FAC",201,CDM,761,RC,13132,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
DERM CYRO 1ST LESION - FAC,202,CDM,761,RC,17000,HCPCS,outpatient,,,73.23,54.92,,65.91,90,,,percent of total billed charges,90% of total billed charges,68.1,93,,,percent of total billed charges,93% of total billed charges,27.83,38,,,percent of total billed charges,38% of total billed charges,27.83,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,27.83,38,,,percent of total billed charges,38% of total billed charges,59.61,81.4,,,percent of total billed charges,81.4% of total billed charges,65.91,90,,,percent of total billed charges,90% of total billed charges,65.91,90,,,percent of total billed charges,90% of total billed charges,27.83,38,,,percent of total billed charges,38% of total billed charges,27.83,38,,,percent of total billed charges,38% of total billed charges,27.83,38,,,percent of total billed charges,38% of total billed charges,54.92,75,,,percent of total billed charges,75% of total billed charges,62.25,85,,,percent of total billed charges,85% of total billed charges,27.83,68.1,
DERM CRYO 2-14 LESIONS - FAC,203,CDM,761,RC,17003,HCPCS,outpatient,,,8.49,6.37,,7.64,90,,,percent of total billed charges,90% of total billed charges,7.9,93,,,percent of total billed charges,93% of total billed charges,3.23,38,,,percent of total billed charges,38% of total billed charges,3.23,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,3.23,38,,,percent of total billed charges,38% of total billed charges,6.91,81.4,,,percent of total billed charges,81.4% of total billed charges,7.64,90,,,percent of total billed charges,90% of total billed charges,7.64,90,,,percent of total billed charges,90% of total billed charges,3.23,38,,,percent of total billed charges,38% of total billed charges,3.23,38,,,percent of total billed charges,38% of total billed charges,3.23,38,,,percent of total billed charges,38% of total billed charges,6.37,75,,,percent of total billed charges,75% of total billed charges,7.22,85,,,percent of total billed charges,85% of total billed charges,3.23,7.9,
DERM CRYO LESIONS 15+ - FAC,204,CDM,761,RC,17004,HCPCS,outpatient,,,159.18,119.39,,143.26,90,,,percent of total billed charges,90% of total billed charges,148.04,93,,,percent of total billed charges,93% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,60.49,38,,,percent of total billed charges,38% of total billed charges,129.57,81.4,,,percent of total billed charges,81.4% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,119.39,75,,,percent of total billed charges,75% of total billed charges,135.3,85,,,percent of total billed charges,85% of total billed charges,60.49,148.04,
DERM WART REMOVAL; UP TO 14 LESIONS - FAC,205,CDM,761,RC,17110,HCPCS,outpatient,,,106.12,79.59,,95.51,90,,,percent of total billed charges,90% of total billed charges,98.69,93,,,percent of total billed charges,93% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,40.33,38,,,percent of total billed charges,38% of total billed charges,86.38,81.4,,,percent of total billed charges,81.4% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,79.59,75,,,percent of total billed charges,75% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,98.69,
DERM DESTRUCTION BENIGN LESION 15/> - FAC,206,CDM,761,RC,17111,HCPCS,outpatient,,,47.76,35.82,,42.98,90,,,percent of total billed charges,90% of total billed charges,44.42,93,,,percent of total billed charges,93% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.15,38,,,percent of total billed charges,38% of total billed charges,38.88,81.4,,,percent of total billed charges,81.4% of total billed charges,42.98,90,,,percent of total billed charges,90% of total billed charges,42.98,90,,,percent of total billed charges,90% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,35.82,75,,,percent of total billed charges,75% of total billed charges,40.6,85,,,percent of total billed charges,85% of total billed charges,18.15,44.42,
DERM MALIGNANT LESION DESTRUC. .5 OR <; TRUNK EXT. - FAC,207,CDM,761,RC,17260,HCPCS,outpatient,,,74.29,55.72,,66.86,90,,,percent of total billed charges,90% of total billed charges,69.09,93,,,percent of total billed charges,93% of total billed charges,28.23,38,,,percent of total billed charges,38% of total billed charges,28.23,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,28.23,38,,,percent of total billed charges,38% of total billed charges,60.47,81.4,,,percent of total billed charges,81.4% of total billed charges,66.86,90,,,percent of total billed charges,90% of total billed charges,66.86,90,,,percent of total billed charges,90% of total billed charges,28.23,38,,,percent of total billed charges,38% of total billed charges,28.23,38,,,percent of total billed charges,38% of total billed charges,28.23,38,,,percent of total billed charges,38% of total billed charges,55.72,75,,,percent of total billed charges,75% of total billed charges,63.15,85,,,percent of total billed charges,85% of total billed charges,28.23,69.09,
DERM MALIGNANT LESION DESTRUC. 0.6-1.0CM; TRUNK EXT - FAC,208,CDM,761,RC,17261,HCPCS,outpatient,,,191.02,143.27,,171.92,90,,,percent of total billed charges,90% of total billed charges,177.65,93,,,percent of total billed charges,93% of total billed charges,72.59,38,,,percent of total billed charges,38% of total billed charges,72.59,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,72.59,38,,,percent of total billed charges,38% of total billed charges,155.49,81.4,,,percent of total billed charges,81.4% of total billed charges,171.92,90,,,percent of total billed charges,90% of total billed charges,171.92,90,,,percent of total billed charges,90% of total billed charges,72.59,38,,,percent of total billed charges,38% of total billed charges,72.59,38,,,percent of total billed charges,38% of total billed charges,72.59,38,,,percent of total billed charges,38% of total billed charges,143.27,75,,,percent of total billed charges,75% of total billed charges,162.37,85,,,percent of total billed charges,85% of total billed charges,72.59,177.65,
DERM MALIGNANT LESION DESTRUC. 1.1-2.0CM;TRUNK EXT - FAC,209,CDM,761,RC,17262,HCPCS,outpatient,,,530.6,397.95,,477.54,90,,,percent of total billed charges,90% of total billed charges,493.46,93,,,percent of total billed charges,93% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,201.63,38,,,percent of total billed charges,38% of total billed charges,431.91,81.4,,,percent of total billed charges,81.4% of total billed charges,477.54,90,,,percent of total billed charges,90% of total billed charges,477.54,90,,,percent of total billed charges,90% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,397.95,75,,,percent of total billed charges,75% of total billed charges,451.01,85,,,percent of total billed charges,85% of total billed charges,201.63,493.46,
"DERM EXC MAL LESION INC MARG (T,EXT) - FAC",210,CDM,761,RC,17263,HCPCS,outpatient,,,350.2,262.65,,315.18,90,,,percent of total billed charges,90% of total billed charges,325.69,93,,,percent of total billed charges,93% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,133.08,38,,,percent of total billed charges,38% of total billed charges,285.06,81.4,,,percent of total billed charges,81.4% of total billed charges,315.18,90,,,percent of total billed charges,90% of total billed charges,315.18,90,,,percent of total billed charges,90% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,262.65,75,,,percent of total billed charges,75% of total billed charges,297.67,85,,,percent of total billed charges,85% of total billed charges,133.08,325.69,
"Derm Destr mal lesion, tr, ext 3.1-4cm - FAC",211,CDM,761,RC,17264,HCPCS,outpatient,,,657.95,493.46,,592.16,90,,,percent of total billed charges,90% of total billed charges,611.89,93,,,percent of total billed charges,93% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,250.02,38,,,percent of total billed charges,38% of total billed charges,535.57,81.4,,,percent of total billed charges,81.4% of total billed charges,592.16,90,,,percent of total billed charges,90% of total billed charges,592.16,90,,,percent of total billed charges,90% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,493.46,75,,,percent of total billed charges,75% of total billed charges,559.26,85,,,percent of total billed charges,85% of total billed charges,250.02,611.89,
"DERM DESTRUCT MALIG LESION - TRUNK, ARM, LEG >4CM - FAC",212,CDM,761,RC,17266,HCPCS,outpatient,,,339.59,254.69,,305.63,90,,,percent of total billed charges,90% of total billed charges,315.82,93,,,percent of total billed charges,93% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,129.04,38,,,percent of total billed charges,38% of total billed charges,276.43,81.4,,,percent of total billed charges,81.4% of total billed charges,305.63,90,,,percent of total billed charges,90% of total billed charges,305.63,90,,,percent of total billed charges,90% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,129.04,38,,,percent of total billed charges,38% of total billed charges,254.69,75,,,percent of total billed charges,75% of total billed charges,288.65,85,,,percent of total billed charges,85% of total billed charges,129.04,315.82,
DERM DESTRUCT MAL LESION SC/N/H/F/G - FAC,213,CDM,761,RC,17271,HCPCS,outpatient,,,328.97,246.73,,296.07,90,,,percent of total billed charges,90% of total billed charges,305.94,93,,,percent of total billed charges,93% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,125.01,38,,,percent of total billed charges,38% of total billed charges,267.78,81.4,,,percent of total billed charges,81.4% of total billed charges,296.07,90,,,percent of total billed charges,90% of total billed charges,296.07,90,,,percent of total billed charges,90% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,246.73,75,,,percent of total billed charges,75% of total billed charges,279.62,85,,,percent of total billed charges,85% of total billed charges,125.01,305.94,
DERM DESTRUCT - SKIN LESION - FAC,214,CDM,761,RC,17272,HCPCS,outpatient,,,212.24,159.18,,191.02,90,,,percent of total billed charges,90% of total billed charges,197.38,93,,,percent of total billed charges,93% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,80.65,38,,,percent of total billed charges,38% of total billed charges,172.76,81.4,,,percent of total billed charges,81.4% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,159.18,75,,,percent of total billed charges,75% of total billed charges,180.4,85,,,percent of total billed charges,85% of total billed charges,80.65,197.38,
Derm Destr. skin MAL 1.2-3cm GEN,215,CDM,982,RC,17273,HCPCS,outpatient,,,673.2,504.9,,196.91,130,,,fee schedule,130% of fee schedule,196.91,130,,,fee schedule,130% of fee schedule,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,172.87,119,,,fee schedule,119% of fee schedule,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,100% of fee schedule,605.88,90,,,percent of total billed charges,90% of total billed charges,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,139.37,100,,,fee schedule,100% of fee schedule,139.37,605.88,
Derm Destr. skin MAL 1.2-3cm PRO,216,CDM,982,RC,17273,HCPCS,outpatient,,,265.2,198.9,,196.91,130,,,fee schedule,130% of fee schedule,196.91,130,,,fee schedule,130% of fee schedule,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,172.87,119,,,fee schedule,119% of fee schedule,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,100% of fee schedule,238.68,90,,,percent of total billed charges,90% of total billed charges,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,139.37,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,139.37,100,,,fee schedule,100% of fee schedule,139.37,238.68,
Derm Destr. skin MAL 1.2-3cm FAC,217,CDM,761,RC,17273,HCPCS,outpatient,,,408,306,,367.2,90,,,percent of total billed charges,90% of total billed charges,379.44,93,,,percent of total billed charges,93% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,155.04,38,,,percent of total billed charges,38% of total billed charges,332.11,81.4,,,percent of total billed charges,81.4% of total billed charges,367.2,90,,,percent of total billed charges,90% of total billed charges,367.2,90,,,percent of total billed charges,90% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,306,75,,,percent of total billed charges,75% of total billed charges,346.8,85,,,percent of total billed charges,85% of total billed charges,155.04,379.44,
DERM dest. MAL lesion face-FAC,218,CDM,761,RC,17280,HCPCS,outpatient,,,224.5,168.38,,202.05,90,,,percent of total billed charges,90% of total billed charges,208.79,93,,,percent of total billed charges,93% of total billed charges,85.31,38,,,percent of total billed charges,38% of total billed charges,85.31,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,85.31,38,,,percent of total billed charges,38% of total billed charges,182.74,81.4,,,percent of total billed charges,81.4% of total billed charges,202.05,90,,,percent of total billed charges,90% of total billed charges,202.05,90,,,percent of total billed charges,90% of total billed charges,85.31,38,,,percent of total billed charges,38% of total billed charges,85.31,38,,,percent of total billed charges,38% of total billed charges,85.31,38,,,percent of total billed charges,38% of total billed charges,168.38,75,,,percent of total billed charges,75% of total billed charges,190.83,85,,,percent of total billed charges,85% of total billed charges,85.31,208.79,
"Derm Destr, mal lesion f, head, .6-1 cm - FAC",219,CDM,761,RC,17281,HCPCS,outpatient,,,657.95,493.46,,592.16,90,,,percent of total billed charges,90% of total billed charges,611.89,93,,,percent of total billed charges,93% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,250.02,38,,,percent of total billed charges,38% of total billed charges,535.57,81.4,,,percent of total billed charges,81.4% of total billed charges,592.16,90,,,percent of total billed charges,90% of total billed charges,592.16,90,,,percent of total billed charges,90% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,493.46,75,,,percent of total billed charges,75% of total billed charges,559.26,85,,,percent of total billed charges,85% of total billed charges,250.02,611.89,
"Derm Destr, mal lesion f, head 2.1-3cm - FAC",220,CDM,761,RC,17283,HCPCS,outpatient,,,657.95,493.46,,592.16,90,,,percent of total billed charges,90% of total billed charges,611.89,93,,,percent of total billed charges,93% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,250.02,38,,,percent of total billed charges,38% of total billed charges,535.57,81.4,,,percent of total billed charges,81.4% of total billed charges,592.16,90,,,percent of total billed charges,90% of total billed charges,592.16,90,,,percent of total billed charges,90% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,250.02,38,,,percent of total billed charges,38% of total billed charges,493.46,75,,,percent of total billed charges,75% of total billed charges,559.26,85,,,percent of total billed charges,85% of total billed charges,250.02,611.89,
Derm Exc tumor soft tissN.T.F<5cm FAC,221,CDM,761,RC,21556,HCPCS,outpatient,,,3621,2715.75,,3258.9,90,,,percent of total billed charges,90% of total billed charges,3367.53,93,,,percent of total billed charges,93% of total billed charges,1375.98,38,,,percent of total billed charges,38% of total billed charges,1375.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,1375.98,38,,,percent of total billed charges,38% of total billed charges,2947.49,81.4,,,percent of total billed charges,81.4% of total billed charges,3258.9,90,,,percent of total billed charges,90% of total billed charges,3258.9,90,,,percent of total billed charges,90% of total billed charges,1375.98,38,,,percent of total billed charges,38% of total billed charges,1375.98,38,,,percent of total billed charges,38% of total billed charges,1375.98,38,,,percent of total billed charges,38% of total billed charges,2715.75,75,,,percent of total billed charges,75% of total billed charges,3077.85,85,,,percent of total billed charges,85% of total billed charges,1375.98,3367.53,
DERM BIOPSY OF LIP - FAC,222,CDM,761,RC,40490,HCPCS,outpatient,,,371.42,278.57,,334.28,90,,,percent of total billed charges,90% of total billed charges,345.42,93,,,percent of total billed charges,93% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,141.14,38,,,percent of total billed charges,38% of total billed charges,302.34,81.4,,,percent of total billed charges,81.4% of total billed charges,334.28,90,,,percent of total billed charges,90% of total billed charges,334.28,90,,,percent of total billed charges,90% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,278.57,75,,,percent of total billed charges,75% of total billed charges,315.71,85,,,percent of total billed charges,85% of total billed charges,141.14,345.42,
DERM UNDER EXCISION AND DESTRUCTION PROCEDURES ON THE VESTIBULE OF MOUTH - FAC,223,CDM,761,RC,40808,HCPCS,outpatient,,,245,183.75,,220.5,90,,,percent of total billed charges,90% of total billed charges,227.85,93,,,percent of total billed charges,93% of total billed charges,93.1,38,,,percent of total billed charges,38% of total billed charges,93.1,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,93.1,38,,,percent of total billed charges,38% of total billed charges,199.43,81.4,,,percent of total billed charges,81.4% of total billed charges,220.5,90,,,percent of total billed charges,90% of total billed charges,220.5,90,,,percent of total billed charges,90% of total billed charges,93.1,38,,,percent of total billed charges,38% of total billed charges,93.1,38,,,percent of total billed charges,38% of total billed charges,93.1,38,,,percent of total billed charges,38% of total billed charges,183.75,75,,,percent of total billed charges,75% of total billed charges,208.25,85,,,percent of total billed charges,85% of total billed charges,93.1,227.85,
Derm cryo dest lesion penile simple global,224,CDM,982,RC,54056,HCPCS,outpatient,,,541.01,405.76,,149.03,130,,,fee schedule,130% of fee schedule,149.03,130,,,fee schedule,130% of fee schedule,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,100% of fee schedule,486.91,90,,,percent of total billed charges,90% of total billed charges,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,114.96,100,,,fee schedule,100% of fee schedule,86.23,486.91,
Derm cryo dest lesion penile simple FAC,225,CDM,761,RC,54056,HCPCS,outpatient,,,312.12,234.09,,280.91,90,,,percent of total billed charges,90% of total billed charges,290.27,93,,,percent of total billed charges,93% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,118.61,38,,,percent of total billed charges,38% of total billed charges,254.07,81.4,,,percent of total billed charges,81.4% of total billed charges,280.91,90,,,percent of total billed charges,90% of total billed charges,280.91,90,,,percent of total billed charges,90% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,234.09,75,,,percent of total billed charges,75% of total billed charges,265.3,85,,,percent of total billed charges,85% of total billed charges,118.61,290.27,
Derm cryo dest lesion penile simple PRO,226,CDM,982,RC,54056,HCPCS,outpatient,,,228.89,171.67,,149.03,130,,,fee schedule,130% of fee schedule,149.03,130,,,fee schedule,130% of fee schedule,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,100% of fee schedule,206,90,,,percent of total billed charges,90% of total billed charges,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,114.96,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,114.96,100,,,fee schedule,100% of fee schedule,86.23,206,
DERM INCISE BIOPSY EYELID - FAC,227,CDM,761,RC,67810,HCPCS,outpatient,,,265.3,198.98,,238.77,90,,,percent of total billed charges,90% of total billed charges,246.73,93,,,percent of total billed charges,93% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,100.81,38,,,percent of total billed charges,38% of total billed charges,215.95,81.4,,,percent of total billed charges,81.4% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,100.81,38,,,percent of total billed charges,38% of total billed charges,198.98,75,,,percent of total billed charges,75% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,100.81,246.73,
"DERM BIOPSY, EAR EXTERNAL - FAC",228,CDM,761,RC,69100,HCPCS,outpatient,,,530.6,397.95,,477.54,90,,,percent of total billed charges,90% of total billed charges,493.46,93,,,percent of total billed charges,93% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,201.63,38,,,percent of total billed charges,38% of total billed charges,431.91,81.4,,,percent of total billed charges,81.4% of total billed charges,477.54,90,,,percent of total billed charges,90% of total billed charges,477.54,90,,,percent of total billed charges,90% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,201.63,38,,,percent of total billed charges,38% of total billed charges,397.95,75,,,percent of total billed charges,75% of total billed charges,451.01,85,,,percent of total billed charges,85% of total billed charges,201.63,493.46,
DERM OFFICE VISIT NEW BRIEF - FAC,229,CDM,761,RC,99202,HCPCS,outpatient,,,48.82,36.62,,43.94,90,,,percent of total billed charges,90% of total billed charges,45.4,93,,,percent of total billed charges,93% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.55,38,,,percent of total billed charges,38% of total billed charges,39.74,81.4,,,percent of total billed charges,81.4% of total billed charges,43.94,90,,,percent of total billed charges,90% of total billed charges,43.94,90,,,percent of total billed charges,90% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,36.62,75,,,percent of total billed charges,75% of total billed charges,41.5,85,,,percent of total billed charges,85% of total billed charges,18.55,45.4,
DERM OFFICE VISIT NEW INT - FAC,230,CDM,761,RC,99203,HCPCS,outpatient,,,94.45,70.84,,85.01,90,,,percent of total billed charges,90% of total billed charges,87.84,93,,,percent of total billed charges,93% of total billed charges,35.89,38,,,percent of total billed charges,38% of total billed charges,35.89,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,35.89,38,,,percent of total billed charges,38% of total billed charges,76.88,81.4,,,percent of total billed charges,81.4% of total billed charges,85.01,90,,,percent of total billed charges,90% of total billed charges,85.01,90,,,percent of total billed charges,90% of total billed charges,35.89,38,,,percent of total billed charges,38% of total billed charges,35.89,38,,,percent of total billed charges,38% of total billed charges,35.89,38,,,percent of total billed charges,38% of total billed charges,70.84,75,,,percent of total billed charges,75% of total billed charges,80.28,85,,,percent of total billed charges,85% of total billed charges,35.89,87.84,
DERM OFFICE VISIT NEW EXT - FAC,231,CDM,761,RC,99204,HCPCS,outpatient,,,286.53,214.9,,257.88,90,,,percent of total billed charges,90% of total billed charges,266.47,93,,,percent of total billed charges,93% of total billed charges,108.88,38,,,percent of total billed charges,38% of total billed charges,108.88,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,108.88,38,,,percent of total billed charges,38% of total billed charges,233.24,81.4,,,percent of total billed charges,81.4% of total billed charges,257.88,90,,,percent of total billed charges,90% of total billed charges,257.88,90,,,percent of total billed charges,90% of total billed charges,108.88,38,,,percent of total billed charges,38% of total billed charges,108.88,38,,,percent of total billed charges,38% of total billed charges,108.88,38,,,percent of total billed charges,38% of total billed charges,214.9,75,,,percent of total billed charges,75% of total billed charges,243.55,85,,,percent of total billed charges,85% of total billed charges,108.88,266.47,
DERM Wound New Ext+-FAC,232,CDM,761,RC,99205,HCPCS,outpatient,,,153.5,115.13,,138.15,90,,,percent of total billed charges,90% of total billed charges,142.76,93,,,percent of total billed charges,93% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,58.33,38,,,percent of total billed charges,38% of total billed charges,124.95,81.4,,,percent of total billed charges,81.4% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,115.13,75,,,percent of total billed charges,75% of total billed charges,130.48,85,,,percent of total billed charges,85% of total billed charges,58.33,142.76,
DERM OFFICE VISIT EST BRIEF - FAC,233,CDM,761,RC,99212,HCPCS,outpatient,,,39.26,29.45,,35.33,90,,,percent of total billed charges,90% of total billed charges,36.51,93,,,percent of total billed charges,93% of total billed charges,14.92,38,,,percent of total billed charges,38% of total billed charges,14.92,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,14.92,38,,,percent of total billed charges,38% of total billed charges,31.96,81.4,,,percent of total billed charges,81.4% of total billed charges,35.33,90,,,percent of total billed charges,90% of total billed charges,35.33,90,,,percent of total billed charges,90% of total billed charges,14.92,38,,,percent of total billed charges,38% of total billed charges,14.92,38,,,percent of total billed charges,38% of total billed charges,14.92,38,,,percent of total billed charges,38% of total billed charges,29.45,75,,,percent of total billed charges,75% of total billed charges,33.37,85,,,percent of total billed charges,85% of total billed charges,14.92,36.51,
DERM OFFICE VISIT EST INT - FAC,234,CDM,761,RC,99213,HCPCS,outpatient,,,48.82,36.62,,43.94,90,,,percent of total billed charges,90% of total billed charges,45.4,93,,,percent of total billed charges,93% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.55,38,,,percent of total billed charges,38% of total billed charges,39.74,81.4,,,percent of total billed charges,81.4% of total billed charges,43.94,90,,,percent of total billed charges,90% of total billed charges,43.94,90,,,percent of total billed charges,90% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,18.55,38,,,percent of total billed charges,38% of total billed charges,36.62,75,,,percent of total billed charges,75% of total billed charges,41.5,85,,,percent of total billed charges,85% of total billed charges,18.55,45.4,
DERM OFFICE VISIT EST EXT - FAC,235,CDM,761,RC,99214,HCPCS,outpatient,,,77.47,58.1,,69.72,90,,,percent of total billed charges,90% of total billed charges,72.05,93,,,percent of total billed charges,93% of total billed charges,29.44,38,,,percent of total billed charges,38% of total billed charges,29.44,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,29.44,38,,,percent of total billed charges,38% of total billed charges,63.06,81.4,,,percent of total billed charges,81.4% of total billed charges,69.72,90,,,percent of total billed charges,90% of total billed charges,69.72,90,,,percent of total billed charges,90% of total billed charges,29.44,38,,,percent of total billed charges,38% of total billed charges,29.44,38,,,percent of total billed charges,38% of total billed charges,29.44,38,,,percent of total billed charges,38% of total billed charges,58.1,75,,,percent of total billed charges,75% of total billed charges,65.85,85,,,percent of total billed charges,85% of total billed charges,29.44,72.05,
DERM OFFICE VISIT EXT + EST - FAC,236,CDM,761,RC,99215,HCPCS,outpatient,,,117.79,88.34,,106.01,90,,,percent of total billed charges,90% of total billed charges,109.54,93,,,percent of total billed charges,93% of total billed charges,44.76,38,,,percent of total billed charges,38% of total billed charges,44.76,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,44.76,38,,,percent of total billed charges,38% of total billed charges,95.88,81.4,,,percent of total billed charges,81.4% of total billed charges,106.01,90,,,percent of total billed charges,90% of total billed charges,106.01,90,,,percent of total billed charges,90% of total billed charges,44.76,38,,,percent of total billed charges,38% of total billed charges,44.76,38,,,percent of total billed charges,38% of total billed charges,44.76,38,,,percent of total billed charges,38% of total billed charges,88.34,75,,,percent of total billed charges,75% of total billed charges,100.12,85,,,percent of total billed charges,85% of total billed charges,44.76,109.54,
Cosmetic lesion removal up to 14,237,CDM,982,RC,,,outpatient,,,196.32,147.24,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,176.69,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,176.69,176.69,
Nutrition Consult - Physician,249,CDM,942,RC,97802,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
BeneProtein,250,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
ENSURE,251,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
FX Scaphoid (Navicular) closed-Pro,253,CDM,981,RC,25622,HCPCS,outpatient,,,563.07,422.3,,358.92,130,,,fee schedule,130% of fee schedule,358.92,130,,,fee schedule,130% of fee schedule,303.25,100,,,fee schedule,Pays 100% Medicare OPPS,303.25,100,,,fee schedule,Pays 100% Medicare OPPS,351.19,119,,,fee schedule,119% of fee schedule,303.25,100,,,fee schedule,Pays 100% Medicare OPPS,303.25,100,,,fee schedule,100% of fee schedule,506.76,90,,,percent of total billed charges,90% of total billed charges,303.25,100,,,fee schedule,Pays 100% Medicare OPPS,303.25,100,,,fee schedule,Pays 100% Medicare OPPS,303.25,100,,,fee schedule,Pays 100% Medicare OPPS,303.25,100,,,fee schedule,Pays 100% Medicare OPPS,251.51,100,,,fee schedule,100% of fee schedule,303.25,100,,,fee schedule,100% of fee schedule,251.51,506.76,
*EKG Facility Charge,254,CDM,730,RC,93005,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
*EKG Facility Charge,255,CDM,730,RC,93005,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
EKG- [Package],256,CDM,730,RC,93005,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
STRESS TEST/TREADMILL - facility,257,CDM,482,RC,93017,HCPCS,outpatient,,,473.4,355.05,,426.06,90,,,percent of total billed charges,90% of total billed charges,440.26,93,,,percent of total billed charges,93% of total billed charges,179.89,38,,,percent of total billed charges,38% of total billed charges,179.89,38,,,percent of total billed charges,38% of total billed charges,402.39,85,,,percent of total billed charges,85% of total billed charges,179.89,38,,,percent of total billed charges,38% of total billed charges,385.35,81.4,,,percent of total billed charges,81.4% of total billed charges,426.06,90,,,percent of total billed charges,90% of total billed charges,426.06,90,,,percent of total billed charges,90% of total billed charges,179.89,38,,,percent of total billed charges,38% of total billed charges,179.89,38,,,percent of total billed charges,38% of total billed charges,179.89,38,,,percent of total billed charges,38% of total billed charges,355.05,75,,,percent of total billed charges,75% of total billed charges,402.39,85,,,percent of total billed charges,85% of total billed charges,179.89,440.26,
Holter Monitor Hookup,258,CDM,731,RC,93225,HCPCS,outpatient,,,214.42,160.82,,192.98,90,,,percent of total billed charges,90% of total billed charges,199.41,93,,,percent of total billed charges,93% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,182.26,85,,,percent of total billed charges,85% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,174.54,81.4,,,percent of total billed charges,81.4% of total billed charges,192.98,90,,,percent of total billed charges,90% of total billed charges,192.98,90,,,percent of total billed charges,90% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,160.82,75,,,percent of total billed charges,75% of total billed charges,182.26,85,,,percent of total billed charges,85% of total billed charges,81.48,199.41,
EKG 12 hrs after inital ekg[Package,259,CDM,730,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
EKG- Welcome to Medicare - Tech,261,CDM,730,RC,G0405,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
Acne surgery-FAC,262,CDM,450,RC,10040,HCPCS,outpatient,,,91.4,68.55,,82.26,90,,,percent of total billed charges,90% of total billed charges,85,93,,,percent of total billed charges,93% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,77.69,85,,,percent of total billed charges,85% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,74.4,81.4,,,percent of total billed charges,81.4% of total billed charges,82.26,90,,,percent of total billed charges,90% of total billed charges,82.26,90,,,percent of total billed charges,90% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,68.55,75,,,percent of total billed charges,75% of total billed charges,77.69,85,,,percent of total billed charges,85% of total billed charges,34.73,85,
Acne surgery-FAC,263,CDM,450,RC,10040,HCPCS,outpatient,,,91.4,68.55,,82.26,90,,,percent of total billed charges,90% of total billed charges,85,93,,,percent of total billed charges,93% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,77.69,85,,,percent of total billed charges,85% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,74.4,81.4,,,percent of total billed charges,81.4% of total billed charges,82.26,90,,,percent of total billed charges,90% of total billed charges,82.26,90,,,percent of total billed charges,90% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,68.55,75,,,percent of total billed charges,75% of total billed charges,77.69,85,,,percent of total billed charges,85% of total billed charges,34.73,85,
I&D Abcess Simple or Single (SQ)-Fac,264,CDM,450,RC,10060,HCPCS,outpatient,,,263.65,197.74,,237.29,90,,,percent of total billed charges,90% of total billed charges,245.19,93,,,percent of total billed charges,93% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,214.61,81.4,,,percent of total billed charges,81.4% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,197.74,75,,,percent of total billed charges,75% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,245.19,
I&D Abcess Simple or Single (SQ)-Fac,265,CDM,450,RC,10060,HCPCS,outpatient,,,263.65,197.74,,237.29,90,,,percent of total billed charges,90% of total billed charges,245.19,93,,,percent of total billed charges,93% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,214.61,81.4,,,percent of total billed charges,81.4% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,197.74,75,,,percent of total billed charges,75% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,245.19,
I&D Abcess Simple or Single (SQ)-Fac,266,CDM,450,RC,10060,HCPCS,outpatient,,,263.65,197.74,,237.29,90,,,percent of total billed charges,90% of total billed charges,245.19,93,,,percent of total billed charges,93% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,214.61,81.4,,,percent of total billed charges,81.4% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,197.74,75,,,percent of total billed charges,75% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,245.19,
I&D multi/complex-Fac,267,CDM,450,RC,10061,HCPCS,outpatient,,,438.24,328.68,,394.42,90,,,percent of total billed charges,90% of total billed charges,407.56,93,,,percent of total billed charges,93% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,372.5,85,,,percent of total billed charges,85% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,356.73,81.4,,,percent of total billed charges,81.4% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,328.68,75,,,percent of total billed charges,75% of total billed charges,372.5,85,,,percent of total billed charges,85% of total billed charges,166.53,407.56,
I&D multi/complex-Fac,268,CDM,450,RC,10061,HCPCS,outpatient,,,438.24,328.68,,394.42,90,,,percent of total billed charges,90% of total billed charges,407.56,93,,,percent of total billed charges,93% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,372.5,85,,,percent of total billed charges,85% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,356.73,81.4,,,percent of total billed charges,81.4% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,328.68,75,,,percent of total billed charges,75% of total billed charges,372.5,85,,,percent of total billed charges,85% of total billed charges,166.53,407.56,
Drain pilonidal cyst-simple fac,269,CDM,450,RC,10080,HCPCS,outpatient,,,371.26,278.45,,334.13,90,,,percent of total billed charges,90% of total billed charges,345.27,93,,,percent of total billed charges,93% of total billed charges,141.08,38,,,percent of total billed charges,38% of total billed charges,141.08,38,,,percent of total billed charges,38% of total billed charges,315.57,85,,,percent of total billed charges,85% of total billed charges,141.08,38,,,percent of total billed charges,38% of total billed charges,302.21,81.4,,,percent of total billed charges,81.4% of total billed charges,334.13,90,,,percent of total billed charges,90% of total billed charges,334.13,90,,,percent of total billed charges,90% of total billed charges,141.08,38,,,percent of total billed charges,38% of total billed charges,141.08,38,,,percent of total billed charges,38% of total billed charges,141.08,38,,,percent of total billed charges,38% of total billed charges,278.45,75,,,percent of total billed charges,75% of total billed charges,315.57,85,,,percent of total billed charges,85% of total billed charges,141.08,345.27,
FB Removal/Incision-Fac,270,CDM,450,RC,10120,HCPCS,outpatient,,,116,87,,104.4,90,,,percent of total billed charges,90% of total billed charges,107.88,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.42,81.4,,,percent of total billed charges,81.4% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87,75,,,percent of total billed charges,75% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,107.88,
FB Removal/Incision-Fac,271,CDM,450,RC,10120,HCPCS,outpatient,,,116,87,,104.4,90,,,percent of total billed charges,90% of total billed charges,107.88,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.42,81.4,,,percent of total billed charges,81.4% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87,75,,,percent of total billed charges,75% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,107.88,
FBR-complicated-Fac,272,CDM,450,RC,10121,HCPCS,outpatient,,,182.8,137.1,,164.52,90,,,percent of total billed charges,90% of total billed charges,170,93,,,percent of total billed charges,93% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,148.8,81.4,,,percent of total billed charges,81.4% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,137.1,75,,,percent of total billed charges,75% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,170,
FBR-complicated-Fac,273,CDM,450,RC,10121,HCPCS,outpatient,,,182.8,137.1,,164.52,90,,,percent of total billed charges,90% of total billed charges,170,93,,,percent of total billed charges,93% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,148.8,81.4,,,percent of total billed charges,81.4% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,137.1,75,,,percent of total billed charges,75% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,170,
I&D hematoma/fluid-Fac,274,CDM,450,RC,10140,HCPCS,outpatient,,,2057.64,1543.23,,1851.88,90,,,percent of total billed charges,90% of total billed charges,1913.61,93,,,percent of total billed charges,93% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,1748.99,85,,,percent of total billed charges,85% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,1674.92,81.4,,,percent of total billed charges,81.4% of total billed charges,1851.88,90,,,percent of total billed charges,90% of total billed charges,1851.88,90,,,percent of total billed charges,90% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,1543.23,75,,,percent of total billed charges,75% of total billed charges,1748.99,85,,,percent of total billed charges,85% of total billed charges,781.9,1913.61,
"Punct. asp. abscess,hematoma,bulla or cyst-FAC",275,CDM,450,RC,10160,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
"Punct. asp. abscess,hematoma,bulla or cyst-FAC",276,CDM,450,RC,10160,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
Debridement - Skin 20 Sq cm or< fac,277,CDM,450,RC,11042,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
Debridement - Skin 20 Sq cm or< fac,278,CDM,450,RC,11042,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
Debridement - Skin 20 Sq cm or< fac,279,CDM,450,RC,11042,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
Debridement - Muscle or fascia <20cm or less-FAC,280,CDM,450,RC,11043,HCPCS,outpatient,,,456.1,342.08,,410.49,90,,,percent of total billed charges,90% of total billed charges,424.17,93,,,percent of total billed charges,93% of total billed charges,173.32,38,,,percent of total billed charges,38% of total billed charges,173.32,38,,,percent of total billed charges,38% of total billed charges,387.69,85,,,percent of total billed charges,85% of total billed charges,173.32,38,,,percent of total billed charges,38% of total billed charges,371.27,81.4,,,percent of total billed charges,81.4% of total billed charges,410.49,90,,,percent of total billed charges,90% of total billed charges,410.49,90,,,percent of total billed charges,90% of total billed charges,173.32,38,,,percent of total billed charges,38% of total billed charges,173.32,38,,,percent of total billed charges,38% of total billed charges,173.32,38,,,percent of total billed charges,38% of total billed charges,342.08,75,,,percent of total billed charges,75% of total billed charges,387.69,85,,,percent of total billed charges,85% of total billed charges,173.32,424.17,
Debridement - Bone <20cm-FAC,281,CDM,450,RC,11044,HCPCS,outpatient,,,1013.54,760.16,,912.19,90,,,percent of total billed charges,90% of total billed charges,942.59,93,,,percent of total billed charges,93% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,861.51,85,,,percent of total billed charges,85% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,825.02,81.4,,,percent of total billed charges,81.4% of total billed charges,912.19,90,,,percent of total billed charges,90% of total billed charges,912.19,90,,,percent of total billed charges,90% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,760.16,75,,,percent of total billed charges,75% of total billed charges,861.51,85,,,percent of total billed charges,85% of total billed charges,385.15,942.59,
Debridement - Bone <20cm-FAC,282,CDM,450,RC,11044,HCPCS,outpatient,,,1013.54,760.16,,912.19,90,,,percent of total billed charges,90% of total billed charges,942.59,93,,,percent of total billed charges,93% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,861.51,85,,,percent of total billed charges,85% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,825.02,81.4,,,percent of total billed charges,81.4% of total billed charges,912.19,90,,,percent of total billed charges,90% of total billed charges,912.19,90,,,percent of total billed charges,90% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,760.16,75,,,percent of total billed charges,75% of total billed charges,861.51,85,,,percent of total billed charges,85% of total billed charges,385.15,942.59,
Debridement skin addtn 20 sq cm-fac,283,CDM,450,RC,11045,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
Debridement - additional 20 cm - muscle-FAC,284,CDM,450,RC,11046,HCPCS,outpatient,,,551.83,413.87,,496.65,90,,,percent of total billed charges,90% of total billed charges,513.2,93,,,percent of total billed charges,93% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,469.06,85,,,percent of total billed charges,85% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,449.19,81.4,,,percent of total billed charges,81.4% of total billed charges,496.65,90,,,percent of total billed charges,90% of total billed charges,496.65,90,,,percent of total billed charges,90% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,413.87,75,,,percent of total billed charges,75% of total billed charges,469.06,85,,,percent of total billed charges,85% of total billed charges,209.7,513.2,
Debridement - additional 20cm - bone-FAC,285,CDM,450,RC,11047,HCPCS,outpatient,,,1520.32,1140.24,,1368.29,90,,,percent of total billed charges,90% of total billed charges,1413.9,93,,,percent of total billed charges,93% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,1292.27,85,,,percent of total billed charges,85% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,1237.54,81.4,,,percent of total billed charges,81.4% of total billed charges,1368.29,90,,,percent of total billed charges,90% of total billed charges,1368.29,90,,,percent of total billed charges,90% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,1140.24,75,,,percent of total billed charges,75% of total billed charges,1292.27,85,,,percent of total billed charges,85% of total billed charges,577.72,1413.9,
Exc. Benign Hyper. Lesion; 2-4-FAC,286,CDM,450,RC,11056,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Exc. Benign Hyper. Lesion; 2-4-FAC,287,CDM,450,RC,11056,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
"Shave-Benign, Skin Tags1-15-FAC",288,CDM,450,RC,11200,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
"Shave-Benign, Skin Tags1-15-FAC",289,CDM,450,RC,11200,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
"Shave Benign(tr,a,l); Diameter 0.6-1.0cm-FAC",290,CDM,450,RC,11301,HCPCS,outpatient,,,71.47,53.6,,64.32,90,,,percent of total billed charges,90% of total billed charges,66.47,93,,,percent of total billed charges,93% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,58.18,81.4,,,percent of total billed charges,81.4% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,53.6,75,,,percent of total billed charges,75% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,66.47,
"Shave Benign(tr,a,l); Diameter 0.6-1.0cm-FAC",291,CDM,450,RC,11301,HCPCS,outpatient,,,71.47,53.6,,64.32,90,,,percent of total billed charges,90% of total billed charges,66.47,93,,,percent of total billed charges,93% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,58.18,81.4,,,percent of total billed charges,81.4% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,53.6,75,,,percent of total billed charges,75% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,66.47,
Skin Rmv.: Shave;1.1-2.0cm-FAC,292,CDM,450,RC,11302,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
Skin Rmv.: Shave;1.1-2.0cm-FAC,293,CDM,450,RC,11302,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
Skin Rmv.: Shave; over 2.0cm-FAC,294,CDM,450,RC,11303,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
Skin Rmv.: Shave; over 2.0cm-FAC,295,CDM,450,RC,11303,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
"Shave Benign(sc,n,ha,fe,g);Lesion .5cm or less-FAC",296,CDM,450,RC,11305,HCPCS,outpatient,,,63.28,47.46,,56.95,90,,,percent of total billed charges,90% of total billed charges,58.85,93,,,percent of total billed charges,93% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,53.79,85,,,percent of total billed charges,85% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,51.51,81.4,,,percent of total billed charges,81.4% of total billed charges,56.95,90,,,percent of total billed charges,90% of total billed charges,56.95,90,,,percent of total billed charges,90% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,47.46,75,,,percent of total billed charges,75% of total billed charges,53.79,85,,,percent of total billed charges,85% of total billed charges,24.05,58.85,
"Shave Benign(sc,n,ha,fe,g);Lesion .5cm or less-FAC",297,CDM,450,RC,11305,HCPCS,outpatient,,,63.28,47.46,,56.95,90,,,percent of total billed charges,90% of total billed charges,58.85,93,,,percent of total billed charges,93% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,53.79,85,,,percent of total billed charges,85% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,51.51,81.4,,,percent of total billed charges,81.4% of total billed charges,56.95,90,,,percent of total billed charges,90% of total billed charges,56.95,90,,,percent of total billed charges,90% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,47.46,75,,,percent of total billed charges,75% of total billed charges,53.79,85,,,percent of total billed charges,85% of total billed charges,24.05,58.85,
"Shave Benign(sc,n,ha,fe,g);Lesion 0.6-1.0cm-FAC",298,CDM,450,RC,11306,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
"Shave Benign(sc,n,ha,fe,g);Lesion 0.6-1.0cm-FAC",299,CDM,450,RC,11306,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
"Shave: Epid/Derm., Nonface; Lesion over 2.0cm-FAC",300,CDM,450,RC,11308,HCPCS,outpatient,,,123.04,92.28,,110.74,90,,,percent of total billed charges,90% of total billed charges,114.43,93,,,percent of total billed charges,93% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,100.15,81.4,,,percent of total billed charges,81.4% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,92.28,75,,,percent of total billed charges,75% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,114.43,
"Shave: Epid/Derm., Nonface; Lesion over 2.0cm-FAC",301,CDM,450,RC,11308,HCPCS,outpatient,,,123.04,92.28,,110.74,90,,,percent of total billed charges,90% of total billed charges,114.43,93,,,percent of total billed charges,93% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,100.15,81.4,,,percent of total billed charges,81.4% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,92.28,75,,,percent of total billed charges,75% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,114.43,
"Shaving,Benign face <0.5cm",302,CDM,510,RC,11310,HCPCS,outpatient,,,290.05,217.54,,261.05,90,,,percent of total billed charges,90% of total billed charges,269.75,93,,,percent of total billed charges,93% of total billed charges,110.22,38,,,percent of total billed charges,38% of total billed charges,110.22,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,110.22,38,,,percent of total billed charges,38% of total billed charges,236.1,81.4,,,percent of total billed charges,81.4% of total billed charges,261.05,90,,,percent of total billed charges,90% of total billed charges,261.05,90,,,percent of total billed charges,90% of total billed charges,110.22,38,,,percent of total billed charges,38% of total billed charges,110.22,38,,,percent of total billed charges,38% of total billed charges,110.22,38,,,percent of total billed charges,38% of total billed charges,217.54,75,,,percent of total billed charges,75% of total billed charges,246.54,85,,,percent of total billed charges,85% of total billed charges,110.22,269.75,
"Shave: Epid/Derm.,Face; 0.6 to 1.0cm-FAC",303,CDM,450,RC,11311,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
"Shave: Epid/Derm.,Face; 0.6 to 1.0cm-FAC",304,CDM,450,RC,11311,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
"Excision Benign(tr,a,l); Lesion 0.5cm/less-FAC",305,CDM,450,RC,11400,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
"Excision Benign(tr,a,l); Lesion 0.5cm/less-FAC",306,CDM,450,RC,11400,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
"Excision Benign(tr,a,l); Lesion .6 to 1.0cm-FAC",307,CDM,450,RC,11401,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
"Excision Benign(tr,a,l); Lesion .6 to 1.0cm-FAC",308,CDM,450,RC,11401,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
"Excision Benign(tr,a,l);1.1 to 2.0cm-FAC",309,CDM,450,RC,11402,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
"Excision Benign(tr,a,l);1.1 to 2.0cm-FAC",310,CDM,450,RC,11402,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
"Excision Benign(tr,a,l);2.1-3.0cm-FAC",311,CDM,450,RC,11403,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,161.27,
"Excision Benign(tr,a,l);2.1-3.0cm-FAC",312,CDM,450,RC,11403,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,161.27,
"Excision Benign(tr,a,l);3.1-4.0cm-FAC",313,CDM,450,RC,11404,HCPCS,outpatient,,,200.38,150.29,,180.34,90,,,percent of total billed charges,90% of total billed charges,186.35,93,,,percent of total billed charges,93% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,170.32,85,,,percent of total billed charges,85% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,163.11,81.4,,,percent of total billed charges,81.4% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,150.29,75,,,percent of total billed charges,75% of total billed charges,170.32,85,,,percent of total billed charges,85% of total billed charges,76.14,186.35,
"Excision Benign(tr,a,l);3.1-4.0cm-FAC",314,CDM,450,RC,11404,HCPCS,outpatient,,,200.38,150.29,,180.34,90,,,percent of total billed charges,90% of total billed charges,186.35,93,,,percent of total billed charges,93% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,170.32,85,,,percent of total billed charges,85% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,163.11,81.4,,,percent of total billed charges,81.4% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,150.29,75,,,percent of total billed charges,75% of total billed charges,170.32,85,,,percent of total billed charges,85% of total billed charges,76.14,186.35,
"Excision Benign(tr,a,l);Over 4.0cm-FAC",315,CDM,450,RC,11406,HCPCS,outpatient,,,274.2,205.65,,246.78,90,,,percent of total billed charges,90% of total billed charges,255.01,93,,,percent of total billed charges,93% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,223.2,81.4,,,percent of total billed charges,81.4% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,205.65,75,,,percent of total billed charges,75% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,104.2,255.01,
"Excision Benign(tr,a,l);Over 4.0cm-FAC",316,CDM,450,RC,11406,HCPCS,outpatient,,,274.2,205.65,,246.78,90,,,percent of total billed charges,90% of total billed charges,255.01,93,,,percent of total billed charges,93% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,223.2,81.4,,,percent of total billed charges,81.4% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,205.65,75,,,percent of total billed charges,75% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,104.2,255.01,
"Excis Benign(sc,n,ha,fe,g);0.5cm or <-FAC",317,CDM,450,RC,11420,HCPCS,outpatient,,,79.68,59.76,,71.71,90,,,percent of total billed charges,90% of total billed charges,74.1,93,,,percent of total billed charges,93% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,67.73,85,,,percent of total billed charges,85% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,64.86,81.4,,,percent of total billed charges,81.4% of total billed charges,71.71,90,,,percent of total billed charges,90% of total billed charges,71.71,90,,,percent of total billed charges,90% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,59.76,75,,,percent of total billed charges,75% of total billed charges,67.73,85,,,percent of total billed charges,85% of total billed charges,30.28,74.1,
"Excis Benign(sc,n,ha,fe,g); 0.6 to 1.0cm-FAC",318,CDM,450,RC,11421,HCPCS,outpatient,,,135.92,101.94,,122.33,90,,,percent of total billed charges,90% of total billed charges,126.41,93,,,percent of total billed charges,93% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,115.53,85,,,percent of total billed charges,85% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,110.64,81.4,,,percent of total billed charges,81.4% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,101.94,75,,,percent of total billed charges,75% of total billed charges,115.53,85,,,percent of total billed charges,85% of total billed charges,51.65,126.41,
"Excis Benign(sc,n,ha,fe,g); 0.6 to 1.0cm-FAC",319,CDM,450,RC,11421,HCPCS,outpatient,,,135.92,101.94,,122.33,90,,,percent of total billed charges,90% of total billed charges,126.41,93,,,percent of total billed charges,93% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,115.53,85,,,percent of total billed charges,85% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,110.64,81.4,,,percent of total billed charges,81.4% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,101.94,75,,,percent of total billed charges,75% of total billed charges,115.53,85,,,percent of total billed charges,85% of total billed charges,51.65,126.41,
"Excis Benign(sc,n,ha,fe,g);2.1 to 3.0cm-FAC",320,CDM,450,RC,11423,HCPCS,outpatient,,,192.17,144.13,,172.95,90,,,percent of total billed charges,90% of total billed charges,178.72,93,,,percent of total billed charges,93% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,156.43,81.4,,,percent of total billed charges,81.4% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,144.13,75,,,percent of total billed charges,75% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,178.72,
"Excis Benign(sc,n,ha,fe,g);2.1 to 3.0cm-FAC",321,CDM,450,RC,11423,HCPCS,outpatient,,,192.17,144.13,,172.95,90,,,percent of total billed charges,90% of total billed charges,178.72,93,,,percent of total billed charges,93% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,156.43,81.4,,,percent of total billed charges,81.4% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,144.13,75,,,percent of total billed charges,75% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,178.72,
Excis Benign Face;0.5cm or <-FAC,322,CDM,450,RC,11440,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
Excis Benign Face;0.5cm or <-FAC,323,CDM,450,RC,11440,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
Excis Benign(Face);0.6-1.0cm-FAC,324,CDM,450,RC,11441,HCPCS,outpatient,,,123.04,92.28,,110.74,90,,,percent of total billed charges,90% of total billed charges,114.43,93,,,percent of total billed charges,93% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,100.15,81.4,,,percent of total billed charges,81.4% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,92.28,75,,,percent of total billed charges,75% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,114.43,
Excis Benign(Face);0.6-1.0cm-FAC,325,CDM,450,RC,11441,HCPCS,outpatient,,,123.04,92.28,,110.74,90,,,percent of total billed charges,90% of total billed charges,114.43,93,,,percent of total billed charges,93% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,100.15,81.4,,,percent of total billed charges,81.4% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,92.28,75,,,percent of total billed charges,75% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,114.43,
Excis Benign(Face);1.1-2.0cm-FAC,326,CDM,450,RC,11442,HCPCS,outpatient,,,134.75,101.06,,121.28,90,,,percent of total billed charges,90% of total billed charges,125.32,93,,,percent of total billed charges,93% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,109.69,81.4,,,percent of total billed charges,81.4% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,101.06,75,,,percent of total billed charges,75% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,125.32,
Excis Benign(Face);1.1-2.0cm-FAC,327,CDM,450,RC,11442,HCPCS,outpatient,,,134.75,101.06,,121.28,90,,,percent of total billed charges,90% of total billed charges,125.32,93,,,percent of total billed charges,93% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,109.69,81.4,,,percent of total billed charges,81.4% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,101.06,75,,,percent of total billed charges,75% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,125.32,
"Exc,Skin,Mal-(tr,a,l);0.6-1.0cm-FAC",328,CDM,450,RC,11601,HCPCS,outpatient,,,133.59,100.19,,120.23,90,,,percent of total billed charges,90% of total billed charges,124.24,93,,,percent of total billed charges,93% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,113.55,85,,,percent of total billed charges,85% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,108.74,81.4,,,percent of total billed charges,81.4% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,100.19,75,,,percent of total billed charges,75% of total billed charges,113.55,85,,,percent of total billed charges,85% of total billed charges,50.76,124.24,
"Exc,Skin,Mal-(tr,a,l);0.6-1.0cm-FAC",329,CDM,450,RC,11601,HCPCS,outpatient,,,133.59,100.19,,120.23,90,,,percent of total billed charges,90% of total billed charges,124.24,93,,,percent of total billed charges,93% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,113.55,85,,,percent of total billed charges,85% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,108.74,81.4,,,percent of total billed charges,81.4% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,100.19,75,,,percent of total billed charges,75% of total billed charges,113.55,85,,,percent of total billed charges,85% of total billed charges,50.76,124.24,
"Exc,Skin,Mal-(tr,a,l);1.1-2.0cm-FAC",330,CDM,450,RC,11602,HCPCS,outpatient,,,157.01,117.76,,141.31,90,,,percent of total billed charges,90% of total billed charges,146.02,93,,,percent of total billed charges,93% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,133.46,85,,,percent of total billed charges,85% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,127.81,81.4,,,percent of total billed charges,81.4% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,117.76,75,,,percent of total billed charges,75% of total billed charges,133.46,85,,,percent of total billed charges,85% of total billed charges,59.66,146.02,
"Exc,Skin,Mal-(tr,a,l);1.1-2.0cm-FAC",331,CDM,450,RC,11602,HCPCS,outpatient,,,157.01,117.76,,141.31,90,,,percent of total billed charges,90% of total billed charges,146.02,93,,,percent of total billed charges,93% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,133.46,85,,,percent of total billed charges,85% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,127.81,81.4,,,percent of total billed charges,81.4% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,117.76,75,,,percent of total billed charges,75% of total billed charges,133.46,85,,,percent of total billed charges,85% of total billed charges,59.66,146.02,
"Excision,Mal(tr,a,l);2.1-3.0cm-FAC",332,CDM,450,RC,11603,HCPCS,outpatient,,,868.28,651.21,,781.45,90,,,percent of total billed charges,90% of total billed charges,807.5,93,,,percent of total billed charges,93% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,738.04,85,,,percent of total billed charges,85% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,706.78,81.4,,,percent of total billed charges,81.4% of total billed charges,781.45,90,,,percent of total billed charges,90% of total billed charges,781.45,90,,,percent of total billed charges,90% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,651.21,75,,,percent of total billed charges,75% of total billed charges,738.04,85,,,percent of total billed charges,85% of total billed charges,329.95,807.5,
"Excision,Mal(tr,a,l);2.1-3.0cm-FAC",333,CDM,450,RC,11603,HCPCS,outpatient,,,868.28,651.21,,781.45,90,,,percent of total billed charges,90% of total billed charges,807.5,93,,,percent of total billed charges,93% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,738.04,85,,,percent of total billed charges,85% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,706.78,81.4,,,percent of total billed charges,81.4% of total billed charges,781.45,90,,,percent of total billed charges,90% of total billed charges,781.45,90,,,percent of total billed charges,90% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,651.21,75,,,percent of total billed charges,75% of total billed charges,738.04,85,,,percent of total billed charges,85% of total billed charges,329.95,807.5,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen)0.5cm/less-FAC",334,CDM,450,RC,11620,HCPCS,outpatient,,,183.98,137.99,,165.58,90,,,percent of total billed charges,90% of total billed charges,171.1,93,,,percent of total billed charges,93% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,156.38,85,,,percent of total billed charges,85% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,149.76,81.4,,,percent of total billed charges,81.4% of total billed charges,165.58,90,,,percent of total billed charges,90% of total billed charges,165.58,90,,,percent of total billed charges,90% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,137.99,75,,,percent of total billed charges,75% of total billed charges,156.38,85,,,percent of total billed charges,85% of total billed charges,69.91,171.1,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen)0.5cm/less-FAC",335,CDM,450,RC,11620,HCPCS,outpatient,,,183.98,137.99,,165.58,90,,,percent of total billed charges,90% of total billed charges,171.1,93,,,percent of total billed charges,93% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,156.38,85,,,percent of total billed charges,85% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,149.76,81.4,,,percent of total billed charges,81.4% of total billed charges,165.58,90,,,percent of total billed charges,90% of total billed charges,165.58,90,,,percent of total billed charges,90% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,137.99,75,,,percent of total billed charges,75% of total billed charges,156.38,85,,,percent of total billed charges,85% of total billed charges,69.91,171.1,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen);0.6-1.0cm-FAC",336,CDM,450,RC,11622,HCPCS,outpatient,,,212.1,159.08,,190.89,90,,,percent of total billed charges,90% of total billed charges,197.25,93,,,percent of total billed charges,93% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,172.65,81.4,,,percent of total billed charges,81.4% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,159.08,75,,,percent of total billed charges,75% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,80.6,197.25,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen);0.6-1.0cm-FAC",337,CDM,450,RC,11622,HCPCS,outpatient,,,212.1,159.08,,190.89,90,,,percent of total billed charges,90% of total billed charges,197.25,93,,,percent of total billed charges,93% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,172.65,81.4,,,percent of total billed charges,81.4% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,159.08,75,,,percent of total billed charges,75% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,80.6,197.25,
"Excision, Mal(sc,n,ha,fe,g);< 4.0cm-FAC",338,CDM,981,RC,11626,HCPCS,outpatient,,,278.88,209.16,,362.54,130,,,fee schedule,130% of fee schedule,362.54,130,,,fee schedule,130% of fee schedule,278.88,100,,,fee schedule,Pays 100% Medicare OPPS,278.88,100,,,fee schedule,Pays 100% Medicare OPPS,331.87,119,,,fee schedule,119% of fee schedule,278.88,100,,,fee schedule,Pays 100% Medicare OPPS,278.88,100,,,fee schedule,100% of fee schedule,250.99,90,,,percent of total billed charges,90% of total billed charges,278.88,100,,,fee schedule,Pays 100% Medicare OPPS,278.88,100,,,fee schedule,Pays 100% Medicare OPPS,278.88,100,,,fee schedule,Pays 100% Medicare OPPS,278.88,100,,,fee schedule,Pays 100% Medicare OPPS,503.02,100,,,fee schedule,100% of fee schedule,278.88,100,,,fee schedule,100% of fee schedule,250.99,503.02,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.6-1.0cm-FAC",339,CDM,450,RC,11641,HCPCS,outpatient,,,147.63,110.72,,132.87,90,,,percent of total billed charges,90% of total billed charges,137.3,93,,,percent of total billed charges,93% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,125.49,85,,,percent of total billed charges,85% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,120.17,81.4,,,percent of total billed charges,81.4% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,110.72,75,,,percent of total billed charges,75% of total billed charges,125.49,85,,,percent of total billed charges,85% of total billed charges,56.1,137.3,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.6-1.0cm-FAC",340,CDM,450,RC,11641,HCPCS,outpatient,,,147.63,110.72,,132.87,90,,,percent of total billed charges,90% of total billed charges,137.3,93,,,percent of total billed charges,93% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,125.49,85,,,percent of total billed charges,85% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,120.17,81.4,,,percent of total billed charges,81.4% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,110.72,75,,,percent of total billed charges,75% of total billed charges,125.49,85,,,percent of total billed charges,85% of total billed charges,56.1,137.3,
"Excis, Mal Lesion(sc,n,ha,fe,g);1.1-2.0cm-FAC",341,CDM,450,RC,11642,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,161.27,
"Excis, Mal Lesion(sc,n,ha,fe,g);1.1-2.0cm-FAC",342,CDM,450,RC,11642,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,161.27,
"Excis, Mal Lesion(sc,n,ha,fe,g);2.1-3.0cm-FAC",343,CDM,450,RC,11643,HCPCS,outpatient,,,341.01,255.76,,306.91,90,,,percent of total billed charges,90% of total billed charges,317.14,93,,,percent of total billed charges,93% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,289.86,85,,,percent of total billed charges,85% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,277.58,81.4,,,percent of total billed charges,81.4% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,255.76,75,,,percent of total billed charges,75% of total billed charges,289.86,85,,,percent of total billed charges,85% of total billed charges,129.58,317.14,
"Excis, Mal Lesion(sc,n,ha,fe,g);2.1-3.0cm-FAC",344,CDM,450,RC,11643,HCPCS,outpatient,,,341.01,255.76,,306.91,90,,,percent of total billed charges,90% of total billed charges,317.14,93,,,percent of total billed charges,93% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,289.86,85,,,percent of total billed charges,85% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,277.58,81.4,,,percent of total billed charges,81.4% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,255.76,75,,,percent of total billed charges,75% of total billed charges,289.86,85,,,percent of total billed charges,85% of total billed charges,129.58,317.14,
"Excis, Mal Lesion(sc,n,ha,fe,g);Over 4.0 cm-FAC",345,CDM,450,RC,11646,HCPCS,outpatient,,,381.99,286.49,,343.79,90,,,percent of total billed charges,90% of total billed charges,355.25,93,,,percent of total billed charges,93% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,310.94,81.4,,,percent of total billed charges,81.4% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,286.49,75,,,percent of total billed charges,75% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,355.25,
"Excis, Mal Lesion(sc,n,ha,fe,g);Over 4.0 cm-FAC",346,CDM,450,RC,11646,HCPCS,outpatient,,,381.99,286.49,,343.79,90,,,percent of total billed charges,90% of total billed charges,355.25,93,,,percent of total billed charges,93% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,310.94,81.4,,,percent of total billed charges,81.4% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,286.49,75,,,percent of total billed charges,75% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,355.25,
Debrid. of Nail(s) Any Method(s); 1-5-FAC,347,CDM,450,RC,11720,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Debrid. of Nail(s) Any Method(s); 1-5-FAC,348,CDM,450,RC,11720,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Debrid. of Nail;Trim. Nondys.;6 or <-FAC,349,CDM,450,RC,11721,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Debrid. of Nail;Trim. Nondys.;6 or <-FAC,350,CDM,450,RC,11721,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Debridement of Nail; Nail Plate-FAC,351,CDM,450,RC,11730,HCPCS,outpatient,,,57.41,43.06,,51.67,90,,,percent of total billed charges,90% of total billed charges,53.39,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.73,81.4,,,percent of total billed charges,81.4% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.06,75,,,percent of total billed charges,75% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,53.39,
Debridement of Nail; Nail Plate-FAC,352,CDM,450,RC,11730,HCPCS,outpatient,,,57.41,43.06,,51.67,90,,,percent of total billed charges,90% of total billed charges,53.39,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.73,81.4,,,percent of total billed charges,81.4% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.06,75,,,percent of total billed charges,75% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,53.39,
Debridement of Nail Plate ea add-FAC,353,CDM,450,RC,11732,HCPCS,outpatient,,,22.52,16.89,,20.27,90,,,percent of total billed charges,90% of total billed charges,20.94,93,,,percent of total billed charges,93% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,19.14,85,,,percent of total billed charges,85% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,18.33,81.4,,,percent of total billed charges,81.4% of total billed charges,20.27,90,,,percent of total billed charges,90% of total billed charges,20.27,90,,,percent of total billed charges,90% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,16.89,75,,,percent of total billed charges,75% of total billed charges,19.14,85,,,percent of total billed charges,85% of total billed charges,8.56,20.94,
Debrid. of Nail;Evac.;Sub.Hematoma-FAC,354,CDM,450,RC,11740,HCPCS,outpatient,,,30.46,22.85,,27.41,90,,,percent of total billed charges,90% of total billed charges,28.33,93,,,percent of total billed charges,93% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,24.79,81.4,,,percent of total billed charges,81.4% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,22.85,75,,,percent of total billed charges,75% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,28.33,
Debrid. of Nail;Evac.;Sub.Hematoma-FAC,355,CDM,450,RC,11740,HCPCS,outpatient,,,30.46,22.85,,27.41,90,,,percent of total billed charges,90% of total billed charges,28.33,93,,,percent of total billed charges,93% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,24.79,81.4,,,percent of total billed charges,81.4% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,22.85,75,,,percent of total billed charges,75% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,28.33,
"Excision:Nail/Matrix, Part/Comp.Rmv.-FAC",356,CDM,450,RC,11750,HCPCS,outpatient,,,168.74,126.56,,151.87,90,,,percent of total billed charges,90% of total billed charges,156.93,93,,,percent of total billed charges,93% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,143.43,85,,,percent of total billed charges,85% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,137.35,81.4,,,percent of total billed charges,81.4% of total billed charges,151.87,90,,,percent of total billed charges,90% of total billed charges,151.87,90,,,percent of total billed charges,90% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,126.56,75,,,percent of total billed charges,75% of total billed charges,143.43,85,,,percent of total billed charges,85% of total billed charges,64.12,156.93,
"Excision:Nail/Matrix, Part/Comp.Rmv.-FAC",357,CDM,450,RC,11750,HCPCS,outpatient,,,168.74,126.56,,151.87,90,,,percent of total billed charges,90% of total billed charges,156.93,93,,,percent of total billed charges,93% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,143.43,85,,,percent of total billed charges,85% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,137.35,81.4,,,percent of total billed charges,81.4% of total billed charges,151.87,90,,,percent of total billed charges,90% of total billed charges,151.87,90,,,percent of total billed charges,90% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,126.56,75,,,percent of total billed charges,75% of total billed charges,143.43,85,,,percent of total billed charges,85% of total billed charges,64.12,156.93,
Repair of Nail Bed-FAC,358,CDM,450,RC,11760,HCPCS,outpatient,,,1099.13,824.35,,989.22,90,,,percent of total billed charges,90% of total billed charges,1022.19,93,,,percent of total billed charges,93% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,934.26,85,,,percent of total billed charges,85% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,894.69,81.4,,,percent of total billed charges,81.4% of total billed charges,989.22,90,,,percent of total billed charges,90% of total billed charges,989.22,90,,,percent of total billed charges,90% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,824.35,75,,,percent of total billed charges,75% of total billed charges,934.26,85,,,percent of total billed charges,85% of total billed charges,417.67,1022.19,
Debrid. Nail;Wedge Exc.of Skin;Fold-FAC,359,CDM,450,RC,11765,HCPCS,outpatient,,,66.79,50.09,,60.11,90,,,percent of total billed charges,90% of total billed charges,62.11,93,,,percent of total billed charges,93% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,54.37,81.4,,,percent of total billed charges,81.4% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,50.09,75,,,percent of total billed charges,75% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,62.11,
Debrid. Nail;Wedge Exc.of Skin;Fold-FAC,360,CDM,450,RC,11765,HCPCS,outpatient,,,66.79,50.09,,60.11,90,,,percent of total billed charges,90% of total billed charges,62.11,93,,,percent of total billed charges,93% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,54.37,81.4,,,percent of total billed charges,81.4% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,50.09,75,,,percent of total billed charges,75% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,62.11,
Treatment of Lesions; Inj.up to 7 Lesions-FAC,361,CDM,450,RC,11900,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Treatment of Lesions; Inj.up to 7 Lesions-FAC,362,CDM,450,RC,11900,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Removal Contraceptive-FAC,363,CDM,450,RC,11976,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Removal Contraceptive-FAC,364,CDM,450,RC,11976,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Lac Repair FAC Supf Nonface less than 2.5 cm,365,CDM,450,RC,12001,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair FAC Supf Nonface less than 2.5 cm,366,CDM,450,RC,12001,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Supf.Nonface;2.6-7.5 cm,367,CDM,450,RC,12002,HCPCS,outpatient,,,144.13,108.1,,129.72,90,,,percent of total billed charges,90% of total billed charges,134.04,93,,,percent of total billed charges,93% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,122.51,85,,,percent of total billed charges,85% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,117.32,81.4,,,percent of total billed charges,81.4% of total billed charges,129.72,90,,,percent of total billed charges,90% of total billed charges,129.72,90,,,percent of total billed charges,90% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,108.1,75,,,percent of total billed charges,75% of total billed charges,122.51,85,,,percent of total billed charges,85% of total billed charges,54.77,134.04,
Lac Repair-FAC Supf.Nonface;2.6-7.5 cm,368,CDM,450,RC,12002,HCPCS,outpatient,,,144.13,108.1,,129.72,90,,,percent of total billed charges,90% of total billed charges,134.04,93,,,percent of total billed charges,93% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,122.51,85,,,percent of total billed charges,85% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,117.32,81.4,,,percent of total billed charges,81.4% of total billed charges,129.72,90,,,percent of total billed charges,90% of total billed charges,129.72,90,,,percent of total billed charges,90% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,108.1,75,,,percent of total billed charges,75% of total billed charges,122.51,85,,,percent of total billed charges,85% of total billed charges,54.77,134.04,
Lac Repair-FAC Supf. Nonface;7.6-12.5cm,369,CDM,450,RC,12004,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Supf.Nonface;12.6-20cm,370,CDM,450,RC,12005,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Supf.Nonface;12.6-20cm,371,CDM,450,RC,12005,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Supf.Nonface; 20.1-30.0cm,372,CDM,450,RC,12006,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Supf.Nonface; 20.1-30.0cm,373,CDM,450,RC,12006,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
"Suture-Sup.wounds(sc,n,ax,EG,tr,fe,ha); Over 30.0cm-FAC",374,CDM,450,RC,12007,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
"Suture-Sup.wounds(sc,n,ax,EG,tr,fe,ha); Over 30.0cm-FAC",375,CDM,450,RC,12007,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair Supf. Face/Head FAC; <2.5 cm,376,CDM,450,RC,12011,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair Supf. Face/Head FAC; <2.5 cm,377,CDM,450,RC,12011,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair Supf. Face/Head FAC ; 2.6-5.0cm,378,CDM,450,RC,12013,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,150.39,
Lac Repair Supf. Face/Head FAC ; 2.6-5.0cm,379,CDM,450,RC,12013,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,150.39,
Lac Repair Supf. Face/Head FAC;5.1-7.5cm,380,CDM,450,RC,12014,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair Supf. Face/Head FAC;5.1-7.5cm,381,CDM,450,RC,12014,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair Supf. Face/Head FAC;7.6-12.5cm,382,CDM,450,RC,12015,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair Supf. Face/Head FAC;7.6-12.5cm,383,CDM,450,RC,12015,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
"Suture-Sup.wound(simple,fa,ea,ey,no,li,mm);12.6-20cm-FAC",384,CDM,450,RC,12016,HCPCS,outpatient,,,699.34,524.51,,629.41,90,,,percent of total billed charges,90% of total billed charges,650.39,93,,,percent of total billed charges,93% of total billed charges,265.75,38,,,percent of total billed charges,38% of total billed charges,265.75,38,,,percent of total billed charges,38% of total billed charges,594.44,85,,,percent of total billed charges,85% of total billed charges,265.75,38,,,percent of total billed charges,38% of total billed charges,569.26,81.4,,,percent of total billed charges,81.4% of total billed charges,629.41,90,,,percent of total billed charges,90% of total billed charges,629.41,90,,,percent of total billed charges,90% of total billed charges,265.75,38,,,percent of total billed charges,38% of total billed charges,265.75,38,,,percent of total billed charges,38% of total billed charges,265.75,38,,,percent of total billed charges,38% of total billed charges,524.51,75,,,percent of total billed charges,75% of total billed charges,594.44,85,,,percent of total billed charges,85% of total billed charges,265.75,650.39,
Lac Repair Supf Head/Face FAC;20.1-30.0cm,385,CDM,450,RC,12017,HCPCS,outpatient,,,257.79,193.34,,232.01,90,,,percent of total billed charges,90% of total billed charges,239.74,93,,,percent of total billed charges,93% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,209.84,81.4,,,percent of total billed charges,81.4% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,193.34,75,,,percent of total billed charges,75% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,239.74,
Lac Repair Supf Head/Face FAC;20.1-30.0cm,386,CDM,450,RC,12017,HCPCS,outpatient,,,257.79,193.34,,232.01,90,,,percent of total billed charges,90% of total billed charges,239.74,93,,,percent of total billed charges,93% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,209.84,81.4,,,percent of total billed charges,81.4% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,193.34,75,,,percent of total billed charges,75% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,239.74,
Lac Repair-FAC Supf Head/Face;< 30.0cm,387,CDM,450,RC,12018,HCPCS,outpatient,,,310.53,232.9,,279.48,90,,,percent of total billed charges,90% of total billed charges,288.79,93,,,percent of total billed charges,93% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,252.77,81.4,,,percent of total billed charges,81.4% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,232.9,75,,,percent of total billed charges,75% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,288.79,
Lac Repair-FAC Supf Head/Face;< 30.0cm,388,CDM,450,RC,12018,HCPCS,outpatient,,,310.53,232.9,,279.48,90,,,percent of total billed charges,90% of total billed charges,288.79,93,,,percent of total billed charges,93% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,252.77,81.4,,,percent of total billed charges,81.4% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,232.9,75,,,percent of total billed charges,75% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,288.79,
Sup. Wound Dehis Simp.-FAC,389,CDM,450,RC,12020,HCPCS,outpatient,,,185.14,138.86,,166.63,90,,,percent of total billed charges,90% of total billed charges,172.18,93,,,percent of total billed charges,93% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,157.37,85,,,percent of total billed charges,85% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,150.7,81.4,,,percent of total billed charges,81.4% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,138.86,75,,,percent of total billed charges,75% of total billed charges,157.37,85,,,percent of total billed charges,85% of total billed charges,70.35,172.18,
Sup. Wound Dehis Simp.-FAC,390,CDM,450,RC,12020,HCPCS,outpatient,,,185.14,138.86,,166.63,90,,,percent of total billed charges,90% of total billed charges,172.18,93,,,percent of total billed charges,93% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,157.37,85,,,percent of total billed charges,85% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,150.7,81.4,,,percent of total billed charges,81.4% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,138.86,75,,,percent of total billed charges,75% of total billed charges,157.37,85,,,percent of total billed charges,85% of total billed charges,70.35,172.18,
Sup. wound Dehis.; w/ Pack-FAC,391,CDM,450,RC,12021,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
Sup. wound Dehis.; w/ Pack-FAC,392,CDM,450,RC,12021,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
Lac Repair-FAC Intermed. Nonface;2.5cm or <,393,CDM,450,RC,12031,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;2.5cm or <,394,CDM,450,RC,12031,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;2.6-7.5cm,395,CDM,450,RC,12032,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;2.6-7.5cm,396,CDM,450,RC,12032,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;7.6-12.5cm,397,CDM,450,RC,12034,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;7.6-12.5cm,398,CDM,450,RC,12034,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;12.6-20.0cm,399,CDM,450,RC,12035,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;12.6-20.0cm,400,CDM,450,RC,12035,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;20.1-30.0cm,401,CDM,450,RC,12036,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;20.1-30.0cm,402,CDM,450,RC,12036,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;< 30.0cm,403,CDM,450,RC,12037,HCPCS,outpatient,,,749.93,562.45,,674.94,90,,,percent of total billed charges,90% of total billed charges,697.43,93,,,percent of total billed charges,93% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,637.44,85,,,percent of total billed charges,85% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,610.44,81.4,,,percent of total billed charges,81.4% of total billed charges,674.94,90,,,percent of total billed charges,90% of total billed charges,674.94,90,,,percent of total billed charges,90% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,562.45,75,,,percent of total billed charges,75% of total billed charges,637.44,85,,,percent of total billed charges,85% of total billed charges,284.97,697.43,
Lac Repair-FAC Intermed. Nonface;< 30.0cm,404,CDM,450,RC,12037,HCPCS,outpatient,,,749.93,562.45,,674.94,90,,,percent of total billed charges,90% of total billed charges,697.43,93,,,percent of total billed charges,93% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,637.44,85,,,percent of total billed charges,85% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,610.44,81.4,,,percent of total billed charges,81.4% of total billed charges,674.94,90,,,percent of total billed charges,90% of total billed charges,674.94,90,,,percent of total billed charges,90% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,562.45,75,,,percent of total billed charges,75% of total billed charges,637.44,85,,,percent of total billed charges,85% of total billed charges,284.97,697.43,
Lac Repair-FAC Intermed. Head/Face;2.5cm or <,405,CDM,450,RC,12041,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Head/Face;2.5cm or <,406,CDM,450,RC,12041,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair FAC Intermed. Head/Face;2.6-7.5cm,407,CDM,450,RC,12042,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair FAC Intermed. Head/Face;2.6-7.5cm,408,CDM,450,RC,12042,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Head/Face;7.6-12.5cm,409,CDM,450,RC,12044,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Head/Face;7.6-12.5cm,410,CDM,450,RC,12044,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Head/Face;12.6-20cm,411,CDM,450,RC,12045,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Head/Face;12.6-20cm,412,CDM,450,RC,12045,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Head/Face;20.1-30.0cm,413,CDM,450,RC,12046,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Head/Face;20.1-30.0cm,414,CDM,450,RC,12046,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Head/Face;< 30.0cm,415,CDM,450,RC,12047,HCPCS,outpatient,,,749.93,562.45,,674.94,90,,,percent of total billed charges,90% of total billed charges,697.43,93,,,percent of total billed charges,93% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,637.44,85,,,percent of total billed charges,85% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,610.44,81.4,,,percent of total billed charges,81.4% of total billed charges,674.94,90,,,percent of total billed charges,90% of total billed charges,674.94,90,,,percent of total billed charges,90% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,562.45,75,,,percent of total billed charges,75% of total billed charges,637.44,85,,,percent of total billed charges,85% of total billed charges,284.97,697.43,
Lac Repair-FAC Intermed. Head/Face;< 30.0cm,416,CDM,450,RC,12047,HCPCS,outpatient,,,749.93,562.45,,674.94,90,,,percent of total billed charges,90% of total billed charges,697.43,93,,,percent of total billed charges,93% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,637.44,85,,,percent of total billed charges,85% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,610.44,81.4,,,percent of total billed charges,81.4% of total billed charges,674.94,90,,,percent of total billed charges,90% of total billed charges,674.94,90,,,percent of total billed charges,90% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,284.97,38,,,percent of total billed charges,38% of total billed charges,562.45,75,,,percent of total billed charges,75% of total billed charges,637.44,85,,,percent of total billed charges,85% of total billed charges,284.97,697.43,
Lac Repair-FAC Intermed. Face;2.5cm or <,417,CDM,450,RC,12051,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Face;2.5cm or <,418,CDM,450,RC,12051,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Face;2.6-5.0cm,419,CDM,450,RC,12052,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Face;2.6-5.0cm,420,CDM,450,RC,12052,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Face;5.1-7.5cm,421,CDM,450,RC,12053,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Face;5.1-7.5cm,422,CDM,450,RC,12053,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Face;7.6-12.5cm,423,CDM,450,RC,12054,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Face;7.6-12.5cm,424,CDM,450,RC,12054,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Face;12.6-20.0cm,425,CDM,450,RC,12055,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Face;12.6-20.0cm,426,CDM,450,RC,12055,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair Intermed. Face;20.1-30cm-Fac,427,CDM,450,RC,12056,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair Int. Face; over 30.0 cm - FAC,428,CDM,450,RC,12057,HCPCS,outpatient,,,700.02,525.02,,630.02,90,,,percent of total billed charges,90% of total billed charges,651.02,93,,,percent of total billed charges,93% of total billed charges,266.01,38,,,percent of total billed charges,38% of total billed charges,266.01,38,,,percent of total billed charges,38% of total billed charges,595.02,85,,,percent of total billed charges,85% of total billed charges,266.01,38,,,percent of total billed charges,38% of total billed charges,569.82,81.4,,,percent of total billed charges,81.4% of total billed charges,630.02,90,,,percent of total billed charges,90% of total billed charges,630.02,90,,,percent of total billed charges,90% of total billed charges,266.01,38,,,percent of total billed charges,38% of total billed charges,266.01,38,,,percent of total billed charges,38% of total billed charges,266.01,38,,,percent of total billed charges,38% of total billed charges,525.02,75,,,percent of total billed charges,75% of total billed charges,595.02,85,,,percent of total billed charges,85% of total billed charges,266.01,651.02,
Lac Repair Cmplx. Trunk; 1.1 cm-2.5 cm-FAC,429,CDM,450,RC,13100,HCPCS,outpatient,,,1100.26,825.2,,990.23,90,,,percent of total billed charges,90% of total billed charges,1023.24,93,,,percent of total billed charges,93% of total billed charges,418.1,38,,,percent of total billed charges,38% of total billed charges,418.1,38,,,percent of total billed charges,38% of total billed charges,935.22,85,,,percent of total billed charges,85% of total billed charges,418.1,38,,,percent of total billed charges,38% of total billed charges,895.61,81.4,,,percent of total billed charges,81.4% of total billed charges,990.23,90,,,percent of total billed charges,90% of total billed charges,990.23,90,,,percent of total billed charges,90% of total billed charges,418.1,38,,,percent of total billed charges,38% of total billed charges,418.1,38,,,percent of total billed charges,38% of total billed charges,418.1,38,,,percent of total billed charges,38% of total billed charges,825.2,75,,,percent of total billed charges,75% of total billed charges,935.22,85,,,percent of total billed charges,85% of total billed charges,418.1,1023.24,
Lac Repair Cmplx. Trunk; 2.6 cm-7.5 cm-FAC,430,CDM,450,RC,13101,HCPCS,outpatient,,,1099.13,824.35,,989.22,90,,,percent of total billed charges,90% of total billed charges,1022.19,93,,,percent of total billed charges,93% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,934.26,85,,,percent of total billed charges,85% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,894.69,81.4,,,percent of total billed charges,81.4% of total billed charges,989.22,90,,,percent of total billed charges,90% of total billed charges,989.22,90,,,percent of total billed charges,90% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,824.35,75,,,percent of total billed charges,75% of total billed charges,934.26,85,,,percent of total billed charges,85% of total billed charges,417.67,1022.19,
Lac Repair Cmplx. Trunk; addtl. 5cm< - FAC,431,CDM,450,RC,13102,HCPCS,outpatient,,,563.07,422.3,,506.76,90,,,percent of total billed charges,90% of total billed charges,523.66,93,,,percent of total billed charges,93% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,478.61,85,,,percent of total billed charges,85% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,458.34,81.4,,,percent of total billed charges,81.4% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,422.3,75,,,percent of total billed charges,75% of total billed charges,478.61,85,,,percent of total billed charges,85% of total billed charges,213.97,523.66,
"Lac Repair Cmplx.(sc,ar,lg); 1.1cm-2.5cm-FAC",432,CDM,450,RC,13120,HCPCS,outpatient,,,1099.13,824.35,,989.22,90,,,percent of total billed charges,90% of total billed charges,1022.19,93,,,percent of total billed charges,93% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,934.26,85,,,percent of total billed charges,85% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,894.69,81.4,,,percent of total billed charges,81.4% of total billed charges,989.22,90,,,percent of total billed charges,90% of total billed charges,989.22,90,,,percent of total billed charges,90% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,824.35,75,,,percent of total billed charges,75% of total billed charges,934.26,85,,,percent of total billed charges,85% of total billed charges,417.67,1022.19,
"Suture,Complex(sa,a,l);2.6-7.5cm-FAC",433,CDM,450,RC,13121,HCPCS,outpatient,,,419.5,314.63,,377.55,90,,,percent of total billed charges,90% of total billed charges,390.14,93,,,percent of total billed charges,93% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,356.58,85,,,percent of total billed charges,85% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,341.47,81.4,,,percent of total billed charges,81.4% of total billed charges,377.55,90,,,percent of total billed charges,90% of total billed charges,377.55,90,,,percent of total billed charges,90% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,314.63,75,,,percent of total billed charges,75% of total billed charges,356.58,85,,,percent of total billed charges,85% of total billed charges,159.41,390.14,
"Suture,Complex(sa,a,l);2.6-7.5cm-FAC",434,CDM,450,RC,13121,HCPCS,outpatient,,,419.5,314.63,,377.55,90,,,percent of total billed charges,90% of total billed charges,390.14,93,,,percent of total billed charges,93% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,356.58,85,,,percent of total billed charges,85% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,341.47,81.4,,,percent of total billed charges,81.4% of total billed charges,377.55,90,,,percent of total billed charges,90% of total billed charges,377.55,90,,,percent of total billed charges,90% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,314.63,75,,,percent of total billed charges,75% of total billed charges,356.58,85,,,percent of total billed charges,85% of total billed charges,159.41,390.14,
"Suture,Cmplx(sa,a,l);Each Add. 5cm or <-FAC",435,CDM,450,RC,13122,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
"Suture,Cmplx(sa,a,l);Each Add. 5cm or <-FAC",436,CDM,450,RC,13122,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
"Repair complx face, nect,gen,extrem 1.1-2.5cm FAC",437,CDM,450,RC,13131,HCPCS,outpatient,,,671.98,503.99,,604.78,90,,,percent of total billed charges,90% of total billed charges,624.94,93,,,percent of total billed charges,93% of total billed charges,255.35,38,,,percent of total billed charges,38% of total billed charges,255.35,38,,,percent of total billed charges,38% of total billed charges,571.18,85,,,percent of total billed charges,85% of total billed charges,255.35,38,,,percent of total billed charges,38% of total billed charges,546.99,81.4,,,percent of total billed charges,81.4% of total billed charges,604.78,90,,,percent of total billed charges,90% of total billed charges,604.78,90,,,percent of total billed charges,90% of total billed charges,255.35,38,,,percent of total billed charges,38% of total billed charges,255.35,38,,,percent of total billed charges,38% of total billed charges,255.35,38,,,percent of total billed charges,38% of total billed charges,503.99,75,,,percent of total billed charges,75% of total billed charges,571.18,85,,,percent of total billed charges,85% of total billed charges,255.35,624.94,
repair complx lac-f/n/g/ext 2.6-7.5cm FAC,438,CDM,450,RC,13132,HCPCS,outpatient,,,738.2,553.65,,664.38,90,,,percent of total billed charges,90% of total billed charges,686.53,93,,,percent of total billed charges,93% of total billed charges,280.52,38,,,percent of total billed charges,38% of total billed charges,280.52,38,,,percent of total billed charges,38% of total billed charges,627.47,85,,,percent of total billed charges,85% of total billed charges,280.52,38,,,percent of total billed charges,38% of total billed charges,600.89,81.4,,,percent of total billed charges,81.4% of total billed charges,664.38,90,,,percent of total billed charges,90% of total billed charges,664.38,90,,,percent of total billed charges,90% of total billed charges,280.52,38,,,percent of total billed charges,38% of total billed charges,280.52,38,,,percent of total billed charges,38% of total billed charges,280.52,38,,,percent of total billed charges,38% of total billed charges,553.65,75,,,percent of total billed charges,75% of total billed charges,627.47,85,,,percent of total billed charges,85% of total billed charges,280.52,686.53,
Lac Repair Cmplx Face; 1.1cm-2.5cm-FAC,439,CDM,450,RC,13151,HCPCS,outpatient,,,818.72,614.04,,736.85,90,,,percent of total billed charges,90% of total billed charges,761.41,93,,,percent of total billed charges,93% of total billed charges,311.11,38,,,percent of total billed charges,38% of total billed charges,311.11,38,,,percent of total billed charges,38% of total billed charges,695.91,85,,,percent of total billed charges,85% of total billed charges,311.11,38,,,percent of total billed charges,38% of total billed charges,666.44,81.4,,,percent of total billed charges,81.4% of total billed charges,736.85,90,,,percent of total billed charges,90% of total billed charges,736.85,90,,,percent of total billed charges,90% of total billed charges,311.11,38,,,percent of total billed charges,38% of total billed charges,311.11,38,,,percent of total billed charges,38% of total billed charges,311.11,38,,,percent of total billed charges,38% of total billed charges,614.04,75,,,percent of total billed charges,75% of total billed charges,695.91,85,,,percent of total billed charges,85% of total billed charges,311.11,761.41,
Lac Repair Cmplx Face; 2.6cm-7.5cm-FAC,440,CDM,450,RC,13152,HCPCS,outpatient,,,1099.13,824.35,,989.22,90,,,percent of total billed charges,90% of total billed charges,1022.19,93,,,percent of total billed charges,93% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,934.26,85,,,percent of total billed charges,85% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,894.69,81.4,,,percent of total billed charges,81.4% of total billed charges,989.22,90,,,percent of total billed charges,90% of total billed charges,989.22,90,,,percent of total billed charges,90% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,417.67,38,,,percent of total billed charges,38% of total billed charges,824.35,75,,,percent of total billed charges,75% of total billed charges,934.26,85,,,percent of total billed charges,85% of total billed charges,417.67,1022.19,
Lac Repair Cmplx Face; addtional 5cm< - FAC,441,CDM,450,RC,13153,HCPCS,outpatient,,,563.07,422.3,,506.76,90,,,percent of total billed charges,90% of total billed charges,523.66,93,,,percent of total billed charges,93% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,478.61,85,,,percent of total billed charges,85% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,458.34,81.4,,,percent of total billed charges,81.4% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,422.3,75,,,percent of total billed charges,75% of total billed charges,478.61,85,,,percent of total billed charges,85% of total billed charges,213.97,523.66,
Burn Init. Trmt-FAC,442,CDM,450,RC,16000,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
Burn Init. Trmt-FAC,443,CDM,450,RC,16000,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
"Burn, Debride <5%-FAC",444,CDM,450,RC,16020,HCPCS,outpatient,,,53.92,40.44,,48.53,90,,,percent of total billed charges,90% of total billed charges,50.15,93,,,percent of total billed charges,93% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,43.89,81.4,,,percent of total billed charges,81.4% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,40.44,75,,,percent of total billed charges,75% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,50.15,
"Burn, Debride <5%-FAC",445,CDM,450,RC,16020,HCPCS,outpatient,,,53.92,40.44,,48.53,90,,,percent of total billed charges,90% of total billed charges,50.15,93,,,percent of total billed charges,93% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,43.89,81.4,,,percent of total billed charges,81.4% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,40.44,75,,,percent of total billed charges,75% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,50.15,
Burn Debride 5%-10% (med.) - FAC,446,CDM,450,RC,16025,HCPCS,outpatient,,,380.64,285.48,,342.58,90,,,percent of total billed charges,90% of total billed charges,354,93,,,percent of total billed charges,93% of total billed charges,144.64,38,,,percent of total billed charges,38% of total billed charges,144.64,38,,,percent of total billed charges,38% of total billed charges,323.54,85,,,percent of total billed charges,85% of total billed charges,144.64,38,,,percent of total billed charges,38% of total billed charges,309.84,81.4,,,percent of total billed charges,81.4% of total billed charges,342.58,90,,,percent of total billed charges,90% of total billed charges,342.58,90,,,percent of total billed charges,90% of total billed charges,144.64,38,,,percent of total billed charges,38% of total billed charges,144.64,38,,,percent of total billed charges,38% of total billed charges,144.64,38,,,percent of total billed charges,38% of total billed charges,285.48,75,,,percent of total billed charges,75% of total billed charges,323.54,85,,,percent of total billed charges,85% of total billed charges,144.64,354,
Burn; Large> 10%-FAC,447,CDM,450,RC,16030,HCPCS,outpatient,,,127.72,95.79,,114.95,90,,,percent of total billed charges,90% of total billed charges,118.78,93,,,percent of total billed charges,93% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,108.56,85,,,percent of total billed charges,85% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,103.96,81.4,,,percent of total billed charges,81.4% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,95.79,75,,,percent of total billed charges,75% of total billed charges,108.56,85,,,percent of total billed charges,85% of total billed charges,48.53,118.78,
Burn; Large> 10%-FAC,448,CDM,450,RC,16030,HCPCS,outpatient,,,127.72,95.79,,114.95,90,,,percent of total billed charges,90% of total billed charges,118.78,93,,,percent of total billed charges,93% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,108.56,85,,,percent of total billed charges,85% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,103.96,81.4,,,percent of total billed charges,81.4% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,95.79,75,,,percent of total billed charges,75% of total billed charges,108.56,85,,,percent of total billed charges,85% of total billed charges,48.53,118.78,
Cryo-1st Lesion-FAC,449,CDM,450,RC,17000,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
Cryo-1st Lesion-FAC,450,CDM,450,RC,17000,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
Cryo:2-14 Lesions-FAC,451,CDM,450,RC,17003,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
Cryo:2-14 Lesions-FAC,452,CDM,450,RC,17003,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
Cryo Lesions 15+-FAC,453,CDM,450,RC,17004,HCPCS,outpatient,,,225,168.75,,202.5,90,,,percent of total billed charges,90% of total billed charges,209.25,93,,,percent of total billed charges,93% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,183.15,81.4,,,percent of total billed charges,81.4% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,168.75,75,,,percent of total billed charges,75% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,209.25,
Cryo Lesions 15+-FAC,454,CDM,450,RC,17004,HCPCS,outpatient,,,225,168.75,,202.5,90,,,percent of total billed charges,90% of total billed charges,209.25,93,,,percent of total billed charges,93% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,183.15,81.4,,,percent of total billed charges,81.4% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,168.75,75,,,percent of total billed charges,75% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,209.25,
Wart Removal;up to 14 Lesions-FAC,455,CDM,450,RC,17110,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
Wart Removal;up to 14 Lesions-FAC,456,CDM,450,RC,17110,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
Chem. Cauterize of Gran Tissue-FAC,457,CDM,450,RC,17250,HCPCS,outpatient,,,35.15,26.36,,31.64,90,,,percent of total billed charges,90% of total billed charges,32.69,93,,,percent of total billed charges,93% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,29.88,85,,,percent of total billed charges,85% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,28.61,81.4,,,percent of total billed charges,81.4% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,26.36,75,,,percent of total billed charges,75% of total billed charges,29.88,85,,,percent of total billed charges,85% of total billed charges,13.36,32.69,
Chem. Cauterize of Gran Tissue-FAC,458,CDM,450,RC,17250,HCPCS,outpatient,,,35.15,26.36,,31.64,90,,,percent of total billed charges,90% of total billed charges,32.69,93,,,percent of total billed charges,93% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,29.88,85,,,percent of total billed charges,85% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,28.61,81.4,,,percent of total billed charges,81.4% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,26.36,75,,,percent of total billed charges,75% of total billed charges,29.88,85,,,percent of total billed charges,85% of total billed charges,13.36,32.69,
Malignant Lesion Destruc. .5 or <;Trunk Ext.-FAC,459,CDM,450,RC,17260,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Malignant Lesion Destruc. .5 or <;Trunk Ext.-FAC,460,CDM,450,RC,17260,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Malignant Lesion Destruc. 0.6-1.0cm;Trunk Ext.-FAC,461,CDM,450,RC,17261,HCPCS,outpatient,,,119.52,89.64,,107.57,90,,,percent of total billed charges,90% of total billed charges,111.15,93,,,percent of total billed charges,93% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,101.59,85,,,percent of total billed charges,85% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,97.29,81.4,,,percent of total billed charges,81.4% of total billed charges,107.57,90,,,percent of total billed charges,90% of total billed charges,107.57,90,,,percent of total billed charges,90% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,89.64,75,,,percent of total billed charges,75% of total billed charges,101.59,85,,,percent of total billed charges,85% of total billed charges,45.42,111.15,
Malignant Lesion Destruc. 0.6-1.0cm;Trunk Ext.-FAC,462,CDM,450,RC,17261,HCPCS,outpatient,,,119.52,89.64,,107.57,90,,,percent of total billed charges,90% of total billed charges,111.15,93,,,percent of total billed charges,93% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,101.59,85,,,percent of total billed charges,85% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,97.29,81.4,,,percent of total billed charges,81.4% of total billed charges,107.57,90,,,percent of total billed charges,90% of total billed charges,107.57,90,,,percent of total billed charges,90% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,89.64,75,,,percent of total billed charges,75% of total billed charges,101.59,85,,,percent of total billed charges,85% of total billed charges,45.42,111.15,
Malignant Lesion Destruc. 1.1-2.0cm;Trunk Ext-FAC,463,CDM,450,RC,17262,HCPCS,outpatient,,,142.95,107.21,,128.66,90,,,percent of total billed charges,90% of total billed charges,132.94,93,,,percent of total billed charges,93% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,116.36,81.4,,,percent of total billed charges,81.4% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,107.21,75,,,percent of total billed charges,75% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,132.94,
Malignant Lesion Destruc. 1.1-2.0cm;Trunk Ext-FAC,464,CDM,450,RC,17262,HCPCS,outpatient,,,142.95,107.21,,128.66,90,,,percent of total billed charges,90% of total billed charges,132.94,93,,,percent of total billed charges,93% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,116.36,81.4,,,percent of total billed charges,81.4% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,107.21,75,,,percent of total billed charges,75% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,132.94,
Acne/Hair Removal Cryo.-FAC,465,CDM,450,RC,17340,HCPCS,outpatient,,,62.11,46.58,,55.9,90,,,percent of total billed charges,90% of total billed charges,57.76,93,,,percent of total billed charges,93% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,50.56,81.4,,,percent of total billed charges,81.4% of total billed charges,55.9,90,,,percent of total billed charges,90% of total billed charges,55.9,90,,,percent of total billed charges,90% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,46.58,75,,,percent of total billed charges,75% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,23.6,57.76,
Acne/Hair Removal Cryo.-FAC,466,CDM,450,RC,17340,HCPCS,outpatient,,,62.11,46.58,,55.9,90,,,percent of total billed charges,90% of total billed charges,57.76,93,,,percent of total billed charges,93% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,50.56,81.4,,,percent of total billed charges,81.4% of total billed charges,55.9,90,,,percent of total billed charges,90% of total billed charges,55.9,90,,,percent of total billed charges,90% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,46.58,75,,,percent of total billed charges,75% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,23.6,57.76,
Explore penetrating wound to extremety-Fac,467,CDM,450,RC,20103,HCPCS,outpatient,,,967.88,725.91,,871.09,90,,,percent of total billed charges,90% of total billed charges,900.13,93,,,percent of total billed charges,93% of total billed charges,367.79,38,,,percent of total billed charges,38% of total billed charges,367.79,38,,,percent of total billed charges,38% of total billed charges,822.7,85,,,percent of total billed charges,85% of total billed charges,367.79,38,,,percent of total billed charges,38% of total billed charges,787.85,81.4,,,percent of total billed charges,81.4% of total billed charges,871.09,90,,,percent of total billed charges,90% of total billed charges,871.09,90,,,percent of total billed charges,90% of total billed charges,367.79,38,,,percent of total billed charges,38% of total billed charges,367.79,38,,,percent of total billed charges,38% of total billed charges,367.79,38,,,percent of total billed charges,38% of total billed charges,725.91,75,,,percent of total billed charges,75% of total billed charges,822.7,85,,,percent of total billed charges,85% of total billed charges,367.79,900.13,
FB Rmv. Muscle/Tendon sheath- FAC,468,CDM,450,RC,20520,HCPCS,outpatient,,,158.18,118.64,,142.36,90,,,percent of total billed charges,90% of total billed charges,147.11,93,,,percent of total billed charges,93% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,134.45,85,,,percent of total billed charges,85% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,128.76,81.4,,,percent of total billed charges,81.4% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,118.64,75,,,percent of total billed charges,75% of total billed charges,134.45,85,,,percent of total billed charges,85% of total billed charges,60.11,147.11,
FB Rmv. Muscle/Tendon sheath- FAC,469,CDM,450,RC,20520,HCPCS,outpatient,,,158.18,118.64,,142.36,90,,,percent of total billed charges,90% of total billed charges,147.11,93,,,percent of total billed charges,93% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,134.45,85,,,percent of total billed charges,85% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,128.76,81.4,,,percent of total billed charges,81.4% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,118.64,75,,,percent of total billed charges,75% of total billed charges,134.45,85,,,percent of total billed charges,85% of total billed charges,60.11,147.11,
FBR-From finger/deep complicated-Fac,470,CDM,450,RC,20525,HCPCS,outpatient,,,3053.65,2290.24,,2748.29,90,,,percent of total billed charges,90% of total billed charges,2839.89,93,,,percent of total billed charges,93% of total billed charges,1160.39,38,,,percent of total billed charges,38% of total billed charges,1160.39,38,,,percent of total billed charges,38% of total billed charges,2595.6,85,,,percent of total billed charges,85% of total billed charges,1160.39,38,,,percent of total billed charges,38% of total billed charges,2485.67,81.4,,,percent of total billed charges,81.4% of total billed charges,2748.29,90,,,percent of total billed charges,90% of total billed charges,2748.29,90,,,percent of total billed charges,90% of total billed charges,1160.39,38,,,percent of total billed charges,38% of total billed charges,1160.39,38,,,percent of total billed charges,38% of total billed charges,1160.39,38,,,percent of total billed charges,38% of total billed charges,2290.24,75,,,percent of total billed charges,75% of total billed charges,2595.6,85,,,percent of total billed charges,85% of total billed charges,1160.39,2839.89,
Inj. Tendon/Ligament-FAC,471,CDM,450,RC,20550,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
Inj. Tendon/Ligament-FAC,472,CDM,450,RC,20550,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-FAC,473,CDM,450,RC,20552,HCPCS,outpatient,,,348.01,261.01,,313.21,90,,,percent of total billed charges,90% of total billed charges,323.65,93,,,percent of total billed charges,93% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,295.81,85,,,percent of total billed charges,85% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,283.28,81.4,,,percent of total billed charges,81.4% of total billed charges,313.21,90,,,percent of total billed charges,90% of total billed charges,313.21,90,,,percent of total billed charges,90% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,261.01,75,,,percent of total billed charges,75% of total billed charges,295.81,85,,,percent of total billed charges,85% of total billed charges,132.24,323.65,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-FAC,474,CDM,450,RC,20552,HCPCS,outpatient,,,348.01,261.01,,313.21,90,,,percent of total billed charges,90% of total billed charges,323.65,93,,,percent of total billed charges,93% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,295.81,85,,,percent of total billed charges,85% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,283.28,81.4,,,percent of total billed charges,81.4% of total billed charges,313.21,90,,,percent of total billed charges,90% of total billed charges,313.21,90,,,percent of total billed charges,90% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,261.01,75,,,percent of total billed charges,75% of total billed charges,295.81,85,,,percent of total billed charges,85% of total billed charges,132.24,323.65,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-FAC,475,CDM,450,RC,20552,HCPCS,outpatient,,,348.01,261.01,,313.21,90,,,percent of total billed charges,90% of total billed charges,323.65,93,,,percent of total billed charges,93% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,295.81,85,,,percent of total billed charges,85% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,283.28,81.4,,,percent of total billed charges,81.4% of total billed charges,313.21,90,,,percent of total billed charges,90% of total billed charges,313.21,90,,,percent of total billed charges,90% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,261.01,75,,,percent of total billed charges,75% of total billed charges,295.81,85,,,percent of total billed charges,85% of total billed charges,132.24,323.65,
INJ; Trig pts-3 or < muscles-FAC,476,CDM,450,RC,20553,HCPCS,outpatient,,,155.85,116.89,,140.27,90,,,percent of total billed charges,90% of total billed charges,144.94,93,,,percent of total billed charges,93% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,126.86,81.4,,,percent of total billed charges,81.4% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,116.89,75,,,percent of total billed charges,75% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,144.94,
INJ; Trig pts-3 or < muscles-FAC,477,CDM,450,RC,20553,HCPCS,outpatient,,,155.85,116.89,,140.27,90,,,percent of total billed charges,90% of total billed charges,144.94,93,,,percent of total billed charges,93% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,126.86,81.4,,,percent of total billed charges,81.4% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,116.89,75,,,percent of total billed charges,75% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,144.94,
Asp/Inj-small joint (w/o ultra)-FAC,478,CDM,450,RC,20600,HCPCS,outpatient,,,269.4,202.05,,242.46,90,,,percent of total billed charges,90% of total billed charges,250.54,93,,,percent of total billed charges,93% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,228.99,85,,,percent of total billed charges,85% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,219.29,81.4,,,percent of total billed charges,81.4% of total billed charges,242.46,90,,,percent of total billed charges,90% of total billed charges,242.46,90,,,percent of total billed charges,90% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,202.05,75,,,percent of total billed charges,75% of total billed charges,228.99,85,,,percent of total billed charges,85% of total billed charges,102.37,250.54,
Asp/Inj-small joint (w/o ultra)-FAC,479,CDM,450,RC,20600,HCPCS,outpatient,,,269.4,202.05,,242.46,90,,,percent of total billed charges,90% of total billed charges,250.54,93,,,percent of total billed charges,93% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,228.99,85,,,percent of total billed charges,85% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,219.29,81.4,,,percent of total billed charges,81.4% of total billed charges,242.46,90,,,percent of total billed charges,90% of total billed charges,242.46,90,,,percent of total billed charges,90% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,102.37,38,,,percent of total billed charges,38% of total billed charges,202.05,75,,,percent of total billed charges,75% of total billed charges,228.99,85,,,percent of total billed charges,85% of total billed charges,102.37,250.54,
Asp/Inj-small joint (w/ultra)-FAC,480,CDM,450,RC,20604,HCPCS,outpatient,,,331.22,248.42,,298.1,90,,,percent of total billed charges,90% of total billed charges,308.03,93,,,percent of total billed charges,93% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,281.54,85,,,percent of total billed charges,85% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,269.61,81.4,,,percent of total billed charges,81.4% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,248.42,75,,,percent of total billed charges,75% of total billed charges,281.54,85,,,percent of total billed charges,85% of total billed charges,125.86,308.03,
Asp/Inj-Intermed Jnt (w/o ultra)-FAC,481,CDM,450,RC,20605,HCPCS,outpatient,,,270.16,202.62,,243.14,90,,,percent of total billed charges,90% of total billed charges,251.25,93,,,percent of total billed charges,93% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,219.91,81.4,,,percent of total billed charges,81.4% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,202.62,75,,,percent of total billed charges,75% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,251.25,
Asp/Inj-Intermed Jnt (w/o ultra)-FAC,482,CDM,450,RC,20605,HCPCS,outpatient,,,270.16,202.62,,243.14,90,,,percent of total billed charges,90% of total billed charges,251.25,93,,,percent of total billed charges,93% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,219.91,81.4,,,percent of total billed charges,81.4% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,202.62,75,,,percent of total billed charges,75% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,251.25,
Asp/Inj-Intermed Jnt (w/ultra)-FAC,483,CDM,450,RC,20606,HCPCS,outpatient,,,600.63,450.47,,540.57,90,,,percent of total billed charges,90% of total billed charges,558.59,93,,,percent of total billed charges,93% of total billed charges,228.24,38,,,percent of total billed charges,38% of total billed charges,228.24,38,,,percent of total billed charges,38% of total billed charges,510.54,85,,,percent of total billed charges,85% of total billed charges,228.24,38,,,percent of total billed charges,38% of total billed charges,488.91,81.4,,,percent of total billed charges,81.4% of total billed charges,540.57,90,,,percent of total billed charges,90% of total billed charges,540.57,90,,,percent of total billed charges,90% of total billed charges,228.24,38,,,percent of total billed charges,38% of total billed charges,228.24,38,,,percent of total billed charges,38% of total billed charges,228.24,38,,,percent of total billed charges,38% of total billed charges,450.47,75,,,percent of total billed charges,75% of total billed charges,510.54,85,,,percent of total billed charges,85% of total billed charges,228.24,558.59,
Asp/Inj-Major joint (w/o ultra)-FAC,484,CDM,450,RC,20610,HCPCS,outpatient,,,270.16,202.62,,243.14,90,,,percent of total billed charges,90% of total billed charges,251.25,93,,,percent of total billed charges,93% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,219.91,81.4,,,percent of total billed charges,81.4% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,202.62,75,,,percent of total billed charges,75% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,251.25,
Asp/Inj-Major joint (w/o ultra)-FAC,485,CDM,450,RC,20610,HCPCS,outpatient,,,270.16,202.62,,243.14,90,,,percent of total billed charges,90% of total billed charges,251.25,93,,,percent of total billed charges,93% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,219.91,81.4,,,percent of total billed charges,81.4% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,202.62,75,,,percent of total billed charges,75% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,251.25,
Asp/Inj-Major joint (w/o ultra)-FAC,486,CDM,450,RC,20610,HCPCS,outpatient,,,270.16,202.62,,243.14,90,,,percent of total billed charges,90% of total billed charges,251.25,93,,,percent of total billed charges,93% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,219.91,81.4,,,percent of total billed charges,81.4% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,243.14,90,,,percent of total billed charges,90% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,102.66,38,,,percent of total billed charges,38% of total billed charges,202.62,75,,,percent of total billed charges,75% of total billed charges,229.64,85,,,percent of total billed charges,85% of total billed charges,102.66,251.25,
Asp/Inj-Major joint (w/ultra)-FAC,487,CDM,450,RC,20611,HCPCS,outpatient,,,386.43,289.82,,347.79,90,,,percent of total billed charges,90% of total billed charges,359.38,93,,,percent of total billed charges,93% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,328.47,85,,,percent of total billed charges,85% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,314.55,81.4,,,percent of total billed charges,81.4% of total billed charges,347.79,90,,,percent of total billed charges,90% of total billed charges,347.79,90,,,percent of total billed charges,90% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,289.82,75,,,percent of total billed charges,75% of total billed charges,328.47,85,,,percent of total billed charges,85% of total billed charges,146.84,359.38,
Asp/Inj. of Ganglion-FAC,488,CDM,450,RC,20612,HCPCS,outpatient,,,64.44,48.33,,58,90,,,percent of total billed charges,90% of total billed charges,59.93,93,,,percent of total billed charges,93% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,52.45,81.4,,,percent of total billed charges,81.4% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,48.33,75,,,percent of total billed charges,75% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,59.93,
Asp/Inj. of Ganglion-FAC,489,CDM,450,RC,20612,HCPCS,outpatient,,,64.44,48.33,,58,90,,,percent of total billed charges,90% of total billed charges,59.93,93,,,percent of total billed charges,93% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,52.45,81.4,,,percent of total billed charges,81.4% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,48.33,75,,,percent of total billed charges,75% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,59.93,
FRX/DIS-Clsd.Nasal W/O Manip.-FAC,490,CDM,450,RC,21310,HCPCS,outpatient,,,154.67,116,,139.2,90,,,percent of total billed charges,90% of total billed charges,143.84,93,,,percent of total billed charges,93% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,125.9,81.4,,,percent of total billed charges,81.4% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,116,75,,,percent of total billed charges,75% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,143.84,
FRX/DIS-Clsd.Nasal W/O Manip.-FAC,491,CDM,450,RC,21310,HCPCS,outpatient,,,154.67,116,,139.2,90,,,percent of total billed charges,90% of total billed charges,143.84,93,,,percent of total billed charges,93% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,125.9,81.4,,,percent of total billed charges,81.4% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,116,75,,,percent of total billed charges,75% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,143.84,
Closed Eye Socket Fracture-Fac,492,CDM,450,RC,21400,HCPCS,outpatient,,,1074.51,805.88,,967.06,90,,,percent of total billed charges,90% of total billed charges,999.29,93,,,percent of total billed charges,93% of total billed charges,408.31,38,,,percent of total billed charges,38% of total billed charges,408.31,38,,,percent of total billed charges,38% of total billed charges,913.33,85,,,percent of total billed charges,85% of total billed charges,408.31,38,,,percent of total billed charges,38% of total billed charges,874.65,81.4,,,percent of total billed charges,81.4% of total billed charges,967.06,90,,,percent of total billed charges,90% of total billed charges,967.06,90,,,percent of total billed charges,90% of total billed charges,408.31,38,,,percent of total billed charges,38% of total billed charges,408.31,38,,,percent of total billed charges,38% of total billed charges,408.31,38,,,percent of total billed charges,38% of total billed charges,805.88,75,,,percent of total billed charges,75% of total billed charges,913.33,85,,,percent of total billed charges,85% of total billed charges,408.31,999.29,
FRX/DIS-Mandible W/O Manip.-FAC,493,CDM,450,RC,21450,HCPCS,outpatient,,,462.85,347.14,,416.57,90,,,percent of total billed charges,90% of total billed charges,430.45,93,,,percent of total billed charges,93% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,393.42,85,,,percent of total billed charges,85% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,376.76,81.4,,,percent of total billed charges,81.4% of total billed charges,416.57,90,,,percent of total billed charges,90% of total billed charges,416.57,90,,,percent of total billed charges,90% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,347.14,75,,,percent of total billed charges,75% of total billed charges,393.42,85,,,percent of total billed charges,85% of total billed charges,175.88,430.45,
FRX/DIS-Mandible W/O Manip.-FAC,494,CDM,450,RC,21450,HCPCS,outpatient,,,462.85,347.14,,416.57,90,,,percent of total billed charges,90% of total billed charges,430.45,93,,,percent of total billed charges,93% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,393.42,85,,,percent of total billed charges,85% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,376.76,81.4,,,percent of total billed charges,81.4% of total billed charges,416.57,90,,,percent of total billed charges,90% of total billed charges,416.57,90,,,percent of total billed charges,90% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,347.14,75,,,percent of total billed charges,75% of total billed charges,393.42,85,,,percent of total billed charges,85% of total billed charges,175.88,430.45,
Dislocation TX jaw  facility,495,CDM,450,RC,21480,HCPCS,outpatient,,,324.84,243.63,,292.36,90,,,percent of total billed charges,90% of total billed charges,302.1,93,,,percent of total billed charges,93% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,276.11,85,,,percent of total billed charges,85% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,264.42,81.4,,,percent of total billed charges,81.4% of total billed charges,292.36,90,,,percent of total billed charges,90% of total billed charges,292.36,90,,,percent of total billed charges,90% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,243.63,75,,,percent of total billed charges,75% of total billed charges,276.11,85,,,percent of total billed charges,85% of total billed charges,123.44,302.1,
FXR- Sternum Closed-FAC,496,CDM,450,RC,21820,HCPCS,outpatient,,,229.67,172.25,,206.7,90,,,percent of total billed charges,90% of total billed charges,213.59,93,,,percent of total billed charges,93% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,195.22,85,,,percent of total billed charges,85% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,186.95,81.4,,,percent of total billed charges,81.4% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,172.25,75,,,percent of total billed charges,75% of total billed charges,195.22,85,,,percent of total billed charges,85% of total billed charges,87.27,213.59,
FXR- Sternum Closed-FAC,497,CDM,450,RC,21820,HCPCS,outpatient,,,229.67,172.25,,206.7,90,,,percent of total billed charges,90% of total billed charges,213.59,93,,,percent of total billed charges,93% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,195.22,85,,,percent of total billed charges,85% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,186.95,81.4,,,percent of total billed charges,81.4% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,172.25,75,,,percent of total billed charges,75% of total billed charges,195.22,85,,,percent of total billed charges,85% of total billed charges,87.27,213.59,
I&D Shoulder area deep abscess or hematoma-PRO,498,CDM,981,RC,23030,HCPCS,outpatient,,,965.54,724.16,,337.86,130,,,fee schedule,130% of fee schedule,337.86,130,,,fee schedule,130% of fee schedule,260.99,100,,,fee schedule,Pays 100% Medicare OPPS,260.99,100,,,fee schedule,Pays 100% Medicare OPPS,310.15,119,,,fee schedule,119% of fee schedule,260.99,100,,,fee schedule,Pays 100% Medicare OPPS,260.99,100,,,fee schedule,100% of fee schedule,868.99,90,,,percent of total billed charges,90% of total billed charges,260.99,100,,,fee schedule,Pays 100% Medicare OPPS,260.99,100,,,fee schedule,Pays 100% Medicare OPPS,260.99,100,,,fee schedule,Pays 100% Medicare OPPS,260.99,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,260.99,100,,,fee schedule,100% of fee schedule,215.58,868.99,
I&D Shoulder area; deep abscess or hematoma-Fac,499,CDM,450,RC,23030,HCPCS,outpatient,,,3203.62,2402.72,,2883.26,90,,,percent of total billed charges,90% of total billed charges,2979.37,93,,,percent of total billed charges,93% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,2723.08,85,,,percent of total billed charges,85% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,2607.75,81.4,,,percent of total billed charges,81.4% of total billed charges,2883.26,90,,,percent of total billed charges,90% of total billed charges,2883.26,90,,,percent of total billed charges,90% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,2402.72,75,,,percent of total billed charges,75% of total billed charges,2723.08,85,,,percent of total billed charges,85% of total billed charges,1217.38,2979.37,
FBR-Shoulder; subcutaneous-Fac,500,CDM,450,RC,23330,HCPCS,outpatient,,,1203.41,902.56,,1083.07,90,,,percent of total billed charges,90% of total billed charges,1119.17,93,,,percent of total billed charges,93% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,1022.9,85,,,percent of total billed charges,85% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,979.58,81.4,,,percent of total billed charges,81.4% of total billed charges,1083.07,90,,,percent of total billed charges,90% of total billed charges,1083.07,90,,,percent of total billed charges,90% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,902.56,75,,,percent of total billed charges,75% of total billed charges,1022.9,85,,,percent of total billed charges,85% of total billed charges,457.3,1119.17,
Soft tissue FB removal - Shoulder - Deep-FAC,501,CDM,450,RC,23333,HCPCS,outpatient,,,2277.1,1707.83,,2049.39,90,,,percent of total billed charges,90% of total billed charges,2117.7,93,,,percent of total billed charges,93% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1935.54,85,,,percent of total billed charges,85% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1853.56,81.4,,,percent of total billed charges,81.4% of total billed charges,2049.39,90,,,percent of total billed charges,90% of total billed charges,2049.39,90,,,percent of total billed charges,90% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1707.83,75,,,percent of total billed charges,75% of total billed charges,1935.54,85,,,percent of total billed charges,85% of total billed charges,865.3,2117.7,
FRX-Clavicle clsd (w/o manip)-FAC,502,CDM,450,RC,23500,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
Closed Fracture Reduction- Clavicular-FAC,503,CDM,450,RC,23505,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
Dislocation of Clavicle-Fac,504,CDM,450,RC,23520,HCPCS,outpatient,,,290.6,217.95,,261.54,90,,,percent of total billed charges,90% of total billed charges,270.26,93,,,percent of total billed charges,93% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,236.55,81.4,,,percent of total billed charges,81.4% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,217.95,75,,,percent of total billed charges,75% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,270.26,
FRX-prox humerus clsd (w/o manip)-FAC,505,CDM,450,RC,23600,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
Closed Frx Red-Prox Hum (w/man.) - FAC,506,CDM,450,RC,23605,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
"Disloc.-Shoulder W/ Manip,W/O anes-FAC",507,CDM,450,RC,23650,HCPCS,outpatient,,,251.92,188.94,,226.73,90,,,percent of total billed charges,90% of total billed charges,234.29,93,,,percent of total billed charges,93% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,214.13,85,,,percent of total billed charges,85% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,205.06,81.4,,,percent of total billed charges,81.4% of total billed charges,226.73,90,,,percent of total billed charges,90% of total billed charges,226.73,90,,,percent of total billed charges,90% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,188.94,75,,,percent of total billed charges,75% of total billed charges,214.13,85,,,percent of total billed charges,85% of total billed charges,95.73,234.29,
DIS-Shoulder (w/manip & w/anesth)-FAC,508,CDM,450,RC,23655,HCPCS,outpatient,,,1490.51,1117.88,,1341.46,90,,,percent of total billed charges,90% of total billed charges,1386.17,93,,,percent of total billed charges,93% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1213.28,81.4,,,percent of total billed charges,81.4% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1117.88,75,,,percent of total billed charges,75% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,1386.17,
I&D upper arm or elbow area; deep abscess or hematoma-Fac,509,CDM,450,RC,23930,HCPCS,outpatient,,,3203.62,2402.72,,2883.26,90,,,percent of total billed charges,90% of total billed charges,2979.37,93,,,percent of total billed charges,93% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,2723.08,85,,,percent of total billed charges,85% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,2607.75,81.4,,,percent of total billed charges,81.4% of total billed charges,2883.26,90,,,percent of total billed charges,90% of total billed charges,2883.26,90,,,percent of total billed charges,90% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,1217.38,38,,,percent of total billed charges,38% of total billed charges,2402.72,75,,,percent of total billed charges,75% of total billed charges,2723.08,85,,,percent of total billed charges,85% of total billed charges,1217.38,2979.37,
Soft tissue FB removal - Upper Arm-FAC,510,CDM,450,RC,24200,HCPCS,outpatient,,,2277.1,1707.83,,2049.39,90,,,percent of total billed charges,90% of total billed charges,2117.7,93,,,percent of total billed charges,93% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1935.54,85,,,percent of total billed charges,85% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1853.56,81.4,,,percent of total billed charges,81.4% of total billed charges,2049.39,90,,,percent of total billed charges,90% of total billed charges,2049.39,90,,,percent of total billed charges,90% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1707.83,75,,,percent of total billed charges,75% of total billed charges,1935.54,85,,,percent of total billed charges,85% of total billed charges,865.3,2117.7,
Soft tissue FB removal - Upper Arm -  Deep-FAC,511,CDM,450,RC,24201,HCPCS,outpatient,,,3926.93,2945.2,,3534.24,90,,,percent of total billed charges,90% of total billed charges,3652.04,93,,,percent of total billed charges,93% of total billed charges,1492.23,38,,,percent of total billed charges,38% of total billed charges,1492.23,38,,,percent of total billed charges,38% of total billed charges,3337.89,85,,,percent of total billed charges,85% of total billed charges,1492.23,38,,,percent of total billed charges,38% of total billed charges,3196.52,81.4,,,percent of total billed charges,81.4% of total billed charges,3534.24,90,,,percent of total billed charges,90% of total billed charges,3534.24,90,,,percent of total billed charges,90% of total billed charges,1492.23,38,,,percent of total billed charges,38% of total billed charges,1492.23,38,,,percent of total billed charges,38% of total billed charges,1492.23,38,,,percent of total billed charges,38% of total billed charges,2945.2,75,,,percent of total billed charges,75% of total billed charges,3337.89,85,,,percent of total billed charges,85% of total billed charges,1492.23,3652.04,
FRX-humerus clsd (w/o manip)-FAC,512,CDM,450,RC,24500,HCPCS,outpatient,,,496.83,372.62,,447.15,90,,,percent of total billed charges,90% of total billed charges,462.05,93,,,percent of total billed charges,93% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,404.42,81.4,,,percent of total billed charges,81.4% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,372.62,75,,,percent of total billed charges,75% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,462.05,
FRX-humerus clsd (w/o manip)-FAC,513,CDM,450,RC,24500,HCPCS,outpatient,,,496.83,372.62,,447.15,90,,,percent of total billed charges,90% of total billed charges,462.05,93,,,percent of total billed charges,93% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,404.42,81.4,,,percent of total billed charges,81.4% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,372.62,75,,,percent of total billed charges,75% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,462.05,
Closed Humerus Fx w/ manipulation-Fac,514,CDM,450,RC,24505,HCPCS,outpatient,,,984.29,738.22,,885.86,90,,,percent of total billed charges,90% of total billed charges,915.39,93,,,percent of total billed charges,93% of total billed charges,374.03,38,,,percent of total billed charges,38% of total billed charges,374.03,38,,,percent of total billed charges,38% of total billed charges,836.65,85,,,percent of total billed charges,85% of total billed charges,374.03,38,,,percent of total billed charges,38% of total billed charges,801.21,81.4,,,percent of total billed charges,81.4% of total billed charges,885.86,90,,,percent of total billed charges,90% of total billed charges,885.86,90,,,percent of total billed charges,90% of total billed charges,374.03,38,,,percent of total billed charges,38% of total billed charges,374.03,38,,,percent of total billed charges,38% of total billed charges,374.03,38,,,percent of total billed charges,38% of total billed charges,738.22,75,,,percent of total billed charges,75% of total billed charges,836.65,85,,,percent of total billed charges,85% of total billed charges,374.03,915.39,
Closed Fracture Reduction - Supracondylar-FAC,515,CDM,450,RC,24535,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
FX-HUM epicon W/O manip-FAC,516,CDM,450,RC,24560,HCPCS,outpatient,,,256.62,192.47,,230.96,90,,,percent of total billed charges,90% of total billed charges,238.66,93,,,percent of total billed charges,93% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,218.13,85,,,percent of total billed charges,85% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,208.89,81.4,,,percent of total billed charges,81.4% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,192.47,75,,,percent of total billed charges,75% of total billed charges,218.13,85,,,percent of total billed charges,85% of total billed charges,97.52,238.66,
FX-HUM epicon W/O manip-FAC,517,CDM,450,RC,24560,HCPCS,outpatient,,,256.62,192.47,,230.96,90,,,percent of total billed charges,90% of total billed charges,238.66,93,,,percent of total billed charges,93% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,218.13,85,,,percent of total billed charges,85% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,208.89,81.4,,,percent of total billed charges,81.4% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,192.47,75,,,percent of total billed charges,75% of total billed charges,218.13,85,,,percent of total billed charges,85% of total billed charges,97.52,238.66,
"Disl-Elbow,Closed W/O Manip-FAC",518,CDM,450,RC,24600,HCPCS,outpatient,,,315.21,236.41,,283.69,90,,,percent of total billed charges,90% of total billed charges,293.15,93,,,percent of total billed charges,93% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,267.93,85,,,percent of total billed charges,85% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,256.58,81.4,,,percent of total billed charges,81.4% of total billed charges,283.69,90,,,percent of total billed charges,90% of total billed charges,283.69,90,,,percent of total billed charges,90% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,236.41,75,,,percent of total billed charges,75% of total billed charges,267.93,85,,,percent of total billed charges,85% of total billed charges,119.78,293.15,
"Disl-Elbow,Closed W/O Manip-FAC",519,CDM,450,RC,24600,HCPCS,outpatient,,,315.21,236.41,,283.69,90,,,percent of total billed charges,90% of total billed charges,293.15,93,,,percent of total billed charges,93% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,267.93,85,,,percent of total billed charges,85% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,256.58,81.4,,,percent of total billed charges,81.4% of total billed charges,283.69,90,,,percent of total billed charges,90% of total billed charges,283.69,90,,,percent of total billed charges,90% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,236.41,75,,,percent of total billed charges,75% of total billed charges,267.93,85,,,percent of total billed charges,85% of total billed charges,119.78,293.15,
DIS-Elbow (w/anesth)-FAC,520,CDM,450,RC,24605,HCPCS,outpatient,,,1490.51,1117.88,,1341.46,90,,,percent of total billed charges,90% of total billed charges,1386.17,93,,,percent of total billed charges,93% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1213.28,81.4,,,percent of total billed charges,81.4% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1117.88,75,,,percent of total billed charges,75% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,1386.17,
FRX-Radial Head W/O Manip-FAC,521,CDM,450,RC,24650,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
FRX-Radial Head W/O Manip-FAC,522,CDM,450,RC,24650,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
Closed Fracture Reduction - Radial head-FAC,523,CDM,450,RC,24655,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
FRX-Ulnar (prox)-clsd (w/o manip)-FAC,524,CDM,450,RC,24670,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
Closed Fracture Reduction - Ulnar-FAC,525,CDM,450,RC,24675,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
FRX-radial shaft-clsd-w/o manip-FAC,526,CDM,450,RC,25500,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
Closed Radial Fx w/ manipulation-Fac,527,CDM,450,RC,25505,HCPCS,outpatient,,,1258.49,943.87,,1132.64,90,,,percent of total billed charges,90% of total billed charges,1170.4,93,,,percent of total billed charges,93% of total billed charges,478.23,38,,,percent of total billed charges,38% of total billed charges,478.23,38,,,percent of total billed charges,38% of total billed charges,1069.72,85,,,percent of total billed charges,85% of total billed charges,478.23,38,,,percent of total billed charges,38% of total billed charges,1024.41,81.4,,,percent of total billed charges,81.4% of total billed charges,1132.64,90,,,percent of total billed charges,90% of total billed charges,1132.64,90,,,percent of total billed charges,90% of total billed charges,478.23,38,,,percent of total billed charges,38% of total billed charges,478.23,38,,,percent of total billed charges,38% of total billed charges,478.23,38,,,percent of total billed charges,38% of total billed charges,943.87,75,,,percent of total billed charges,75% of total billed charges,1069.72,85,,,percent of total billed charges,85% of total billed charges,478.23,1170.4,
FRX-Ulnar Shaft closed w/o manip-FAC,528,CDM,450,RC,25530,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
Closed Ulnar Shaft Fx w/ manipulation-Fac,529,CDM,450,RC,25535,HCPCS,outpatient,,,1171.78,878.84,,1054.6,90,,,percent of total billed charges,90% of total billed charges,1089.76,93,,,percent of total billed charges,93% of total billed charges,445.28,38,,,percent of total billed charges,38% of total billed charges,445.28,38,,,percent of total billed charges,38% of total billed charges,996.01,85,,,percent of total billed charges,85% of total billed charges,445.28,38,,,percent of total billed charges,38% of total billed charges,953.83,81.4,,,percent of total billed charges,81.4% of total billed charges,1054.6,90,,,percent of total billed charges,90% of total billed charges,1054.6,90,,,percent of total billed charges,90% of total billed charges,445.28,38,,,percent of total billed charges,38% of total billed charges,445.28,38,,,percent of total billed charges,38% of total billed charges,445.28,38,,,percent of total billed charges,38% of total billed charges,878.84,75,,,percent of total billed charges,75% of total billed charges,996.01,85,,,percent of total billed charges,85% of total billed charges,445.28,1089.76,
FRX-Radial/Ulnar Shaft w/o manip-FAC,530,CDM,450,RC,25560,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
FRX-Radial/Ulnar Shaft w/o manip-FAC,531,CDM,450,RC,25560,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
Closed Radial & Ulnar Fx w/ manipulation-Fac,532,CDM,450,RC,25565,HCPCS,outpatient,,,1549.07,1161.8,,1394.16,90,,,percent of total billed charges,90% of total billed charges,1440.64,93,,,percent of total billed charges,93% of total billed charges,588.65,38,,,percent of total billed charges,38% of total billed charges,588.65,38,,,percent of total billed charges,38% of total billed charges,1316.71,85,,,percent of total billed charges,85% of total billed charges,588.65,38,,,percent of total billed charges,38% of total billed charges,1260.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1394.16,90,,,percent of total billed charges,90% of total billed charges,1394.16,90,,,percent of total billed charges,90% of total billed charges,588.65,38,,,percent of total billed charges,38% of total billed charges,588.65,38,,,percent of total billed charges,38% of total billed charges,588.65,38,,,percent of total billed charges,38% of total billed charges,1161.8,75,,,percent of total billed charges,75% of total billed charges,1316.71,85,,,percent of total billed charges,85% of total billed charges,588.65,1440.64,
FRX-Distal Radial closed w/o manip-FAC,533,CDM,450,RC,25600,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
FRX-Distal Radial closed w/manip-FAC,534,CDM,450,RC,25605,HCPCS,outpatient,,,1591.28,1193.46,,1432.15,90,,,percent of total billed charges,90% of total billed charges,1479.89,93,,,percent of total billed charges,93% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,1352.59,85,,,percent of total billed charges,85% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,1295.3,81.4,,,percent of total billed charges,81.4% of total billed charges,1432.15,90,,,percent of total billed charges,90% of total billed charges,1432.15,90,,,percent of total billed charges,90% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,1193.46,75,,,percent of total billed charges,75% of total billed charges,1352.59,85,,,percent of total billed charges,85% of total billed charges,604.69,1479.89,
FRX-Distal Radial closed w/manip-FAC,535,CDM,450,RC,25605,HCPCS,outpatient,,,1591.28,1193.46,,1432.15,90,,,percent of total billed charges,90% of total billed charges,1479.89,93,,,percent of total billed charges,93% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,1352.59,85,,,percent of total billed charges,85% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,1295.3,81.4,,,percent of total billed charges,81.4% of total billed charges,1432.15,90,,,percent of total billed charges,90% of total billed charges,1432.15,90,,,percent of total billed charges,90% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,1193.46,75,,,percent of total billed charges,75% of total billed charges,1352.59,85,,,percent of total billed charges,85% of total billed charges,604.69,1479.89,
FX Scaphoid (Navicular) closed-Fac,536,CDM,450,RC,25622,HCPCS,outpatient,,,450.46,337.85,,405.41,90,,,percent of total billed charges,90% of total billed charges,418.93,93,,,percent of total billed charges,93% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,382.89,85,,,percent of total billed charges,85% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,366.67,81.4,,,percent of total billed charges,81.4% of total billed charges,405.41,90,,,percent of total billed charges,90% of total billed charges,405.41,90,,,percent of total billed charges,90% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,337.85,75,,,percent of total billed charges,75% of total billed charges,382.89,85,,,percent of total billed charges,85% of total billed charges,171.17,418.93,
FRX-Carpal Bone W/O Manip-FAC,537,CDM,450,RC,25630,HCPCS,outpatient,,,250.76,188.07,,225.68,90,,,percent of total billed charges,90% of total billed charges,233.21,93,,,percent of total billed charges,93% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,213.15,85,,,percent of total billed charges,85% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,204.12,81.4,,,percent of total billed charges,81.4% of total billed charges,225.68,90,,,percent of total billed charges,90% of total billed charges,225.68,90,,,percent of total billed charges,90% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,188.07,75,,,percent of total billed charges,75% of total billed charges,213.15,85,,,percent of total billed charges,85% of total billed charges,95.29,233.21,
FRX-Carpal Bone W/O Manip-FAC,538,CDM,450,RC,25630,HCPCS,outpatient,,,250.76,188.07,,225.68,90,,,percent of total billed charges,90% of total billed charges,233.21,93,,,percent of total billed charges,93% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,213.15,85,,,percent of total billed charges,85% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,204.12,81.4,,,percent of total billed charges,81.4% of total billed charges,225.68,90,,,percent of total billed charges,90% of total billed charges,225.68,90,,,percent of total billed charges,90% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,188.07,75,,,percent of total billed charges,75% of total billed charges,213.15,85,,,percent of total billed charges,85% of total billed charges,95.29,233.21,
FRX-Ulnar Styloid-FAC,539,CDM,450,RC,25650,HCPCS,outpatient,,,299.97,224.98,,269.97,90,,,percent of total billed charges,90% of total billed charges,278.97,93,,,percent of total billed charges,93% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,254.97,85,,,percent of total billed charges,85% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,244.18,81.4,,,percent of total billed charges,81.4% of total billed charges,269.97,90,,,percent of total billed charges,90% of total billed charges,269.97,90,,,percent of total billed charges,90% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,224.98,75,,,percent of total billed charges,75% of total billed charges,254.97,85,,,percent of total billed charges,85% of total billed charges,113.99,278.97,
FRX-Ulnar Styloid-FAC,540,CDM,450,RC,25650,HCPCS,outpatient,,,299.97,224.98,,269.97,90,,,percent of total billed charges,90% of total billed charges,278.97,93,,,percent of total billed charges,93% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,254.97,85,,,percent of total billed charges,85% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,244.18,81.4,,,percent of total billed charges,81.4% of total billed charges,269.97,90,,,percent of total billed charges,90% of total billed charges,269.97,90,,,percent of total billed charges,90% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,224.98,75,,,percent of total billed charges,75% of total billed charges,254.97,85,,,percent of total billed charges,85% of total billed charges,113.99,278.97,
Dislocation of Intercarpel-Fac,541,CDM,450,RC,25660,HCPCS,outpatient,,,310.53,232.9,,279.48,90,,,percent of total billed charges,90% of total billed charges,288.79,93,,,percent of total billed charges,93% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,252.77,81.4,,,percent of total billed charges,81.4% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,232.9,75,,,percent of total billed charges,75% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,288.79,
Closed Wrist Fx w/ dislocation w/ manipulation-Fac,542,CDM,450,RC,25680,HCPCS,outpatient,,,312.87,234.65,,281.58,90,,,percent of total billed charges,90% of total billed charges,290.97,93,,,percent of total billed charges,93% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,265.94,85,,,percent of total billed charges,85% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,254.68,81.4,,,percent of total billed charges,81.4% of total billed charges,281.58,90,,,percent of total billed charges,90% of total billed charges,281.58,90,,,percent of total billed charges,90% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,234.65,75,,,percent of total billed charges,75% of total billed charges,265.94,85,,,percent of total billed charges,85% of total billed charges,118.89,290.97,
Drainage of finger abcess simple-Fac,543,CDM,450,RC,26010,HCPCS,outpatient,,,278.88,209.16,,250.99,90,,,percent of total billed charges,90% of total billed charges,259.36,93,,,percent of total billed charges,93% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,237.05,85,,,percent of total billed charges,85% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,227.01,81.4,,,percent of total billed charges,81.4% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,209.16,75,,,percent of total billed charges,75% of total billed charges,237.05,85,,,percent of total billed charges,85% of total billed charges,105.97,259.36,
FRX-Metacarpal closed w/o manip (each)-FAC,544,CDM,450,RC,26600,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
"FRX-Single; w/manip, each bone-fac",545,CDM,450,RC,26605,HCPCS,outpatient,,,290.6,217.95,,261.54,90,,,percent of total billed charges,90% of total billed charges,270.26,93,,,percent of total billed charges,93% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,236.55,81.4,,,percent of total billed charges,81.4% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,217.95,75,,,percent of total billed charges,75% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,270.26,
FRX/DIS-Carpo:Thumb W/ Manip-FAC,546,CDM,450,RC,26645,HCPCS,outpatient,,,355.05,266.29,,319.55,90,,,percent of total billed charges,90% of total billed charges,330.2,93,,,percent of total billed charges,93% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,301.79,85,,,percent of total billed charges,85% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,289.01,81.4,,,percent of total billed charges,81.4% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,266.29,75,,,percent of total billed charges,75% of total billed charges,301.79,85,,,percent of total billed charges,85% of total billed charges,134.92,330.2,
FRX/DIS-Carpo:Thumb W/ Manip-FAC,547,CDM,450,RC,26645,HCPCS,outpatient,,,355.05,266.29,,319.55,90,,,percent of total billed charges,90% of total billed charges,330.2,93,,,percent of total billed charges,93% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,301.79,85,,,percent of total billed charges,85% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,289.01,81.4,,,percent of total billed charges,81.4% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,266.29,75,,,percent of total billed charges,75% of total billed charges,301.79,85,,,percent of total billed charges,85% of total billed charges,134.92,330.2,
"DISL.-METACARP. W/ Manip, W/O Anes-FAC",548,CDM,450,RC,26700,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
"DISL.-METACARP. W/ Manip, W/O Anes-FAC",549,CDM,450,RC,26700,HCPCS,outpatient,,,474.76,356.07,,427.28,90,,,percent of total billed charges,90% of total billed charges,441.53,93,,,percent of total billed charges,93% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,386.45,81.4,,,percent of total billed charges,81.4% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,427.28,90,,,percent of total billed charges,90% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,180.41,38,,,percent of total billed charges,38% of total billed charges,356.07,75,,,percent of total billed charges,75% of total billed charges,403.55,85,,,percent of total billed charges,85% of total billed charges,180.41,441.53,
DIS-Metacarpophal (w/manip & anesth)-FAC,550,CDM,450,RC,26705,HCPCS,outpatient,,,1458.5,1093.88,,1312.65,90,,,percent of total billed charges,90% of total billed charges,1356.41,93,,,percent of total billed charges,93% of total billed charges,554.23,38,,,percent of total billed charges,38% of total billed charges,554.23,38,,,percent of total billed charges,38% of total billed charges,1239.73,85,,,percent of total billed charges,85% of total billed charges,554.23,38,,,percent of total billed charges,38% of total billed charges,1187.22,81.4,,,percent of total billed charges,81.4% of total billed charges,1312.65,90,,,percent of total billed charges,90% of total billed charges,1312.65,90,,,percent of total billed charges,90% of total billed charges,554.23,38,,,percent of total billed charges,38% of total billed charges,554.23,38,,,percent of total billed charges,38% of total billed charges,554.23,38,,,percent of total billed charges,38% of total billed charges,1093.88,75,,,percent of total billed charges,75% of total billed charges,1239.73,85,,,percent of total billed charges,85% of total billed charges,554.23,1356.41,
FRX phalangeal shaft closed w/o manip-FAC,551,CDM,450,RC,26720,HCPCS,outpatient,,,441.63,331.22,,397.47,90,,,percent of total billed charges,90% of total billed charges,410.72,93,,,percent of total billed charges,93% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,375.39,85,,,percent of total billed charges,85% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,359.49,81.4,,,percent of total billed charges,81.4% of total billed charges,397.47,90,,,percent of total billed charges,90% of total billed charges,397.47,90,,,percent of total billed charges,90% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,331.22,75,,,percent of total billed charges,75% of total billed charges,375.39,85,,,percent of total billed charges,85% of total billed charges,167.82,410.72,
FRX/DIS-W/ Manip; W/ or W/O Skin/Skele. Tract.-FAC,552,CDM,450,RC,26725,HCPCS,outpatient,,,284.74,213.56,,256.27,90,,,percent of total billed charges,90% of total billed charges,264.81,93,,,percent of total billed charges,93% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,242.03,85,,,percent of total billed charges,85% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,231.78,81.4,,,percent of total billed charges,81.4% of total billed charges,256.27,90,,,percent of total billed charges,90% of total billed charges,256.27,90,,,percent of total billed charges,90% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,213.56,75,,,percent of total billed charges,75% of total billed charges,242.03,85,,,percent of total billed charges,85% of total billed charges,108.2,264.81,
FRX/DIS-W/ Manip; W/ or W/O Skin/Skele. Tract.-FAC,553,CDM,450,RC,26725,HCPCS,outpatient,,,284.74,213.56,,256.27,90,,,percent of total billed charges,90% of total billed charges,264.81,93,,,percent of total billed charges,93% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,242.03,85,,,percent of total billed charges,85% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,231.78,81.4,,,percent of total billed charges,81.4% of total billed charges,256.27,90,,,percent of total billed charges,90% of total billed charges,256.27,90,,,percent of total billed charges,90% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,213.56,75,,,percent of total billed charges,75% of total billed charges,242.03,85,,,percent of total billed charges,85% of total billed charges,108.2,264.81,
FRX-Distal phalangeal closed w/o manip-FAC,554,CDM,450,RC,26750,HCPCS,outpatient,,,425.06,318.8,,382.55,90,,,percent of total billed charges,90% of total billed charges,395.31,93,,,percent of total billed charges,93% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,361.3,85,,,percent of total billed charges,85% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,346,81.4,,,percent of total billed charges,81.4% of total billed charges,382.55,90,,,percent of total billed charges,90% of total billed charges,382.55,90,,,percent of total billed charges,90% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,318.8,75,,,percent of total billed charges,75% of total billed charges,361.3,85,,,percent of total billed charges,85% of total billed charges,161.52,395.31,
FRX-Distal phalangeal closed w/o manip-FAC,555,CDM,450,RC,26750,HCPCS,outpatient,,,425.06,318.8,,382.55,90,,,percent of total billed charges,90% of total billed charges,395.31,93,,,percent of total billed charges,93% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,361.3,85,,,percent of total billed charges,85% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,346,81.4,,,percent of total billed charges,81.4% of total billed charges,382.55,90,,,percent of total billed charges,90% of total billed charges,382.55,90,,,percent of total billed charges,90% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,161.52,38,,,percent of total billed charges,38% of total billed charges,318.8,75,,,percent of total billed charges,75% of total billed charges,361.3,85,,,percent of total billed charges,85% of total billed charges,161.52,395.31,
Open Tuft Fracture (phalange) splinting & sutures-Fac,556,CDM,450,RC,26765,HCPCS,outpatient,,,3457.91,2593.43,,3112.12,90,,,percent of total billed charges,90% of total billed charges,3215.86,93,,,percent of total billed charges,93% of total billed charges,1314.01,38,,,percent of total billed charges,38% of total billed charges,1314.01,38,,,percent of total billed charges,38% of total billed charges,2939.22,85,,,percent of total billed charges,85% of total billed charges,1314.01,38,,,percent of total billed charges,38% of total billed charges,2814.74,81.4,,,percent of total billed charges,81.4% of total billed charges,3112.12,90,,,percent of total billed charges,90% of total billed charges,3112.12,90,,,percent of total billed charges,90% of total billed charges,1314.01,38,,,percent of total billed charges,38% of total billed charges,1314.01,38,,,percent of total billed charges,38% of total billed charges,1314.01,38,,,percent of total billed charges,38% of total billed charges,2593.43,75,,,percent of total billed charges,75% of total billed charges,2939.22,85,,,percent of total billed charges,85% of total billed charges,1314.01,3215.86,
DIS Treatment Inter joint w/manip w/o anes-FAC,557,CDM,450,RC,26770,HCPCS,outpatient,,,269.5,202.13,,242.55,90,,,percent of total billed charges,90% of total billed charges,250.64,93,,,percent of total billed charges,93% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,229.08,85,,,percent of total billed charges,85% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,219.37,81.4,,,percent of total billed charges,81.4% of total billed charges,242.55,90,,,percent of total billed charges,90% of total billed charges,242.55,90,,,percent of total billed charges,90% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,202.13,75,,,percent of total billed charges,75% of total billed charges,229.08,85,,,percent of total billed charges,85% of total billed charges,102.41,250.64,
FBR-pelvis or hip; subcutaneous tissue-Fac,558,CDM,450,RC,27086,HCPCS,outpatient,,,1203.41,902.56,,1083.07,90,,,percent of total billed charges,90% of total billed charges,1119.17,93,,,percent of total billed charges,93% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,1022.9,85,,,percent of total billed charges,85% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,979.58,81.4,,,percent of total billed charges,81.4% of total billed charges,1083.07,90,,,percent of total billed charges,90% of total billed charges,1083.07,90,,,percent of total billed charges,90% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,457.3,38,,,percent of total billed charges,38% of total billed charges,902.56,75,,,percent of total billed charges,75% of total billed charges,1022.9,85,,,percent of total billed charges,85% of total billed charges,457.3,1119.17,
FBR Pelvis/Hip; Deep - FAC,559,CDM,450,RC,27087,HCPCS,outpatient,,,4468.62,3351.47,,4021.76,90,,,percent of total billed charges,90% of total billed charges,4155.82,93,,,percent of total billed charges,93% of total billed charges,1698.08,38,,,percent of total billed charges,38% of total billed charges,1698.08,38,,,percent of total billed charges,38% of total billed charges,3798.33,85,,,percent of total billed charges,85% of total billed charges,1698.08,38,,,percent of total billed charges,38% of total billed charges,3637.46,81.4,,,percent of total billed charges,81.4% of total billed charges,4021.76,90,,,percent of total billed charges,90% of total billed charges,4021.76,90,,,percent of total billed charges,90% of total billed charges,1698.08,38,,,percent of total billed charges,38% of total billed charges,1698.08,38,,,percent of total billed charges,38% of total billed charges,1698.08,38,,,percent of total billed charges,38% of total billed charges,3351.47,75,,,percent of total billed charges,75% of total billed charges,3798.33,85,,,percent of total billed charges,85% of total billed charges,1698.08,4155.82,
Coccygeal Fracture-Fac,560,CDM,450,RC,27200,HCPCS,outpatient,,,290.6,217.95,,261.54,90,,,percent of total billed charges,90% of total billed charges,270.26,93,,,percent of total billed charges,93% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,236.55,81.4,,,percent of total billed charges,81.4% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,217.95,75,,,percent of total billed charges,75% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,270.26,
Closed Hip Socket Fracture-Fac,561,CDM,450,RC,27220,HCPCS,outpatient,,,310.53,232.9,,279.48,90,,,percent of total billed charges,90% of total billed charges,288.79,93,,,percent of total billed charges,93% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,252.77,81.4,,,percent of total billed charges,81.4% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,232.9,75,,,percent of total billed charges,75% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,288.79,
Closed Femoral Fracture-Fac,562,CDM,450,RC,27230,HCPCS,outpatient,,,310.53,232.9,,279.48,90,,,percent of total billed charges,90% of total billed charges,288.79,93,,,percent of total billed charges,93% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,252.77,81.4,,,percent of total billed charges,81.4% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,232.9,75,,,percent of total billed charges,75% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,288.79,
Dislocation of Hip-Fac,563,CDM,450,RC,27250,HCPCS,outpatient,,,287.08,215.31,,258.37,90,,,percent of total billed charges,90% of total billed charges,266.98,93,,,percent of total billed charges,93% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,244.02,85,,,percent of total billed charges,85% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,233.68,81.4,,,percent of total billed charges,81.4% of total billed charges,258.37,90,,,percent of total billed charges,90% of total billed charges,258.37,90,,,percent of total billed charges,90% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,215.31,75,,,percent of total billed charges,75% of total billed charges,244.02,85,,,percent of total billed charges,85% of total billed charges,109.09,266.98,
DIS-Hip (trauma)(w/anesth)-FAC,564,CDM,450,RC,27252,HCPCS,outpatient,,,1490.51,1117.88,,1341.46,90,,,percent of total billed charges,90% of total billed charges,1386.17,93,,,percent of total billed charges,93% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1213.28,81.4,,,percent of total billed charges,81.4% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1117.88,75,,,percent of total billed charges,75% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,1386.17,
DIS-Hip(spontan)(w/o anes./manip.)-FAC,565,CDM,450,RC,27256,HCPCS,outpatient,,,942.89,707.17,,848.6,90,,,percent of total billed charges,90% of total billed charges,876.89,93,,,percent of total billed charges,93% of total billed charges,358.3,38,,,percent of total billed charges,38% of total billed charges,358.3,38,,,percent of total billed charges,38% of total billed charges,801.46,85,,,percent of total billed charges,85% of total billed charges,358.3,38,,,percent of total billed charges,38% of total billed charges,767.51,81.4,,,percent of total billed charges,81.4% of total billed charges,848.6,90,,,percent of total billed charges,90% of total billed charges,848.6,90,,,percent of total billed charges,90% of total billed charges,358.3,38,,,percent of total billed charges,38% of total billed charges,358.3,38,,,percent of total billed charges,38% of total billed charges,358.3,38,,,percent of total billed charges,38% of total billed charges,707.17,75,,,percent of total billed charges,75% of total billed charges,801.46,85,,,percent of total billed charges,85% of total billed charges,358.3,876.89,
DIS-Hip(spontan)(w/manip & anesth)-FAC,566,CDM,450,RC,27257,HCPCS,outpatient,,,1490.51,1117.88,,1341.46,90,,,percent of total billed charges,90% of total billed charges,1386.17,93,,,percent of total billed charges,93% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1213.28,81.4,,,percent of total billed charges,81.4% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1117.88,75,,,percent of total billed charges,75% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,1386.17,
Post Hip Arthro. Disloc.(w/o anes.) - FAC,567,CDM,450,RC,27265,HCPCS,outpatient,,,484.26,363.2,,435.83,90,,,percent of total billed charges,90% of total billed charges,450.36,93,,,percent of total billed charges,93% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,394.19,81.4,,,percent of total billed charges,81.4% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,363.2,75,,,percent of total billed charges,75% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,450.36,
FRX Femoral Shaft closed w/o manip-FAC,568,CDM,450,RC,27500,HCPCS,outpatient,,,607.24,455.43,,546.52,90,,,percent of total billed charges,90% of total billed charges,564.73,93,,,percent of total billed charges,93% of total billed charges,230.75,38,,,percent of total billed charges,38% of total billed charges,230.75,38,,,percent of total billed charges,38% of total billed charges,516.15,85,,,percent of total billed charges,85% of total billed charges,230.75,38,,,percent of total billed charges,38% of total billed charges,494.29,81.4,,,percent of total billed charges,81.4% of total billed charges,546.52,90,,,percent of total billed charges,90% of total billed charges,546.52,90,,,percent of total billed charges,90% of total billed charges,230.75,38,,,percent of total billed charges,38% of total billed charges,230.75,38,,,percent of total billed charges,38% of total billed charges,230.75,38,,,percent of total billed charges,38% of total billed charges,455.43,75,,,percent of total billed charges,75% of total billed charges,516.15,85,,,percent of total billed charges,85% of total billed charges,230.75,564.73,
Closed Frx. Red. Femoral Shft. (w/manip.)-FAC,569,CDM,450,RC,27502,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
Closed Frx. Red. Supracond. (w/manip) - FAC,570,CDM,450,RC,27503,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
FRX femoral distal end closed w/o manip-FAC,571,CDM,450,RC,27508,HCPCS,outpatient,,,662.44,496.83,,596.2,90,,,percent of total billed charges,90% of total billed charges,616.07,93,,,percent of total billed charges,93% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,563.07,85,,,percent of total billed charges,85% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,539.23,81.4,,,percent of total billed charges,81.4% of total billed charges,596.2,90,,,percent of total billed charges,90% of total billed charges,596.2,90,,,percent of total billed charges,90% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,496.83,75,,,percent of total billed charges,75% of total billed charges,563.07,85,,,percent of total billed charges,85% of total billed charges,251.73,616.07,
Closed Frx. Red. Femoral Distal (w/manip)-FAC,572,CDM,450,RC,27510,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
Closed Patellar Fracture-fac,573,CDM,450,RC,27520,HCPCS,outpatient,,,290.6,217.95,,261.54,90,,,percent of total billed charges,90% of total billed charges,270.26,93,,,percent of total billed charges,93% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,236.55,81.4,,,percent of total billed charges,81.4% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,217.95,75,,,percent of total billed charges,75% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,270.26,
"FRX-Tibial, Proximal; W/O Mantip-FAC",574,CDM,450,RC,27530,HCPCS,outpatient,,,377.3,282.98,,339.57,90,,,percent of total billed charges,90% of total billed charges,350.89,93,,,percent of total billed charges,93% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,307.12,81.4,,,percent of total billed charges,81.4% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,282.98,75,,,percent of total billed charges,75% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,350.89,
"FRX-Tibial, Proximal; W/O Mantip-FAC",575,CDM,450,RC,27530,HCPCS,outpatient,,,377.3,282.98,,339.57,90,,,percent of total billed charges,90% of total billed charges,350.89,93,,,percent of total billed charges,93% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,307.12,81.4,,,percent of total billed charges,81.4% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,282.98,75,,,percent of total billed charges,75% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,350.89,
Dislocation of Patella-Fac,576,CDM,450,RC,27550,HCPCS,outpatient,,,290.6,217.95,,261.54,90,,,percent of total billed charges,90% of total billed charges,270.26,93,,,percent of total billed charges,93% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,236.55,81.4,,,percent of total billed charges,81.4% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,217.95,75,,,percent of total billed charges,75% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,270.26,
DIS-Knee (w/anesth)-FAC,577,CDM,450,RC,27552,HCPCS,outpatient,,,1876.93,1407.7,,1689.24,90,,,percent of total billed charges,90% of total billed charges,1745.54,93,,,percent of total billed charges,93% of total billed charges,713.23,38,,,percent of total billed charges,38% of total billed charges,713.23,38,,,percent of total billed charges,38% of total billed charges,1595.39,85,,,percent of total billed charges,85% of total billed charges,713.23,38,,,percent of total billed charges,38% of total billed charges,1527.82,81.4,,,percent of total billed charges,81.4% of total billed charges,1689.24,90,,,percent of total billed charges,90% of total billed charges,1689.24,90,,,percent of total billed charges,90% of total billed charges,713.23,38,,,percent of total billed charges,38% of total billed charges,713.23,38,,,percent of total billed charges,38% of total billed charges,713.23,38,,,percent of total billed charges,38% of total billed charges,1407.7,75,,,percent of total billed charges,75% of total billed charges,1595.39,85,,,percent of total billed charges,85% of total billed charges,713.23,1745.54,
DIS-Patellar; W/O Anes-Fac,578,CDM,450,RC,27560,HCPCS,outpatient,,,482,361.5,,433.8,90,,,percent of total billed charges,90% of total billed charges,448.26,93,,,percent of total billed charges,93% of total billed charges,183.16,38,,,percent of total billed charges,38% of total billed charges,183.16,38,,,percent of total billed charges,38% of total billed charges,409.7,85,,,percent of total billed charges,85% of total billed charges,183.16,38,,,percent of total billed charges,38% of total billed charges,392.35,81.4,,,percent of total billed charges,81.4% of total billed charges,433.8,90,,,percent of total billed charges,90% of total billed charges,433.8,90,,,percent of total billed charges,90% of total billed charges,183.16,38,,,percent of total billed charges,38% of total billed charges,183.16,38,,,percent of total billed charges,38% of total billed charges,183.16,38,,,percent of total billed charges,38% of total billed charges,361.5,75,,,percent of total billed charges,75% of total billed charges,409.7,85,,,percent of total billed charges,85% of total billed charges,183.16,448.26,
DIS-Patellar (w/anesth)-FAC,579,CDM,450,RC,27562,HCPCS,outpatient,,,1115.13,836.35,,1003.62,90,,,percent of total billed charges,90% of total billed charges,1037.07,93,,,percent of total billed charges,93% of total billed charges,423.75,38,,,percent of total billed charges,38% of total billed charges,423.75,38,,,percent of total billed charges,38% of total billed charges,947.86,85,,,percent of total billed charges,85% of total billed charges,423.75,38,,,percent of total billed charges,38% of total billed charges,907.72,81.4,,,percent of total billed charges,81.4% of total billed charges,1003.62,90,,,percent of total billed charges,90% of total billed charges,1003.62,90,,,percent of total billed charges,90% of total billed charges,423.75,38,,,percent of total billed charges,38% of total billed charges,423.75,38,,,percent of total billed charges,38% of total billed charges,423.75,38,,,percent of total billed charges,38% of total billed charges,836.35,75,,,percent of total billed charges,75% of total billed charges,947.86,85,,,percent of total billed charges,85% of total billed charges,423.75,1037.07,
FRX-Tibial Shaft closed w/o manip-FAC,580,CDM,450,RC,27750,HCPCS,outpatient,,,496.83,372.62,,447.15,90,,,percent of total billed charges,90% of total billed charges,462.05,93,,,percent of total billed charges,93% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,404.42,81.4,,,percent of total billed charges,81.4% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,372.62,75,,,percent of total billed charges,75% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,462.05,
FRX-Tibial Shaft closed w/o manip-FAC,581,CDM,450,RC,27750,HCPCS,outpatient,,,496.83,372.62,,447.15,90,,,percent of total billed charges,90% of total billed charges,462.05,93,,,percent of total billed charges,93% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,404.42,81.4,,,percent of total billed charges,81.4% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,372.62,75,,,percent of total billed charges,75% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,462.05,
Closed Frx Red.Tibial Shaft (w/manip)-FAC,582,CDM,450,RC,27752,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
FX medial malleolus closed w/o manip-TECH,583,CDM,450,RC,27760,HCPCS,outpatient,,,461.51,346.13,,415.36,90,,,percent of total billed charges,90% of total billed charges,429.2,93,,,percent of total billed charges,93% of total billed charges,175.37,38,,,percent of total billed charges,38% of total billed charges,175.37,38,,,percent of total billed charges,38% of total billed charges,392.28,85,,,percent of total billed charges,85% of total billed charges,175.37,38,,,percent of total billed charges,38% of total billed charges,375.67,81.4,,,percent of total billed charges,81.4% of total billed charges,415.36,90,,,percent of total billed charges,90% of total billed charges,415.36,90,,,percent of total billed charges,90% of total billed charges,175.37,38,,,percent of total billed charges,38% of total billed charges,175.37,38,,,percent of total billed charges,38% of total billed charges,175.37,38,,,percent of total billed charges,38% of total billed charges,346.13,75,,,percent of total billed charges,75% of total billed charges,392.28,85,,,percent of total billed charges,85% of total billed charges,175.37,429.2,
Closed Frx Red Medial Mall. (w/manip)-FAC,584,CDM,450,RC,27762,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
FRX-Posterior Malleolus closed w/o manip-FAC,585,CDM,450,RC,27767,HCPCS,outpatient,,,473.66,355.25,,426.29,90,,,percent of total billed charges,90% of total billed charges,440.5,93,,,percent of total billed charges,93% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,402.61,85,,,percent of total billed charges,85% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,385.56,81.4,,,percent of total billed charges,81.4% of total billed charges,426.29,90,,,percent of total billed charges,90% of total billed charges,426.29,90,,,percent of total billed charges,90% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,355.25,75,,,percent of total billed charges,75% of total billed charges,402.61,85,,,percent of total billed charges,85% of total billed charges,179.99,440.5,
Closed Frx Red Posterior Mall. (w/manip)-FAC,586,CDM,450,RC,27768,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
FRX-Proximal Fibula closed w/o manip-FAC,587,CDM,450,RC,27780,HCPCS,outpatient,,,473.66,355.25,,426.29,90,,,percent of total billed charges,90% of total billed charges,440.5,93,,,percent of total billed charges,93% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,402.61,85,,,percent of total billed charges,85% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,385.56,81.4,,,percent of total billed charges,81.4% of total billed charges,426.29,90,,,percent of total billed charges,90% of total billed charges,426.29,90,,,percent of total billed charges,90% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,179.99,38,,,percent of total billed charges,38% of total billed charges,355.25,75,,,percent of total billed charges,75% of total billed charges,402.61,85,,,percent of total billed charges,85% of total billed charges,179.99,440.5,
Closed Frx Red. Prox. Fibula (w/manip)-FAC,588,CDM,450,RC,27781,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
FRX-Distal Fibular Closed w/o manip-FAC,589,CDM,450,RC,27786,HCPCS,outpatient,,,331.22,248.42,,298.1,90,,,percent of total billed charges,90% of total billed charges,308.03,93,,,percent of total billed charges,93% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,281.54,85,,,percent of total billed charges,85% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,269.61,81.4,,,percent of total billed charges,81.4% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,248.42,75,,,percent of total billed charges,75% of total billed charges,281.54,85,,,percent of total billed charges,85% of total billed charges,125.86,308.03,
Closed Frx Red. Distal Fibular (w/manip)-FAC,590,CDM,450,RC,27788,HCPCS,outpatient,,,484.26,363.2,,435.83,90,,,percent of total billed charges,90% of total billed charges,450.36,93,,,percent of total billed charges,93% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,394.19,81.4,,,percent of total billed charges,81.4% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,363.2,75,,,percent of total billed charges,75% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,450.36,
FRX Bimalleolar closed w/o manip-FAC,591,CDM,450,RC,27808,HCPCS,outpatient,,,437.21,327.91,,393.49,90,,,percent of total billed charges,90% of total billed charges,406.61,93,,,percent of total billed charges,93% of total billed charges,166.14,38,,,percent of total billed charges,38% of total billed charges,166.14,38,,,percent of total billed charges,38% of total billed charges,371.63,85,,,percent of total billed charges,85% of total billed charges,166.14,38,,,percent of total billed charges,38% of total billed charges,355.89,81.4,,,percent of total billed charges,81.4% of total billed charges,393.49,90,,,percent of total billed charges,90% of total billed charges,393.49,90,,,percent of total billed charges,90% of total billed charges,166.14,38,,,percent of total billed charges,38% of total billed charges,166.14,38,,,percent of total billed charges,38% of total billed charges,166.14,38,,,percent of total billed charges,38% of total billed charges,327.91,75,,,percent of total billed charges,75% of total billed charges,371.63,85,,,percent of total billed charges,85% of total billed charges,166.14,406.61,
Closed Frx Red. Bimalleolar (w/manip)-FAC,592,CDM,450,RC,27810,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
FRX trimalleolar closed w/o manip-FAC,593,CDM,450,RC,27816,HCPCS,outpatient,,,552.03,414.02,,496.83,90,,,percent of total billed charges,90% of total billed charges,513.39,93,,,percent of total billed charges,93% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,469.23,85,,,percent of total billed charges,85% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,449.35,81.4,,,percent of total billed charges,81.4% of total billed charges,496.83,90,,,percent of total billed charges,90% of total billed charges,496.83,90,,,percent of total billed charges,90% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,414.02,75,,,percent of total billed charges,75% of total billed charges,469.23,85,,,percent of total billed charges,85% of total billed charges,209.77,513.39,
Closed Frx Red. Trimalleolar (w/manip)-FAC,594,CDM,450,RC,27818,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
Closed Frx Red. Wt. Bear. Art. DT-FAC,595,CDM,450,RC,27825,HCPCS,outpatient,,,2280.49,1710.37,,2052.44,90,,,percent of total billed charges,90% of total billed charges,2120.86,93,,,percent of total billed charges,93% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1856.32,81.4,,,percent of total billed charges,81.4% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,2052.44,90,,,percent of total billed charges,90% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,866.59,38,,,percent of total billed charges,38% of total billed charges,1710.37,75,,,percent of total billed charges,75% of total billed charges,1938.42,85,,,percent of total billed charges,85% of total billed charges,866.59,2120.86,
DIS-Ankle (w/o anesth.)-FAC,596,CDM,450,RC,27840,HCPCS,outpatient,,,484.26,363.2,,435.83,90,,,percent of total billed charges,90% of total billed charges,450.36,93,,,percent of total billed charges,93% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,394.19,81.4,,,percent of total billed charges,81.4% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,363.2,75,,,percent of total billed charges,75% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,450.36,
DIS-Ankle (w/anesth)-FAC,597,CDM,450,RC,27842,HCPCS,outpatient,,,1490.51,1117.88,,1341.46,90,,,percent of total billed charges,90% of total billed charges,1386.17,93,,,percent of total billed charges,93% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1213.28,81.4,,,percent of total billed charges,81.4% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,1341.46,90,,,percent of total billed charges,90% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,566.39,38,,,percent of total billed charges,38% of total billed charges,1117.88,75,,,percent of total billed charges,75% of total billed charges,1266.93,85,,,percent of total billed charges,85% of total billed charges,566.39,1386.17,
FBR-From foot-Fac,598,CDM,450,RC,28190,HCPCS,outpatient,,,655.01,491.26,,589.51,90,,,percent of total billed charges,90% of total billed charges,609.16,93,,,percent of total billed charges,93% of total billed charges,248.9,38,,,percent of total billed charges,38% of total billed charges,248.9,38,,,percent of total billed charges,38% of total billed charges,556.76,85,,,percent of total billed charges,85% of total billed charges,248.9,38,,,percent of total billed charges,38% of total billed charges,533.18,81.4,,,percent of total billed charges,81.4% of total billed charges,589.51,90,,,percent of total billed charges,90% of total billed charges,589.51,90,,,percent of total billed charges,90% of total billed charges,248.9,38,,,percent of total billed charges,38% of total billed charges,248.9,38,,,percent of total billed charges,38% of total billed charges,248.9,38,,,percent of total billed charges,38% of total billed charges,491.26,75,,,percent of total billed charges,75% of total billed charges,556.76,85,,,percent of total billed charges,85% of total billed charges,248.9,609.16,
FB Removal From foot/deep-Fac,599,CDM,450,RC,28192,HCPCS,outpatient,,,2345.88,1759.41,,2111.29,90,,,percent of total billed charges,90% of total billed charges,2181.67,93,,,percent of total billed charges,93% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,1994,85,,,percent of total billed charges,85% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,1909.55,81.4,,,percent of total billed charges,81.4% of total billed charges,2111.29,90,,,percent of total billed charges,90% of total billed charges,2111.29,90,,,percent of total billed charges,90% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,1759.41,75,,,percent of total billed charges,75% of total billed charges,1994,85,,,percent of total billed charges,85% of total billed charges,891.43,2181.67,
FB Removal From foot/deep-Fac,600,CDM,450,RC,28192,HCPCS,outpatient,,,2345.88,1759.41,,2111.29,90,,,percent of total billed charges,90% of total billed charges,2181.67,93,,,percent of total billed charges,93% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,1994,85,,,percent of total billed charges,85% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,1909.55,81.4,,,percent of total billed charges,81.4% of total billed charges,2111.29,90,,,percent of total billed charges,90% of total billed charges,2111.29,90,,,percent of total billed charges,90% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,1759.41,75,,,percent of total billed charges,75% of total billed charges,1994,85,,,percent of total billed charges,85% of total billed charges,891.43,2181.67,
FBR Foot Complicated - FAC,601,CDM,450,RC,28193,HCPCS,outpatient,,,2277.1,1707.83,,2049.39,90,,,percent of total billed charges,90% of total billed charges,2117.7,93,,,percent of total billed charges,93% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1935.54,85,,,percent of total billed charges,85% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1853.56,81.4,,,percent of total billed charges,81.4% of total billed charges,2049.39,90,,,percent of total billed charges,90% of total billed charges,2049.39,90,,,percent of total billed charges,90% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1707.83,75,,,percent of total billed charges,75% of total billed charges,1935.54,85,,,percent of total billed charges,85% of total billed charges,865.3,2117.7,
Closed Calcaneal Fracture w/o manipulation-Fac,602,CDM,450,RC,28400,HCPCS,outpatient,,,448.79,336.59,,403.91,90,,,percent of total billed charges,90% of total billed charges,417.37,93,,,percent of total billed charges,93% of total billed charges,170.54,38,,,percent of total billed charges,38% of total billed charges,170.54,38,,,percent of total billed charges,38% of total billed charges,381.47,85,,,percent of total billed charges,85% of total billed charges,170.54,38,,,percent of total billed charges,38% of total billed charges,365.32,81.4,,,percent of total billed charges,81.4% of total billed charges,403.91,90,,,percent of total billed charges,90% of total billed charges,403.91,90,,,percent of total billed charges,90% of total billed charges,170.54,38,,,percent of total billed charges,38% of total billed charges,170.54,38,,,percent of total billed charges,38% of total billed charges,170.54,38,,,percent of total billed charges,38% of total billed charges,336.59,75,,,percent of total billed charges,75% of total billed charges,381.47,85,,,percent of total billed charges,85% of total billed charges,170.54,417.37,
FRX - Metatarsal Closed w/o manip-FAC,603,CDM,450,RC,28470,HCPCS,outpatient,,,414.03,310.52,,372.63,90,,,percent of total billed charges,90% of total billed charges,385.05,93,,,percent of total billed charges,93% of total billed charges,157.33,38,,,percent of total billed charges,38% of total billed charges,157.33,38,,,percent of total billed charges,38% of total billed charges,351.93,85,,,percent of total billed charges,85% of total billed charges,157.33,38,,,percent of total billed charges,38% of total billed charges,337.02,81.4,,,percent of total billed charges,81.4% of total billed charges,372.63,90,,,percent of total billed charges,90% of total billed charges,372.63,90,,,percent of total billed charges,90% of total billed charges,157.33,38,,,percent of total billed charges,38% of total billed charges,157.33,38,,,percent of total billed charges,38% of total billed charges,157.33,38,,,percent of total billed charges,38% of total billed charges,310.52,75,,,percent of total billed charges,75% of total billed charges,351.93,85,,,percent of total billed charges,85% of total billed charges,157.33,385.05,
Closed Frx Red-Metatarsal - FAC,604,CDM,450,RC,28475,HCPCS,outpatient,,,484.26,363.2,,435.83,90,,,percent of total billed charges,90% of total billed charges,450.36,93,,,percent of total billed charges,93% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,394.19,81.4,,,percent of total billed charges,81.4% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,363.2,75,,,percent of total billed charges,75% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,450.36,
FRX/DIS Great Toe Closed w/o manip-FAC,605,CDM,450,RC,28490,HCPCS,outpatient,,,290.6,217.95,,261.54,90,,,percent of total billed charges,90% of total billed charges,270.26,93,,,percent of total billed charges,93% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,236.55,81.4,,,percent of total billed charges,81.4% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,217.95,75,,,percent of total billed charges,75% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,270.26,
Closed Frx Red-Great Toe - FAC,606,CDM,450,RC,28495,HCPCS,outpatient,,,484.26,363.2,,435.83,90,,,percent of total billed charges,90% of total billed charges,450.36,93,,,percent of total billed charges,93% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,394.19,81.4,,,percent of total billed charges,81.4% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,363.2,75,,,percent of total billed charges,75% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,450.36,
FRX/DIS FT/Toe Phalanx Closed w/o Manip-FAC,607,CDM,450,RC,28510,HCPCS,outpatient,,,290.6,217.95,,261.54,90,,,percent of total billed charges,90% of total billed charges,270.26,93,,,percent of total billed charges,93% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,236.55,81.4,,,percent of total billed charges,81.4% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,261.54,90,,,percent of total billed charges,90% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,110.43,38,,,percent of total billed charges,38% of total billed charges,217.95,75,,,percent of total billed charges,75% of total billed charges,247.01,85,,,percent of total billed charges,85% of total billed charges,110.43,270.26,
Closed Frx Red - Phalanx - FAC,608,CDM,450,RC,28515,HCPCS,outpatient,,,484.26,363.2,,435.83,90,,,percent of total billed charges,90% of total billed charges,450.36,93,,,percent of total billed charges,93% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,394.19,81.4,,,percent of total billed charges,81.4% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,363.2,75,,,percent of total billed charges,75% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,450.36,
DIS Toe - Metatarsophalangeal - FAC,609,CDM,450,RC,28630,HCPCS,outpatient,,,484.26,363.2,,435.83,90,,,percent of total billed charges,90% of total billed charges,450.36,93,,,percent of total billed charges,93% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,394.19,81.4,,,percent of total billed charges,81.4% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,363.2,75,,,percent of total billed charges,75% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,450.36,
DIS-TOE Metatarsophal (w/anesth)-FAC,610,CDM,450,RC,28635,HCPCS,outpatient,,,496.83,372.62,,447.15,90,,,percent of total billed charges,90% of total billed charges,462.05,93,,,percent of total billed charges,93% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,404.42,81.4,,,percent of total billed charges,81.4% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,372.62,75,,,percent of total billed charges,75% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,462.05,
DIS-Toe Interphal. Jnt. (w/out anesth.)-FAC,611,CDM,450,RC,28660,HCPCS,outpatient,,,484.26,363.2,,435.83,90,,,percent of total billed charges,90% of total billed charges,450.36,93,,,percent of total billed charges,93% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,394.19,81.4,,,percent of total billed charges,81.4% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,435.83,90,,,percent of total billed charges,90% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,184.02,38,,,percent of total billed charges,38% of total billed charges,363.2,75,,,percent of total billed charges,75% of total billed charges,411.62,85,,,percent of total billed charges,85% of total billed charges,184.02,450.36,
DIS-TOE Interphalang (w/anesth)-FAC,612,CDM,450,RC,28665,HCPCS,outpatient,,,524.43,393.32,,471.99,90,,,percent of total billed charges,90% of total billed charges,487.72,93,,,percent of total billed charges,93% of total billed charges,199.28,38,,,percent of total billed charges,38% of total billed charges,199.28,38,,,percent of total billed charges,38% of total billed charges,445.77,85,,,percent of total billed charges,85% of total billed charges,199.28,38,,,percent of total billed charges,38% of total billed charges,426.89,81.4,,,percent of total billed charges,81.4% of total billed charges,471.99,90,,,percent of total billed charges,90% of total billed charges,471.99,90,,,percent of total billed charges,90% of total billed charges,199.28,38,,,percent of total billed charges,38% of total billed charges,199.28,38,,,percent of total billed charges,38% of total billed charges,199.28,38,,,percent of total billed charges,38% of total billed charges,393.32,75,,,percent of total billed charges,75% of total billed charges,445.77,85,,,percent of total billed charges,85% of total billed charges,199.28,487.72,
APPLY CAST LONG ARM-FAC,613,CDM,450,RC,29065,HCPCS,outpatient,,,534.92,401.19,,481.43,90,,,percent of total billed charges,90% of total billed charges,497.48,93,,,percent of total billed charges,93% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,435.42,81.4,,,percent of total billed charges,81.4% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,401.19,75,,,percent of total billed charges,75% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,497.48,
Casting:Arm/Shldr/Torso'Elbow to Finger-FAC,614,CDM,450,RC,29075,HCPCS,outpatient,,,534.92,401.19,,481.43,90,,,percent of total billed charges,90% of total billed charges,497.48,93,,,percent of total billed charges,93% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,435.42,81.4,,,percent of total billed charges,81.4% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,401.19,75,,,percent of total billed charges,75% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,497.48,
Splint/Strap:Torso/Upper;Shldr. to Hand(long)FAC,615,CDM,450,RC,29105,HCPCS,outpatient,,,92.57,69.43,,83.31,90,,,percent of total billed charges,90% of total billed charges,86.09,93,,,percent of total billed charges,93% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,78.68,85,,,percent of total billed charges,85% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,75.35,81.4,,,percent of total billed charges,81.4% of total billed charges,83.31,90,,,percent of total billed charges,90% of total billed charges,83.31,90,,,percent of total billed charges,90% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,69.43,75,,,percent of total billed charges,75% of total billed charges,78.68,85,,,percent of total billed charges,85% of total billed charges,35.18,86.09,
Splint/Strap:Torso/Upper;Shldr. to Hand(long)FAC,616,CDM,450,RC,29105,HCPCS,outpatient,,,92.57,69.43,,83.31,90,,,percent of total billed charges,90% of total billed charges,86.09,93,,,percent of total billed charges,93% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,78.68,85,,,percent of total billed charges,85% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,75.35,81.4,,,percent of total billed charges,81.4% of total billed charges,83.31,90,,,percent of total billed charges,90% of total billed charges,83.31,90,,,percent of total billed charges,90% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,69.43,75,,,percent of total billed charges,75% of total billed charges,78.68,85,,,percent of total billed charges,85% of total billed charges,35.18,86.09,
Apply forearm splint-Fac,617,CDM,450,RC,29125,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,161.27,
Application of finger splint-Fac,618,CDM,450,RC,29130,HCPCS,outpatient,,,64.44,48.33,,58,90,,,percent of total billed charges,90% of total billed charges,59.93,93,,,percent of total billed charges,93% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,52.45,81.4,,,percent of total billed charges,81.4% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,48.33,75,,,percent of total billed charges,75% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,59.93,
Application of finger splint-Fac,619,CDM,450,RC,29130,HCPCS,outpatient,,,64.44,48.33,,58,90,,,percent of total billed charges,90% of total billed charges,59.93,93,,,percent of total billed charges,93% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,52.45,81.4,,,percent of total billed charges,81.4% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,48.33,75,,,percent of total billed charges,75% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,59.93,
Strapping - Thorax - FAC,620,CDM,450,RC,29200,HCPCS,outpatient,,,305.19,228.89,,274.67,90,,,percent of total billed charges,90% of total billed charges,283.83,93,,,percent of total billed charges,93% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,259.41,85,,,percent of total billed charges,85% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,248.42,81.4,,,percent of total billed charges,81.4% of total billed charges,274.67,90,,,percent of total billed charges,90% of total billed charges,274.67,90,,,percent of total billed charges,90% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,228.89,75,,,percent of total billed charges,75% of total billed charges,259.41,85,,,percent of total billed charges,85% of total billed charges,115.97,283.83,
Strapping - Shoulder - FAC,621,CDM,450,RC,29240,HCPCS,outpatient,,,236.5,177.38,,212.85,90,,,percent of total billed charges,90% of total billed charges,219.95,93,,,percent of total billed charges,93% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,192.51,81.4,,,percent of total billed charges,81.4% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,177.38,75,,,percent of total billed charges,75% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,219.95,
Strapping - Elbow or wrist - FAC,622,CDM,450,RC,29260,HCPCS,outpatient,,,72.08,54.06,,64.87,90,,,percent of total billed charges,90% of total billed charges,67.03,93,,,percent of total billed charges,93% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,61.27,85,,,percent of total billed charges,85% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,58.67,81.4,,,percent of total billed charges,81.4% of total billed charges,64.87,90,,,percent of total billed charges,90% of total billed charges,64.87,90,,,percent of total billed charges,90% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,54.06,75,,,percent of total billed charges,75% of total billed charges,61.27,85,,,percent of total billed charges,85% of total billed charges,27.39,67.03,
Strapping - Hand or finger - FAC,623,CDM,450,RC,29280,HCPCS,outpatient,,,72.08,54.06,,64.87,90,,,percent of total billed charges,90% of total billed charges,67.03,93,,,percent of total billed charges,93% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,61.27,85,,,percent of total billed charges,85% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,58.67,81.4,,,percent of total billed charges,81.4% of total billed charges,64.87,90,,,percent of total billed charges,90% of total billed charges,64.87,90,,,percent of total billed charges,90% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,27.39,38,,,percent of total billed charges,38% of total billed charges,54.06,75,,,percent of total billed charges,75% of total billed charges,61.27,85,,,percent of total billed charges,85% of total billed charges,27.39,67.03,
Cast - Long Leg (Thigh to Toes)-FAC,624,CDM,450,RC,29345,HCPCS,outpatient,,,534.92,401.19,,481.43,90,,,percent of total billed charges,90% of total billed charges,497.48,93,,,percent of total billed charges,93% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,435.42,81.4,,,percent of total billed charges,81.4% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,401.19,75,,,percent of total billed charges,75% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,497.48,
Casting:Legs;Below Knee to Toes(short)-FAC,625,CDM,450,RC,29405,HCPCS,outpatient,,,534.92,401.19,,481.43,90,,,percent of total billed charges,90% of total billed charges,497.48,93,,,percent of total billed charges,93% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,435.42,81.4,,,percent of total billed charges,81.4% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,401.19,75,,,percent of total billed charges,75% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,497.48,
"Application, long leg splint-Fac",626,CDM,450,RC,29505,HCPCS,outpatient,,,186.31,139.73,,167.68,90,,,percent of total billed charges,90% of total billed charges,173.27,93,,,percent of total billed charges,93% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,151.66,81.4,,,percent of total billed charges,81.4% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,139.73,75,,,percent of total billed charges,75% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,173.27,
Splint/Strap:Ankle/FT-Calf(Short)-Fac,627,CDM,450,RC,29515,HCPCS,outpatient,,,186.31,139.73,,167.68,90,,,percent of total billed charges,90% of total billed charges,173.27,93,,,percent of total billed charges,93% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,151.66,81.4,,,percent of total billed charges,81.4% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,139.73,75,,,percent of total billed charges,75% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,173.27,
Splint/Strap:Ankle/FT-Calf(Short)-Fac,628,CDM,450,RC,29515,HCPCS,outpatient,,,186.31,139.73,,167.68,90,,,percent of total billed charges,90% of total billed charges,173.27,93,,,percent of total billed charges,93% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,151.66,81.4,,,percent of total billed charges,81.4% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,139.73,75,,,percent of total billed charges,75% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,173.27,
Splint/Strap:Ankle/FT-Calf(Short)-Fac,629,CDM,450,RC,29515,HCPCS,outpatient,,,186.31,139.73,,167.68,90,,,percent of total billed charges,90% of total billed charges,173.27,93,,,percent of total billed charges,93% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,151.66,81.4,,,percent of total billed charges,81.4% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,139.73,75,,,percent of total billed charges,75% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,173.27,
Strapping - Knee - FAC,630,CDM,450,RC,29530,HCPCS,outpatient,,,236.5,177.38,,212.85,90,,,percent of total billed charges,90% of total billed charges,219.95,93,,,percent of total billed charges,93% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,192.51,81.4,,,percent of total billed charges,81.4% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,177.38,75,,,percent of total billed charges,75% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,219.95,
Strapping - Ankle and or/foot - FAC,631,CDM,450,RC,29540,HCPCS,outpatient,,,305.19,228.89,,274.67,90,,,percent of total billed charges,90% of total billed charges,283.83,93,,,percent of total billed charges,93% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,259.41,85,,,percent of total billed charges,85% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,248.42,81.4,,,percent of total billed charges,81.4% of total billed charges,274.67,90,,,percent of total billed charges,90% of total billed charges,274.67,90,,,percent of total billed charges,90% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,228.89,75,,,percent of total billed charges,75% of total billed charges,259.41,85,,,percent of total billed charges,85% of total billed charges,115.97,283.83,
Strapping Toes - FAC,632,CDM,450,RC,29550,HCPCS,outpatient,,,126.12,94.59,,113.51,90,,,percent of total billed charges,90% of total billed charges,117.29,93,,,percent of total billed charges,93% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,107.2,85,,,percent of total billed charges,85% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,102.66,81.4,,,percent of total billed charges,81.4% of total billed charges,113.51,90,,,percent of total billed charges,90% of total billed charges,113.51,90,,,percent of total billed charges,90% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,94.59,75,,,percent of total billed charges,75% of total billed charges,107.2,85,,,percent of total billed charges,85% of total billed charges,47.93,117.29,
Strapping - Unna Boot - FAC,633,CDM,450,RC,29580,HCPCS,outpatient,,,305.19,228.89,,274.67,90,,,percent of total billed charges,90% of total billed charges,283.83,93,,,percent of total billed charges,93% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,259.41,85,,,percent of total billed charges,85% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,248.42,81.4,,,percent of total billed charges,81.4% of total billed charges,274.67,90,,,percent of total billed charges,90% of total billed charges,274.67,90,,,percent of total billed charges,90% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,115.97,38,,,percent of total billed charges,38% of total billed charges,228.89,75,,,percent of total billed charges,75% of total billed charges,259.41,85,,,percent of total billed charges,85% of total billed charges,115.97,283.83,
"Turb.inj.FB, intranasal-FAC",634,CDM,450,RC,30300,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
"Turb.inj.FB, intranasal-FAC",635,CDM,450,RC,30300,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
Control of nosebleed-simple anterior-Fac,636,CDM,450,RC,30901,HCPCS,outpatient,,,219.13,164.35,,197.22,90,,,percent of total billed charges,90% of total billed charges,203.79,93,,,percent of total billed charges,93% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,186.26,85,,,percent of total billed charges,85% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,178.37,81.4,,,percent of total billed charges,81.4% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,164.35,75,,,percent of total billed charges,75% of total billed charges,186.26,85,,,percent of total billed charges,85% of total billed charges,83.27,203.79,
Control of nosebleed-simple anterior-Fac,637,CDM,450,RC,30901,HCPCS,outpatient,,,219.13,164.35,,197.22,90,,,percent of total billed charges,90% of total billed charges,203.79,93,,,percent of total billed charges,93% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,186.26,85,,,percent of total billed charges,85% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,178.37,81.4,,,percent of total billed charges,81.4% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,164.35,75,,,percent of total billed charges,75% of total billed charges,186.26,85,,,percent of total billed charges,85% of total billed charges,83.27,203.79,
Control of nosebleed-complex anterior-Fac,638,CDM,450,RC,30903,HCPCS,outpatient,,,219.13,164.35,,197.22,90,,,percent of total billed charges,90% of total billed charges,203.79,93,,,percent of total billed charges,93% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,186.26,85,,,percent of total billed charges,85% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,178.37,81.4,,,percent of total billed charges,81.4% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,164.35,75,,,percent of total billed charges,75% of total billed charges,186.26,85,,,percent of total billed charges,85% of total billed charges,83.27,203.79,
Nasal Cauterization/pac-Fac,639,CDM,450,RC,30905,HCPCS,outpatient,,,221.46,166.1,,199.31,90,,,percent of total billed charges,90% of total billed charges,205.96,93,,,percent of total billed charges,93% of total billed charges,84.15,38,,,percent of total billed charges,38% of total billed charges,84.15,38,,,percent of total billed charges,38% of total billed charges,188.24,85,,,percent of total billed charges,85% of total billed charges,84.15,38,,,percent of total billed charges,38% of total billed charges,180.27,81.4,,,percent of total billed charges,81.4% of total billed charges,199.31,90,,,percent of total billed charges,90% of total billed charges,199.31,90,,,percent of total billed charges,90% of total billed charges,84.15,38,,,percent of total billed charges,38% of total billed charges,84.15,38,,,percent of total billed charges,38% of total billed charges,84.15,38,,,percent of total billed charges,38% of total billed charges,166.1,75,,,percent of total billed charges,75% of total billed charges,188.24,85,,,percent of total billed charges,85% of total billed charges,84.15,205.96,
Control of nosebleed simple/comp-posterior-PRO,640,CDM,981,RC,30905,HCPCS,outpatient,,,573.02,429.77,,136.86,130,,,fee schedule,130% of fee schedule,136.86,130,,,fee schedule,130% of fee schedule,106.43,100,,,fee schedule,Pays 100% Medicare OPPS,106.43,100,,,fee schedule,Pays 100% Medicare OPPS,131.53,119,,,fee schedule,119% of fee schedule,106.43,100,,,fee schedule,Pays 100% Medicare OPPS,106.43,100,,,fee schedule,100% of fee schedule,515.72,90,,,percent of total billed charges,90% of total billed charges,106.43,100,,,fee schedule,Pays 100% Medicare OPPS,106.43,100,,,fee schedule,Pays 100% Medicare OPPS,106.43,100,,,fee schedule,Pays 100% Medicare OPPS,106.43,100,,,fee schedule,Pays 100% Medicare OPPS,222.77,100,,,fee schedule,100% of fee schedule,106.43,100,,,fee schedule,100% of fee schedule,106.43,515.72,
Control of nosebleed-simple/comp-posterior-Fac,641,CDM,450,RC,30905,HCPCS,outpatient,,,219.13,164.35,,197.22,90,,,percent of total billed charges,90% of total billed charges,203.79,93,,,percent of total billed charges,93% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,186.26,85,,,percent of total billed charges,85% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,178.37,81.4,,,percent of total billed charges,81.4% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,164.35,75,,,percent of total billed charges,75% of total billed charges,186.26,85,,,percent of total billed charges,85% of total billed charges,83.27,203.79,
Intubation-Fac,642,CDM,450,RC,31500,HCPCS,outpatient,,,435.91,326.93,,392.32,90,,,percent of total billed charges,90% of total billed charges,405.4,93,,,percent of total billed charges,93% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,354.83,81.4,,,percent of total billed charges,81.4% of total billed charges,392.32,90,,,percent of total billed charges,90% of total billed charges,392.32,90,,,percent of total billed charges,90% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,326.93,75,,,percent of total billed charges,75% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,165.65,405.4,
Incision of trachea-Fac,643,CDM,450,RC,31605,HCPCS,outpatient,,,772.86,579.65,,695.57,90,,,percent of total billed charges,90% of total billed charges,718.76,93,,,percent of total billed charges,93% of total billed charges,293.69,38,,,percent of total billed charges,38% of total billed charges,293.69,38,,,percent of total billed charges,38% of total billed charges,656.93,85,,,percent of total billed charges,85% of total billed charges,293.69,38,,,percent of total billed charges,38% of total billed charges,629.11,81.4,,,percent of total billed charges,81.4% of total billed charges,695.57,90,,,percent of total billed charges,90% of total billed charges,695.57,90,,,percent of total billed charges,90% of total billed charges,293.69,38,,,percent of total billed charges,38% of total billed charges,293.69,38,,,percent of total billed charges,38% of total billed charges,293.69,38,,,percent of total billed charges,38% of total billed charges,579.65,75,,,percent of total billed charges,75% of total billed charges,656.93,85,,,percent of total billed charges,85% of total billed charges,293.69,718.76,
Chest tube thoracostomy with draining-FAC,644,CDM,450,RC,32551,HCPCS,outpatient,,,642.57,481.93,,578.31,90,,,percent of total billed charges,90% of total billed charges,597.59,93,,,percent of total billed charges,93% of total billed charges,244.18,38,,,percent of total billed charges,38% of total billed charges,244.18,38,,,percent of total billed charges,38% of total billed charges,546.18,85,,,percent of total billed charges,85% of total billed charges,244.18,38,,,percent of total billed charges,38% of total billed charges,523.05,81.4,,,percent of total billed charges,81.4% of total billed charges,578.31,90,,,percent of total billed charges,90% of total billed charges,578.31,90,,,percent of total billed charges,90% of total billed charges,244.18,38,,,percent of total billed charges,38% of total billed charges,244.18,38,,,percent of total billed charges,38% of total billed charges,244.18,38,,,percent of total billed charges,38% of total billed charges,481.93,75,,,percent of total billed charges,75% of total billed charges,546.18,85,,,percent of total billed charges,85% of total billed charges,244.18,597.59,
"Thorocentesis w/o imaging, w/o tube -Fac",645,CDM,450,RC,32554,HCPCS,outpatient,,,1068.66,801.5,,961.79,90,,,percent of total billed charges,90% of total billed charges,993.85,93,,,percent of total billed charges,93% of total billed charges,406.09,38,,,percent of total billed charges,38% of total billed charges,406.09,38,,,percent of total billed charges,38% of total billed charges,908.36,85,,,percent of total billed charges,85% of total billed charges,406.09,38,,,percent of total billed charges,38% of total billed charges,869.89,81.4,,,percent of total billed charges,81.4% of total billed charges,961.79,90,,,percent of total billed charges,90% of total billed charges,961.79,90,,,percent of total billed charges,90% of total billed charges,406.09,38,,,percent of total billed charges,38% of total billed charges,406.09,38,,,percent of total billed charges,38% of total billed charges,406.09,38,,,percent of total billed charges,38% of total billed charges,801.5,75,,,percent of total billed charges,75% of total billed charges,908.36,85,,,percent of total billed charges,85% of total billed charges,406.09,993.85,
Thorocentesis w imaging w/o tube -FAC,646,CDM,450,RC,32555,HCPCS,outpatient,,,1042.88,782.16,,938.59,90,,,percent of total billed charges,90% of total billed charges,969.88,93,,,percent of total billed charges,93% of total billed charges,396.29,38,,,percent of total billed charges,38% of total billed charges,396.29,38,,,percent of total billed charges,38% of total billed charges,886.45,85,,,percent of total billed charges,85% of total billed charges,396.29,38,,,percent of total billed charges,38% of total billed charges,848.9,81.4,,,percent of total billed charges,81.4% of total billed charges,938.59,90,,,percent of total billed charges,90% of total billed charges,938.59,90,,,percent of total billed charges,90% of total billed charges,396.29,38,,,percent of total billed charges,38% of total billed charges,396.29,38,,,percent of total billed charges,38% of total billed charges,396.29,38,,,percent of total billed charges,38% of total billed charges,782.16,75,,,percent of total billed charges,75% of total billed charges,886.45,85,,,percent of total billed charges,85% of total billed charges,396.29,969.88,
Place needle in vein IV/Int-Fac,647,CDM,450,RC,36000,HCPCS,outpatient,,,201.54,151.16,,181.39,90,,,percent of total billed charges,90% of total billed charges,187.43,93,,,percent of total billed charges,93% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,171.31,85,,,percent of total billed charges,85% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,164.05,81.4,,,percent of total billed charges,81.4% of total billed charges,181.39,90,,,percent of total billed charges,90% of total billed charges,181.39,90,,,percent of total billed charges,90% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,151.16,75,,,percent of total billed charges,75% of total billed charges,171.31,85,,,percent of total billed charges,85% of total billed charges,76.59,187.43,
* Venipuncture - < 3 years-FAC,648,CDM,450,RC,36400,HCPCS,outpatient,,,56.3,42.23,,50.67,90,,,percent of total billed charges,90% of total billed charges,52.36,93,,,percent of total billed charges,93% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,45.83,81.4,,,percent of total billed charges,81.4% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,42.23,75,,,percent of total billed charges,75% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,21.39,52.36,
* Venipuncture - > 3 years-FAC,649,CDM,450,RC,36410,HCPCS,outpatient,,,56.3,42.23,,50.67,90,,,percent of total billed charges,90% of total billed charges,52.36,93,,,percent of total billed charges,93% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,45.83,81.4,,,percent of total billed charges,81.4% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,42.23,75,,,percent of total billed charges,75% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,21.39,52.36,
Central Line insertion-FAC,650,CDM,450,RC,36556,HCPCS,outpatient,,,2214.04,1660.53,,1992.64,90,,,percent of total billed charges,90% of total billed charges,2059.06,93,,,percent of total billed charges,93% of total billed charges,841.34,38,,,percent of total billed charges,38% of total billed charges,841.34,38,,,percent of total billed charges,38% of total billed charges,1881.93,85,,,percent of total billed charges,85% of total billed charges,841.34,38,,,percent of total billed charges,38% of total billed charges,1802.23,81.4,,,percent of total billed charges,81.4% of total billed charges,1992.64,90,,,percent of total billed charges,90% of total billed charges,1992.64,90,,,percent of total billed charges,90% of total billed charges,841.34,38,,,percent of total billed charges,38% of total billed charges,841.34,38,,,percent of total billed charges,38% of total billed charges,841.34,38,,,percent of total billed charges,38% of total billed charges,1660.53,75,,,percent of total billed charges,75% of total billed charges,1881.93,85,,,percent of total billed charges,85% of total billed charges,841.34,2059.06,
Declotting W Thrombolytic -cath,651,CDM,450,RC,36593,HCPCS,outpatient,,,270.61,202.96,,243.55,90,,,percent of total billed charges,90% of total billed charges,251.67,93,,,percent of total billed charges,93% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,220.28,81.4,,,percent of total billed charges,81.4% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,202.96,75,,,percent of total billed charges,75% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,251.67,
IO Placement-Fac,652,CDM,450,RC,36680,HCPCS,outpatient,,,241.38,181.04,,217.24,90,,,percent of total billed charges,90% of total billed charges,224.48,93,,,percent of total billed charges,93% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,205.17,85,,,percent of total billed charges,85% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,196.48,81.4,,,percent of total billed charges,81.4% of total billed charges,217.24,90,,,percent of total billed charges,90% of total billed charges,217.24,90,,,percent of total billed charges,90% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,181.04,75,,,percent of total billed charges,75% of total billed charges,205.17,85,,,percent of total billed charges,85% of total billed charges,91.72,224.48,
Thrombolytic -cerebral   FAC,653,CDM,450,RC,37195,HCPCS,outpatient,,,1689.24,1266.93,,1520.32,90,,,percent of total billed charges,90% of total billed charges,1570.99,93,,,percent of total billed charges,93% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,1435.85,85,,,percent of total billed charges,85% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,1375.04,81.4,,,percent of total billed charges,81.4% of total billed charges,1520.32,90,,,percent of total billed charges,90% of total billed charges,1520.32,90,,,percent of total billed charges,90% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,1266.93,75,,,percent of total billed charges,75% of total billed charges,1435.85,85,,,percent of total billed charges,85% of total billed charges,641.91,1570.99,
FBR-Mouth-Fac,654,CDM,450,RC,40804,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
Soft tissue FBR - Vestibule - Complicated-FAC,655,CDM,450,RC,40805,HCPCS,outpatient,,,1036.08,777.06,,932.47,90,,,percent of total billed charges,90% of total billed charges,963.55,93,,,percent of total billed charges,93% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,880.67,85,,,percent of total billed charges,85% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,843.37,81.4,,,percent of total billed charges,81.4% of total billed charges,932.47,90,,,percent of total billed charges,90% of total billed charges,932.47,90,,,percent of total billed charges,90% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,777.06,75,,,percent of total billed charges,75% of total billed charges,880.67,85,,,percent of total billed charges,85% of total billed charges,393.71,963.55,
"Wound Repair - Mouth, Tongue <2.5 cm-FAC",656,CDM,450,RC,41250,HCPCS,outpatient,,,236.5,177.38,,212.85,90,,,percent of total billed charges,90% of total billed charges,219.95,93,,,percent of total billed charges,93% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,192.51,81.4,,,percent of total billed charges,81.4% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,177.38,75,,,percent of total billed charges,75% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,219.95,
Wound Repair - Posterior Tongue - FAC,657,CDM,450,RC,41251,HCPCS,outpatient,,,402.04,301.53,,361.84,90,,,percent of total billed charges,90% of total billed charges,373.9,93,,,percent of total billed charges,93% of total billed charges,152.78,38,,,percent of total billed charges,38% of total billed charges,152.78,38,,,percent of total billed charges,38% of total billed charges,341.73,85,,,percent of total billed charges,85% of total billed charges,152.78,38,,,percent of total billed charges,38% of total billed charges,327.26,81.4,,,percent of total billed charges,81.4% of total billed charges,361.84,90,,,percent of total billed charges,90% of total billed charges,361.84,90,,,percent of total billed charges,90% of total billed charges,152.78,38,,,percent of total billed charges,38% of total billed charges,152.78,38,,,percent of total billed charges,38% of total billed charges,152.78,38,,,percent of total billed charges,38% of total billed charges,301.53,75,,,percent of total billed charges,75% of total billed charges,341.73,85,,,percent of total billed charges,85% of total billed charges,152.78,373.9,
"Wound Repair - Mouth, Tongue >2.6 cm-FAC",658,CDM,450,RC,41252,HCPCS,outpatient,,,1036.08,777.06,,932.47,90,,,percent of total billed charges,90% of total billed charges,963.55,93,,,percent of total billed charges,93% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,880.67,85,,,percent of total billed charges,85% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,843.37,81.4,,,percent of total billed charges,81.4% of total billed charges,932.47,90,,,percent of total billed charges,90% of total billed charges,932.47,90,,,percent of total billed charges,90% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,393.71,38,,,percent of total billed charges,38% of total billed charges,777.06,75,,,percent of total billed charges,75% of total billed charges,880.67,85,,,percent of total billed charges,85% of total billed charges,393.71,963.55,
Drainage of gum lesions facility,659,CDM,450,RC,41800,HCPCS,outpatient,,,172.3,129.23,,155.07,90,,,percent of total billed charges,90% of total billed charges,160.24,93,,,percent of total billed charges,93% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,146.46,85,,,percent of total billed charges,85% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,140.25,81.4,,,percent of total billed charges,81.4% of total billed charges,155.07,90,,,percent of total billed charges,90% of total billed charges,155.07,90,,,percent of total billed charges,90% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,129.23,75,,,percent of total billed charges,75% of total billed charges,146.46,85,,,percent of total billed charges,85% of total billed charges,65.47,160.24,
FBO dental-alveolar-Fac,660,CDM,450,RC,41805,HCPCS,outpatient,,,1791.95,1343.96,,1612.76,90,,,percent of total billed charges,90% of total billed charges,1666.51,93,,,percent of total billed charges,93% of total billed charges,680.94,38,,,percent of total billed charges,38% of total billed charges,680.94,38,,,percent of total billed charges,38% of total billed charges,1523.16,85,,,percent of total billed charges,85% of total billed charges,680.94,38,,,percent of total billed charges,38% of total billed charges,1458.65,81.4,,,percent of total billed charges,81.4% of total billed charges,1612.76,90,,,percent of total billed charges,90% of total billed charges,1612.76,90,,,percent of total billed charges,90% of total billed charges,680.94,38,,,percent of total billed charges,38% of total billed charges,680.94,38,,,percent of total billed charges,38% of total billed charges,680.94,38,,,percent of total billed charges,38% of total billed charges,1343.96,75,,,percent of total billed charges,75% of total billed charges,1523.16,85,,,percent of total billed charges,85% of total billed charges,680.94,1666.51,
I&D Peritonsillar-FAC,661,CDM,450,RC,42700,HCPCS,outpatient,,,573.02,429.77,,515.72,90,,,percent of total billed charges,90% of total billed charges,532.91,93,,,percent of total billed charges,93% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,487.07,85,,,percent of total billed charges,85% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,466.44,81.4,,,percent of total billed charges,81.4% of total billed charges,515.72,90,,,percent of total billed charges,90% of total billed charges,515.72,90,,,percent of total billed charges,90% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,429.77,75,,,percent of total billed charges,75% of total billed charges,487.07,85,,,percent of total billed charges,85% of total billed charges,217.75,532.91,
FBR-pharynx-Fac,662,CDM,450,RC,42809,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
Gastric intubations treatment-NG tube-Fac,663,CDM,450,RC,43752,HCPCS,outpatient,,,232.01,174.01,,208.81,90,,,percent of total billed charges,90% of total billed charges,215.77,93,,,percent of total billed charges,93% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,188.86,81.4,,,percent of total billed charges,81.4% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,174.01,75,,,percent of total billed charges,75% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,215.77,
Gastric intubations treatment-NG tube-Fac,664,CDM,450,RC,43752,HCPCS,outpatient,,,232.01,174.01,,208.81,90,,,percent of total billed charges,90% of total billed charges,215.77,93,,,percent of total billed charges,93% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,188.86,81.4,,,percent of total billed charges,81.4% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,174.01,75,,,percent of total billed charges,75% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,215.77,
Gastric Lavage-Fac,665,CDM,450,RC,43753,HCPCS,outpatient,,,278.88,209.16,,250.99,90,,,percent of total billed charges,90% of total billed charges,259.36,93,,,percent of total billed charges,93% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,237.05,85,,,percent of total billed charges,85% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,227.01,81.4,,,percent of total billed charges,81.4% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,209.16,75,,,percent of total billed charges,75% of total billed charges,237.05,85,,,percent of total billed charges,85% of total billed charges,105.97,259.36,
Change gastrostomy tube-Fac,666,CDM,450,RC,43762,HCPCS,outpatient,,,414.8,311.1,,373.32,90,,,percent of total billed charges,90% of total billed charges,385.76,93,,,percent of total billed charges,93% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,337.65,81.4,,,percent of total billed charges,81.4% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,311.1,75,,,percent of total billed charges,75% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,385.76,
I&D - Perirectal - FAC,667,CDM,450,RC,46040,HCPCS,outpatient,,,2109.3,1581.98,,1898.37,90,,,percent of total billed charges,90% of total billed charges,1961.65,93,,,percent of total billed charges,93% of total billed charges,801.53,38,,,percent of total billed charges,38% of total billed charges,801.53,38,,,percent of total billed charges,38% of total billed charges,1792.91,85,,,percent of total billed charges,85% of total billed charges,801.53,38,,,percent of total billed charges,38% of total billed charges,1716.97,81.4,,,percent of total billed charges,81.4% of total billed charges,1898.37,90,,,percent of total billed charges,90% of total billed charges,1898.37,90,,,percent of total billed charges,90% of total billed charges,801.53,38,,,percent of total billed charges,38% of total billed charges,801.53,38,,,percent of total billed charges,38% of total billed charges,801.53,38,,,percent of total billed charges,38% of total billed charges,1581.98,75,,,percent of total billed charges,75% of total billed charges,1792.91,85,,,percent of total billed charges,85% of total billed charges,801.53,1961.65,
I&D perianal abscess; superficial-Fac,668,CDM,450,RC,46050,HCPCS,outpatient,,,1382.7,1037.03,,1244.43,90,,,percent of total billed charges,90% of total billed charges,1285.91,93,,,percent of total billed charges,93% of total billed charges,525.43,38,,,percent of total billed charges,38% of total billed charges,525.43,38,,,percent of total billed charges,38% of total billed charges,1175.3,85,,,percent of total billed charges,85% of total billed charges,525.43,38,,,percent of total billed charges,38% of total billed charges,1125.52,81.4,,,percent of total billed charges,81.4% of total billed charges,1244.43,90,,,percent of total billed charges,90% of total billed charges,1244.43,90,,,percent of total billed charges,90% of total billed charges,525.43,38,,,percent of total billed charges,38% of total billed charges,525.43,38,,,percent of total billed charges,38% of total billed charges,525.43,38,,,percent of total billed charges,38% of total billed charges,1037.03,75,,,percent of total billed charges,75% of total billed charges,1175.3,85,,,percent of total billed charges,85% of total billed charges,525.43,1285.91,
I & D Thrombosed Hemorrhoid - pro,669,CDM,981,RC,46320,HCPCS,outpatient,,,436.51,327.38,,146.02,130,,,fee schedule,130% of fee schedule,146.02,130,,,fee schedule,130% of fee schedule,115.44,100,,,fee schedule,Pays 100% Medicare OPPS,115.44,100,,,fee schedule,Pays 100% Medicare OPPS,138.98,119,,,fee schedule,119% of fee schedule,115.44,100,,,fee schedule,Pays 100% Medicare OPPS,115.44,100,,,fee schedule,100% of fee schedule,392.86,90,,,percent of total billed charges,90% of total billed charges,115.44,100,,,fee schedule,Pays 100% Medicare OPPS,115.44,100,,,fee schedule,Pays 100% Medicare OPPS,115.44,100,,,fee schedule,Pays 100% Medicare OPPS,115.44,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,115.44,100,,,fee schedule,100% of fee schedule,71.86,392.86,
I & D Thrombosed Hemorrhoid -Fac,670,CDM,450,RC,46320,HCPCS,outpatient,,,1899.92,1424.94,,1709.93,90,,,percent of total billed charges,90% of total billed charges,1766.93,93,,,percent of total billed charges,93% of total billed charges,721.97,38,,,percent of total billed charges,38% of total billed charges,721.97,38,,,percent of total billed charges,38% of total billed charges,1614.93,85,,,percent of total billed charges,85% of total billed charges,721.97,38,,,percent of total billed charges,38% of total billed charges,1546.53,81.4,,,percent of total billed charges,81.4% of total billed charges,1709.93,90,,,percent of total billed charges,90% of total billed charges,1709.93,90,,,percent of total billed charges,90% of total billed charges,721.97,38,,,percent of total billed charges,38% of total billed charges,721.97,38,,,percent of total billed charges,38% of total billed charges,721.97,38,,,percent of total billed charges,38% of total billed charges,1424.94,75,,,percent of total billed charges,75% of total billed charges,1614.93,85,,,percent of total billed charges,85% of total billed charges,721.97,1766.93,
Anoscopy - FAC,671,CDM,450,RC,46600,HCPCS,outpatient,,,236.5,177.38,,212.85,90,,,percent of total billed charges,90% of total billed charges,219.95,93,,,percent of total billed charges,93% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,192.51,81.4,,,percent of total billed charges,81.4% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,177.38,75,,,percent of total billed charges,75% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,219.95,
Anoscopy - w/FBR - FAC,672,CDM,450,RC,46608,HCPCS,outpatient,,,1599.16,1199.37,,1439.24,90,,,percent of total billed charges,90% of total billed charges,1487.22,93,,,percent of total billed charges,93% of total billed charges,607.68,38,,,percent of total billed charges,38% of total billed charges,607.68,38,,,percent of total billed charges,38% of total billed charges,1359.29,85,,,percent of total billed charges,85% of total billed charges,607.68,38,,,percent of total billed charges,38% of total billed charges,1301.72,81.4,,,percent of total billed charges,81.4% of total billed charges,1439.24,90,,,percent of total billed charges,90% of total billed charges,1439.24,90,,,percent of total billed charges,90% of total billed charges,607.68,38,,,percent of total billed charges,38% of total billed charges,607.68,38,,,percent of total billed charges,38% of total billed charges,607.68,38,,,percent of total billed charges,38% of total billed charges,1199.37,75,,,percent of total billed charges,75% of total billed charges,1359.29,85,,,percent of total billed charges,85% of total billed charges,607.68,1487.22,
Abd Paracentesis Facility w/o image guidance,673,CDM,450,RC,49082,HCPCS,outpatient,,,828.44,621.33,,745.6,90,,,percent of total billed charges,90% of total billed charges,770.45,93,,,percent of total billed charges,93% of total billed charges,314.81,38,,,percent of total billed charges,38% of total billed charges,314.81,38,,,percent of total billed charges,38% of total billed charges,704.17,85,,,percent of total billed charges,85% of total billed charges,314.81,38,,,percent of total billed charges,38% of total billed charges,674.35,81.4,,,percent of total billed charges,81.4% of total billed charges,745.6,90,,,percent of total billed charges,90% of total billed charges,745.6,90,,,percent of total billed charges,90% of total billed charges,314.81,38,,,percent of total billed charges,38% of total billed charges,314.81,38,,,percent of total billed charges,38% of total billed charges,314.81,38,,,percent of total billed charges,38% of total billed charges,621.33,75,,,percent of total billed charges,75% of total billed charges,704.17,85,,,percent of total billed charges,85% of total billed charges,314.81,770.45,
Abd Paracentesis w imaging PRO,674,CDM,981,RC,49083,HCPCS,outpatient,,,307.01,230.26,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,106.33,100,,,fee schedule,Pays 100% Medicare OPPS,106.33,100,,,fee schedule,Pays 100% Medicare OPPS,134.14,119,,,fee schedule,119% of fee schedule,106.33,100,,,fee schedule,Pays 100% Medicare OPPS,106.33,100,,,fee schedule,100% of fee schedule,276.31,90,,,percent of total billed charges,90% of total billed charges,106.33,100,,,fee schedule,Pays 100% Medicare OPPS,106.33,100,,,fee schedule,Pays 100% Medicare OPPS,106.33,100,,,fee schedule,Pays 100% Medicare OPPS,106.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,106.33,100,,,fee schedule,100% of fee schedule,106.33,276.31,
Abd Paracentesisfacility w imaging-FAC,675,CDM,450,RC,49083,HCPCS,outpatient,,,1006.57,754.93,,905.91,90,,,percent of total billed charges,90% of total billed charges,936.11,93,,,percent of total billed charges,93% of total billed charges,382.5,38,,,percent of total billed charges,38% of total billed charges,382.5,38,,,percent of total billed charges,38% of total billed charges,855.58,85,,,percent of total billed charges,85% of total billed charges,382.5,38,,,percent of total billed charges,38% of total billed charges,819.35,81.4,,,percent of total billed charges,81.4% of total billed charges,905.91,90,,,percent of total billed charges,90% of total billed charges,905.91,90,,,percent of total billed charges,90% of total billed charges,382.5,38,,,percent of total billed charges,38% of total billed charges,382.5,38,,,percent of total billed charges,38% of total billed charges,382.5,38,,,percent of total billed charges,38% of total billed charges,754.93,75,,,percent of total billed charges,75% of total billed charges,855.58,85,,,percent of total billed charges,85% of total billed charges,382.5,936.11,
Peritoneal lavage - FAC,676,CDM,450,RC,49084,HCPCS,outpatient,,,1674.6,1255.95,,1507.14,90,,,percent of total billed charges,90% of total billed charges,1557.38,93,,,percent of total billed charges,93% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,1423.41,85,,,percent of total billed charges,85% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,1363.12,81.4,,,percent of total billed charges,81.4% of total billed charges,1507.14,90,,,percent of total billed charges,90% of total billed charges,1507.14,90,,,percent of total billed charges,90% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,1255.95,75,,,percent of total billed charges,75% of total billed charges,1423.41,85,,,percent of total billed charges,85% of total billed charges,636.35,1557.38,
Peritoneal lavage - FAC,677,CDM,450,RC,49084,HCPCS,outpatient,,,1674.6,1255.95,,1507.14,90,,,percent of total billed charges,90% of total billed charges,1557.38,93,,,percent of total billed charges,93% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,1423.41,85,,,percent of total billed charges,85% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,1363.12,81.4,,,percent of total billed charges,81.4% of total billed charges,1507.14,90,,,percent of total billed charges,90% of total billed charges,1507.14,90,,,percent of total billed charges,90% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,1255.95,75,,,percent of total billed charges,75% of total billed charges,1423.41,85,,,percent of total billed charges,85% of total billed charges,636.35,1557.38,
Aspiration of bladder by needle,678,CDM,450,RC,51100,HCPCS,outpatient,,,344.6,258.45,,310.14,90,,,percent of total billed charges,90% of total billed charges,320.48,93,,,percent of total billed charges,93% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,280.5,81.4,,,percent of total billed charges,81.4% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,258.45,75,,,percent of total billed charges,75% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,130.95,320.48,
Irrigation of bladder-Fac,679,CDM,450,RC,51700,HCPCS,outpatient,,,209.75,157.31,,188.78,90,,,percent of total billed charges,90% of total billed charges,195.07,93,,,percent of total billed charges,93% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,178.29,85,,,percent of total billed charges,85% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,170.74,81.4,,,percent of total billed charges,81.4% of total billed charges,188.78,90,,,percent of total billed charges,90% of total billed charges,188.78,90,,,percent of total billed charges,90% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,157.31,75,,,percent of total billed charges,75% of total billed charges,178.29,85,,,percent of total billed charges,85% of total billed charges,79.71,195.07,
Insert urinary catheter straight,680,CDM,450,RC,51701,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,191.79,
Insert urinary catheter straight,681,CDM,450,RC,51701,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,191.79,
Insert urinary catheter straight,682,CDM,450,RC,51701,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,191.79,
Insert Foley urinary catheter-Fac,683,CDM,450,RC,51702,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,191.79,
Insert Foley urinary catheter-Fac,684,CDM,450,RC,51702,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,191.79,
Insert Foley urinary catheter-Fac,685,CDM,450,RC,51702,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,191.79,
"Insert Foley catheter , complicated",686,CDM,450,RC,51703,HCPCS,outpatient,,,394.16,295.62,,354.74,90,,,percent of total billed charges,90% of total billed charges,366.57,93,,,percent of total billed charges,93% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,335.04,85,,,percent of total billed charges,85% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,320.85,81.4,,,percent of total billed charges,81.4% of total billed charges,354.74,90,,,percent of total billed charges,90% of total billed charges,354.74,90,,,percent of total billed charges,90% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,295.62,75,,,percent of total billed charges,75% of total billed charges,335.04,85,,,percent of total billed charges,85% of total billed charges,149.78,366.57,
Bladder Scan - FAC Hospital,687,CDM,450,RC,51798,HCPCS,outpatient,,,126.12,94.59,,113.51,90,,,percent of total billed charges,90% of total billed charges,117.29,93,,,percent of total billed charges,93% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,107.2,85,,,percent of total billed charges,85% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,102.66,81.4,,,percent of total billed charges,81.4% of total billed charges,113.51,90,,,percent of total billed charges,90% of total billed charges,113.51,90,,,percent of total billed charges,90% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,94.59,75,,,percent of total billed charges,75% of total billed charges,107.2,85,,,percent of total billed charges,85% of total billed charges,47.93,117.29,
Bladder Scan - FAC Hospital,688,CDM,450,RC,51798,HCPCS,outpatient,,,126.12,94.59,,113.51,90,,,percent of total billed charges,90% of total billed charges,117.29,93,,,percent of total billed charges,93% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,107.2,85,,,percent of total billed charges,85% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,102.66,81.4,,,percent of total billed charges,81.4% of total billed charges,113.51,90,,,percent of total billed charges,90% of total billed charges,113.51,90,,,percent of total billed charges,90% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,47.93,38,,,percent of total billed charges,38% of total billed charges,94.59,75,,,percent of total billed charges,75% of total billed charges,107.2,85,,,percent of total billed charges,85% of total billed charges,47.93,117.29,
"I&D Epididymis, testis and/or scrotal space (abscess/hematoma)-Fac",689,CDM,450,RC,54700,HCPCS,outpatient,,,2925.91,2194.43,,2633.32,90,,,percent of total billed charges,90% of total billed charges,2721.1,93,,,percent of total billed charges,93% of total billed charges,1111.85,38,,,percent of total billed charges,38% of total billed charges,1111.85,38,,,percent of total billed charges,38% of total billed charges,2487.02,85,,,percent of total billed charges,85% of total billed charges,1111.85,38,,,percent of total billed charges,38% of total billed charges,2381.69,81.4,,,percent of total billed charges,81.4% of total billed charges,2633.32,90,,,percent of total billed charges,90% of total billed charges,2633.32,90,,,percent of total billed charges,90% of total billed charges,1111.85,38,,,percent of total billed charges,38% of total billed charges,1111.85,38,,,percent of total billed charges,38% of total billed charges,1111.85,38,,,percent of total billed charges,38% of total billed charges,2194.43,75,,,percent of total billed charges,75% of total billed charges,2487.02,85,,,percent of total billed charges,85% of total billed charges,1111.85,2721.1,
I&D - Scrotal Wall Abcess - FAC,690,CDM,450,RC,55100,HCPCS,outpatient,,,2277.1,1707.83,,2049.39,90,,,percent of total billed charges,90% of total billed charges,2117.7,93,,,percent of total billed charges,93% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1935.54,85,,,percent of total billed charges,85% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1853.56,81.4,,,percent of total billed charges,81.4% of total billed charges,2049.39,90,,,percent of total billed charges,90% of total billed charges,2049.39,90,,,percent of total billed charges,90% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,865.3,38,,,percent of total billed charges,38% of total billed charges,1707.83,75,,,percent of total billed charges,75% of total billed charges,1935.54,85,,,percent of total billed charges,85% of total billed charges,865.3,2117.7,
I&D Vulva/Perineal Abscess-Fac,691,CDM,450,RC,56405,HCPCS,outpatient,,,632.76,474.57,,569.48,90,,,percent of total billed charges,90% of total billed charges,588.47,93,,,percent of total billed charges,93% of total billed charges,240.45,38,,,percent of total billed charges,38% of total billed charges,240.45,38,,,percent of total billed charges,38% of total billed charges,537.85,85,,,percent of total billed charges,85% of total billed charges,240.45,38,,,percent of total billed charges,38% of total billed charges,515.07,81.4,,,percent of total billed charges,81.4% of total billed charges,569.48,90,,,percent of total billed charges,90% of total billed charges,569.48,90,,,percent of total billed charges,90% of total billed charges,240.45,38,,,percent of total billed charges,38% of total billed charges,240.45,38,,,percent of total billed charges,38% of total billed charges,240.45,38,,,percent of total billed charges,38% of total billed charges,474.57,75,,,percent of total billed charges,75% of total billed charges,537.85,85,,,percent of total billed charges,85% of total billed charges,240.45,588.47,
I&D Bartholin gland abcess-Fac,692,CDM,450,RC,56420,HCPCS,outpatient,,,353.87,265.4,,318.48,90,,,percent of total billed charges,90% of total billed charges,329.1,93,,,percent of total billed charges,93% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,300.79,85,,,percent of total billed charges,85% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,288.05,81.4,,,percent of total billed charges,81.4% of total billed charges,318.48,90,,,percent of total billed charges,90% of total billed charges,318.48,90,,,percent of total billed charges,90% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,265.4,75,,,percent of total billed charges,75% of total billed charges,300.79,85,,,percent of total billed charges,85% of total billed charges,134.47,329.1,
Procuder of Endo; Samp.W/or W/O Endo. Samp. W/O Dilation-FAC,693,CDM,450,RC,58100,HCPCS,outpatient,,,192.17,144.13,,172.95,90,,,percent of total billed charges,90% of total billed charges,178.72,93,,,percent of total billed charges,93% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,156.43,81.4,,,percent of total billed charges,81.4% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,144.13,75,,,percent of total billed charges,75% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,178.72,
Procuder of Endo; Samp.W/or W/O Endo. Samp. W/O Dilation-FAC,694,CDM,450,RC,58100,HCPCS,outpatient,,,192.17,144.13,,172.95,90,,,percent of total billed charges,90% of total billed charges,178.72,93,,,percent of total billed charges,93% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,156.43,81.4,,,percent of total billed charges,81.4% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,144.13,75,,,percent of total billed charges,75% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,178.72,
Vaginal delivery only-Fac,695,CDM,450,RC,59409,HCPCS,outpatient,,,3164.97,2373.73,,2848.47,90,,,percent of total billed charges,90% of total billed charges,2943.42,93,,,percent of total billed charges,93% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,2690.22,85,,,percent of total billed charges,85% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,2576.29,81.4,,,percent of total billed charges,81.4% of total billed charges,2848.47,90,,,percent of total billed charges,90% of total billed charges,2848.47,90,,,percent of total billed charges,90% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,2373.73,75,,,percent of total billed charges,75% of total billed charges,2690.22,85,,,percent of total billed charges,85% of total billed charges,1202.69,2943.42,
Delivery Placenta-Fac,696,CDM,450,RC,59414,HCPCS,outpatient,,,3164.97,2373.73,,2848.47,90,,,percent of total billed charges,90% of total billed charges,2943.42,93,,,percent of total billed charges,93% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,2690.22,85,,,percent of total billed charges,85% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,2576.29,81.4,,,percent of total billed charges,81.4% of total billed charges,2848.47,90,,,percent of total billed charges,90% of total billed charges,2848.47,90,,,percent of total billed charges,90% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,1202.69,38,,,percent of total billed charges,38% of total billed charges,2373.73,75,,,percent of total billed charges,75% of total billed charges,2690.22,85,,,percent of total billed charges,85% of total billed charges,1202.69,2943.42,
Incomplete Abortion-Fac,697,CDM,450,RC,59812,HCPCS,outpatient,,,2977.47,2233.1,,2679.72,90,,,percent of total billed charges,90% of total billed charges,2769.05,93,,,percent of total billed charges,93% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,2530.85,85,,,percent of total billed charges,85% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,2423.66,81.4,,,percent of total billed charges,81.4% of total billed charges,2679.72,90,,,percent of total billed charges,90% of total billed charges,2679.72,90,,,percent of total billed charges,90% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,2233.1,75,,,percent of total billed charges,75% of total billed charges,2530.85,85,,,percent of total billed charges,85% of total billed charges,1131.44,2769.05,
Lumbar Puncture-Fac,698,CDM,450,RC,62270,HCPCS,outpatient,,,414.8,311.1,,373.32,90,,,percent of total billed charges,90% of total billed charges,385.76,93,,,percent of total billed charges,93% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,337.65,81.4,,,percent of total billed charges,81.4% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,311.1,75,,,percent of total billed charges,75% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,385.76,
dentoalveolar block-FAC,699,CDM,450,RC,64400,HCPCS,outpatient,,,550.71,413.03,,495.64,90,,,percent of total billed charges,90% of total billed charges,512.16,93,,,percent of total billed charges,93% of total billed charges,209.27,38,,,percent of total billed charges,38% of total billed charges,209.27,38,,,percent of total billed charges,38% of total billed charges,468.1,85,,,percent of total billed charges,85% of total billed charges,209.27,38,,,percent of total billed charges,38% of total billed charges,448.28,81.4,,,percent of total billed charges,81.4% of total billed charges,495.64,90,,,percent of total billed charges,90% of total billed charges,495.64,90,,,percent of total billed charges,90% of total billed charges,209.27,38,,,percent of total billed charges,38% of total billed charges,209.27,38,,,percent of total billed charges,38% of total billed charges,209.27,38,,,percent of total billed charges,38% of total billed charges,413.03,75,,,percent of total billed charges,75% of total billed charges,468.1,85,,,percent of total billed charges,85% of total billed charges,209.27,512.16,
Occipital (greater) Block-FAC,700,CDM,450,RC,64405,HCPCS,outpatient,,,534.92,401.19,,481.43,90,,,percent of total billed charges,90% of total billed charges,497.48,93,,,percent of total billed charges,93% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,435.42,81.4,,,percent of total billed charges,81.4% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,481.43,90,,,percent of total billed charges,90% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,203.27,38,,,percent of total billed charges,38% of total billed charges,401.19,75,,,percent of total billed charges,75% of total billed charges,454.68,85,,,percent of total billed charges,85% of total billed charges,203.27,497.48,
N block-Intercostal single,701,CDM,450,RC,64420,HCPCS,outpatient,,,1126.16,844.62,,1013.54,90,,,percent of total billed charges,90% of total billed charges,1047.33,93,,,percent of total billed charges,93% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,957.24,85,,,percent of total billed charges,85% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,916.69,81.4,,,percent of total billed charges,81.4% of total billed charges,1013.54,90,,,percent of total billed charges,90% of total billed charges,1013.54,90,,,percent of total billed charges,90% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,844.62,75,,,percent of total billed charges,75% of total billed charges,957.24,85,,,percent of total billed charges,85% of total billed charges,427.94,1047.33,
N block-Intercostal mult regional-fac,702,CDM,450,RC,64421,HCPCS,outpatient,,,1351.4,1013.55,,1216.26,90,,,percent of total billed charges,90% of total billed charges,1256.8,93,,,percent of total billed charges,93% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,1148.69,85,,,percent of total billed charges,85% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,1100.04,81.4,,,percent of total billed charges,81.4% of total billed charges,1216.26,90,,,percent of total billed charges,90% of total billed charges,1216.26,90,,,percent of total billed charges,90% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,1013.55,75,,,percent of total billed charges,75% of total billed charges,1148.69,85,,,percent of total billed charges,85% of total billed charges,513.53,1256.8,
Nerve Block - Fascia Iliaca-Pro,703,CDM,981,RC,64450,HCPCS,outpatient,,,529.31,396.98,,91.05,130,,,fee schedule,130% of fee schedule,91.05,130,,,fee schedule,130% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,53,119,,,fee schedule,119% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,100% of fee schedule,476.38,90,,,percent of total billed charges,90% of total billed charges,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,42.29,100,,,fee schedule,100% of fee schedule,35.93,476.38,
Digital Nerve Block - Other Periph.-FAC,704,CDM,450,RC,64450,HCPCS,outpatient,,,1224.13,918.1,,1101.72,90,,,percent of total billed charges,90% of total billed charges,1138.44,93,,,percent of total billed charges,93% of total billed charges,465.17,38,,,percent of total billed charges,38% of total billed charges,465.17,38,,,percent of total billed charges,38% of total billed charges,1040.51,85,,,percent of total billed charges,85% of total billed charges,465.17,38,,,percent of total billed charges,38% of total billed charges,996.44,81.4,,,percent of total billed charges,81.4% of total billed charges,1101.72,90,,,percent of total billed charges,90% of total billed charges,1101.72,90,,,percent of total billed charges,90% of total billed charges,465.17,38,,,percent of total billed charges,38% of total billed charges,465.17,38,,,percent of total billed charges,38% of total billed charges,465.17,38,,,percent of total billed charges,38% of total billed charges,918.1,75,,,percent of total billed charges,75% of total billed charges,1040.51,85,,,percent of total billed charges,85% of total billed charges,465.17,1138.44,
Nerve Block - Fascia Iliaca-Facility,705,CDM,450,RC,64450,HCPCS,outpatient,,,1223.01,917.26,,1100.71,90,,,percent of total billed charges,90% of total billed charges,1137.4,93,,,percent of total billed charges,93% of total billed charges,464.74,38,,,percent of total billed charges,38% of total billed charges,464.74,38,,,percent of total billed charges,38% of total billed charges,1039.56,85,,,percent of total billed charges,85% of total billed charges,464.74,38,,,percent of total billed charges,38% of total billed charges,995.53,81.4,,,percent of total billed charges,81.4% of total billed charges,1100.71,90,,,percent of total billed charges,90% of total billed charges,1100.71,90,,,percent of total billed charges,90% of total billed charges,464.74,38,,,percent of total billed charges,38% of total billed charges,464.74,38,,,percent of total billed charges,38% of total billed charges,464.74,38,,,percent of total billed charges,38% of total billed charges,917.26,75,,,percent of total billed charges,75% of total billed charges,1039.56,85,,,percent of total billed charges,85% of total billed charges,464.74,1137.4,
FB Removal:Eye;Conjunctival Superficial-FAC,706,CDM,450,RC,65205,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
FB Removal:Eye;Conjunctival Superficial-FAC,707,CDM,450,RC,65205,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
"FB Rmv:Eye;Conj Embedded,Sub./Scleral Nonper.-FAC",708,CDM,450,RC,65210,HCPCS,outpatient,,,46.87,35.15,,42.18,90,,,percent of total billed charges,90% of total billed charges,43.59,93,,,percent of total billed charges,93% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,38.15,81.4,,,percent of total billed charges,81.4% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,35.15,75,,,percent of total billed charges,75% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,43.59,
"FB Rmv:Eye;Conj Embedded,Sub./Scleral Nonper.-FAC",709,CDM,450,RC,65210,HCPCS,outpatient,,,46.87,35.15,,42.18,90,,,percent of total billed charges,90% of total billed charges,43.59,93,,,percent of total billed charges,93% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,38.15,81.4,,,percent of total billed charges,81.4% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,35.15,75,,,percent of total billed charges,75% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,43.59,
FBR-Corneal w/o slit lamp-Fac,710,CDM,450,RC,65220,HCPCS,outpatient,,,243.73,182.8,,219.36,90,,,percent of total billed charges,90% of total billed charges,226.67,93,,,percent of total billed charges,93% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,207.17,85,,,percent of total billed charges,85% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,198.4,81.4,,,percent of total billed charges,81.4% of total billed charges,219.36,90,,,percent of total billed charges,90% of total billed charges,219.36,90,,,percent of total billed charges,90% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,182.8,75,,,percent of total billed charges,75% of total billed charges,207.17,85,,,percent of total billed charges,85% of total billed charges,92.62,226.67,
FBR Eye - Corneal with slit lamp - FAC,711,CDM,450,RC,65222,HCPCS,outpatient,,,236.5,177.38,,212.85,90,,,percent of total billed charges,90% of total billed charges,219.95,93,,,percent of total billed charges,93% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,192.51,81.4,,,percent of total billed charges,81.4% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,212.85,90,,,percent of total billed charges,90% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,89.87,38,,,percent of total billed charges,38% of total billed charges,177.38,75,,,percent of total billed charges,75% of total billed charges,201.03,85,,,percent of total billed charges,85% of total billed charges,89.87,219.95,
FBR - eye Epithelium - FAC,712,CDM,450,RC,65435,HCPCS,outpatient,,,1821.02,1365.77,,1638.92,90,,,percent of total billed charges,90% of total billed charges,1693.55,93,,,percent of total billed charges,93% of total billed charges,691.99,38,,,percent of total billed charges,38% of total billed charges,691.99,38,,,percent of total billed charges,38% of total billed charges,1547.87,85,,,percent of total billed charges,85% of total billed charges,691.99,38,,,percent of total billed charges,38% of total billed charges,1482.31,81.4,,,percent of total billed charges,81.4% of total billed charges,1638.92,90,,,percent of total billed charges,90% of total billed charges,1638.92,90,,,percent of total billed charges,90% of total billed charges,691.99,38,,,percent of total billed charges,38% of total billed charges,691.99,38,,,percent of total billed charges,38% of total billed charges,691.99,38,,,percent of total billed charges,38% of total billed charges,1365.77,75,,,percent of total billed charges,75% of total billed charges,1547.87,85,,,percent of total billed charges,85% of total billed charges,691.99,1693.55,
FBR-Eyelid - FAC,713,CDM,450,RC,67938,HCPCS,outpatient,,,602.48,451.86,,542.23,90,,,percent of total billed charges,90% of total billed charges,560.31,93,,,percent of total billed charges,93% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,512.11,85,,,percent of total billed charges,85% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,490.42,81.4,,,percent of total billed charges,81.4% of total billed charges,542.23,90,,,percent of total billed charges,90% of total billed charges,542.23,90,,,percent of total billed charges,90% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,451.86,75,,,percent of total billed charges,75% of total billed charges,512.11,85,,,percent of total billed charges,85% of total billed charges,228.94,560.31,
Drainage external auditory canal abscess-Fac,714,CDM,450,RC,69020,HCPCS,outpatient,,,278.88,209.16,,250.99,90,,,percent of total billed charges,90% of total billed charges,259.36,93,,,percent of total billed charges,93% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,237.05,85,,,percent of total billed charges,85% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,227.01,81.4,,,percent of total billed charges,81.4% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,209.16,75,,,percent of total billed charges,75% of total billed charges,237.05,85,,,percent of total billed charges,85% of total billed charges,105.97,259.36,
"Excis. Proc:Exter. Ear/Canal;Rmv from Canal,W/O Anes.-FAC",715,CDM,450,RC,69200,HCPCS,outpatient,,,125.38,94.04,,112.84,90,,,percent of total billed charges,90% of total billed charges,116.6,93,,,percent of total billed charges,93% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,102.06,81.4,,,percent of total billed charges,81.4% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,94.04,75,,,percent of total billed charges,75% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,116.6,
"Excis. Proc:Exter. Ear/Canal;Rmv from Canal,W/O Anes.-FAC",716,CDM,450,RC,69200,HCPCS,outpatient,,,125.38,94.04,,112.84,90,,,percent of total billed charges,90% of total billed charges,116.6,93,,,percent of total billed charges,93% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,102.06,81.4,,,percent of total billed charges,81.4% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,94.04,75,,,percent of total billed charges,75% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,116.6,
Remove impacted Cerumen(irr/lav)-FAC,717,CDM,450,RC,69209,HCPCS,outpatient,,,123.65,92.74,,111.29,90,,,percent of total billed charges,90% of total billed charges,114.99,93,,,percent of total billed charges,93% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,105.1,85,,,percent of total billed charges,85% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,100.65,81.4,,,percent of total billed charges,81.4% of total billed charges,111.29,90,,,percent of total billed charges,90% of total billed charges,111.29,90,,,percent of total billed charges,90% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,92.74,75,,,percent of total billed charges,75% of total billed charges,105.1,85,,,percent of total billed charges,85% of total billed charges,46.99,114.99,
Remove impacted cerumen-Fac,718,CDM,450,RC,69210,HCPCS,outpatient,,,45.7,34.28,,41.13,90,,,percent of total billed charges,90% of total billed charges,42.5,93,,,percent of total billed charges,93% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,37.2,81.4,,,percent of total billed charges,81.4% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,34.28,75,,,percent of total billed charges,75% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,42.5,
Admin. one vaccine - FAC,719,CDM,450,RC,90471,HCPCS,outpatient,,,130.63,97.97,,117.57,90,,,percent of total billed charges,90% of total billed charges,121.49,93,,,percent of total billed charges,93% of total billed charges,49.64,38,,,percent of total billed charges,38% of total billed charges,49.64,38,,,percent of total billed charges,38% of total billed charges,111.04,85,,,percent of total billed charges,85% of total billed charges,49.64,38,,,percent of total billed charges,38% of total billed charges,106.33,81.4,,,percent of total billed charges,81.4% of total billed charges,117.57,90,,,percent of total billed charges,90% of total billed charges,117.57,90,,,percent of total billed charges,90% of total billed charges,49.64,38,,,percent of total billed charges,38% of total billed charges,49.64,38,,,percent of total billed charges,38% of total billed charges,49.64,38,,,percent of total billed charges,38% of total billed charges,97.97,75,,,percent of total billed charges,75% of total billed charges,111.04,85,,,percent of total billed charges,85% of total billed charges,49.64,121.49,
Admin additional vaccines - FAC,720,CDM,450,RC,90472,HCPCS,outpatient,,,129.51,97.13,,116.56,90,,,percent of total billed charges,90% of total billed charges,120.44,93,,,percent of total billed charges,93% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,110.08,85,,,percent of total billed charges,85% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,105.42,81.4,,,percent of total billed charges,81.4% of total billed charges,116.56,90,,,percent of total billed charges,90% of total billed charges,116.56,90,,,percent of total billed charges,90% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,97.13,75,,,percent of total billed charges,75% of total billed charges,110.08,85,,,percent of total billed charges,85% of total billed charges,49.21,120.44,
Discharge Transfer,721,CDM,450,RC,911,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
CPR- facility,722,CDM,450,RC,92950,HCPCS,outpatient,,,587.06,440.3,,528.35,90,,,percent of total billed charges,90% of total billed charges,545.97,93,,,percent of total billed charges,93% of total billed charges,223.08,38,,,percent of total billed charges,38% of total billed charges,223.08,38,,,percent of total billed charges,38% of total billed charges,499,85,,,percent of total billed charges,85% of total billed charges,223.08,38,,,percent of total billed charges,38% of total billed charges,477.87,81.4,,,percent of total billed charges,81.4% of total billed charges,528.35,90,,,percent of total billed charges,90% of total billed charges,528.35,90,,,percent of total billed charges,90% of total billed charges,223.08,38,,,percent of total billed charges,38% of total billed charges,223.08,38,,,percent of total billed charges,38% of total billed charges,223.08,38,,,percent of total billed charges,38% of total billed charges,440.3,75,,,percent of total billed charges,75% of total billed charges,499,85,,,percent of total billed charges,85% of total billed charges,223.08,545.97,
Temporary External Pacing-Fac,723,CDM,450,RC,92953,HCPCS,outpatient,,,171.07,128.3,,153.96,90,,,percent of total billed charges,90% of total billed charges,159.1,93,,,percent of total billed charges,93% of total billed charges,65.01,38,,,percent of total billed charges,38% of total billed charges,65.01,38,,,percent of total billed charges,38% of total billed charges,145.41,85,,,percent of total billed charges,85% of total billed charges,65.01,38,,,percent of total billed charges,38% of total billed charges,139.25,81.4,,,percent of total billed charges,81.4% of total billed charges,153.96,90,,,percent of total billed charges,90% of total billed charges,153.96,90,,,percent of total billed charges,90% of total billed charges,65.01,38,,,percent of total billed charges,38% of total billed charges,65.01,38,,,percent of total billed charges,38% of total billed charges,65.01,38,,,percent of total billed charges,38% of total billed charges,128.3,75,,,percent of total billed charges,75% of total billed charges,145.41,85,,,percent of total billed charges,85% of total billed charges,65.01,159.1,
Defibrillation (Cardioversion)-Fac,724,CDM,450,RC,92960,HCPCS,outpatient,,,421.83,316.37,,379.65,90,,,percent of total billed charges,90% of total billed charges,392.3,93,,,percent of total billed charges,93% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,358.56,85,,,percent of total billed charges,85% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,343.37,81.4,,,percent of total billed charges,81.4% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,316.37,75,,,percent of total billed charges,75% of total billed charges,358.56,85,,,percent of total billed charges,85% of total billed charges,160.3,392.3,
Defibrillation (Cardioversion)-Fac,725,CDM,450,RC,92960,HCPCS,outpatient,,,421.83,316.37,,379.65,90,,,percent of total billed charges,90% of total billed charges,392.3,93,,,percent of total billed charges,93% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,358.56,85,,,percent of total billed charges,85% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,343.37,81.4,,,percent of total billed charges,81.4% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,316.37,75,,,percent of total billed charges,75% of total billed charges,358.56,85,,,percent of total billed charges,85% of total billed charges,160.3,392.3,
Defibrillation (Cardioversion)-Fac,726,CDM,450,RC,92960,HCPCS,outpatient,,,421.83,316.37,,379.65,90,,,percent of total billed charges,90% of total billed charges,392.3,93,,,percent of total billed charges,93% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,358.56,85,,,percent of total billed charges,85% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,343.37,81.4,,,percent of total billed charges,81.4% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,316.37,75,,,percent of total billed charges,75% of total billed charges,358.56,85,,,percent of total billed charges,85% of total billed charges,160.3,392.3,
Thrombolytic Therapy-CORONARY fac,727,CDM,450,RC,92977,HCPCS,outpatient,,,1238.78,929.09,,1114.9,90,,,percent of total billed charges,90% of total billed charges,1152.07,93,,,percent of total billed charges,93% of total billed charges,470.74,38,,,percent of total billed charges,38% of total billed charges,470.74,38,,,percent of total billed charges,38% of total billed charges,1052.96,85,,,percent of total billed charges,85% of total billed charges,470.74,38,,,percent of total billed charges,38% of total billed charges,1008.37,81.4,,,percent of total billed charges,81.4% of total billed charges,1114.9,90,,,percent of total billed charges,90% of total billed charges,1114.9,90,,,percent of total billed charges,90% of total billed charges,470.74,38,,,percent of total billed charges,38% of total billed charges,470.74,38,,,percent of total billed charges,38% of total billed charges,470.74,38,,,percent of total billed charges,38% of total billed charges,929.09,75,,,percent of total billed charges,75% of total billed charges,1052.96,85,,,percent of total billed charges,85% of total billed charges,470.74,1152.07,
"IV infusion therapy, for hydration > 30 minutes",728,CDM,450,RC,96360,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
"IV infusion therapy, for hydration > 30 minutes",729,CDM,450,RC,96360,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
"IV infusion therapy, for hydration > 30 minutes",730,CDM,450,RC,96360,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
"IV infusion therapy, for hydration > 30 minutes",731,CDM,450,RC,96360,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
"IV infusion hydration, ea add hr up to 8-Fac",732,CDM,450,RC,96361,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
"IV infusion hydration, ea add hr up to 8-Fac",733,CDM,450,RC,96361,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
"IV infusion hydration, ea add hr up to 8-Fac",734,CDM,450,RC,96361,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
"IV infusion hydration, ea add hr up to 8-Fac",735,CDM,450,RC,96361,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
"IV infusion therapy, 1 hour",736,CDM,450,RC,96365,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
"IV infusion therapy, 1 hour",737,CDM,450,RC,96365,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
"IV infusion therapy, 1 hour",738,CDM,450,RC,96365,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
"IV infusion therapy, 1 hour",739,CDM,450,RC,96365,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
"IV infusion therapy, 1 hour",740,CDM,450,RC,96365,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
"IV infusion therapy, ea add hr up to 8",741,CDM,450,RC,96366,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
IV Therapy new drug,742,CDM,450,RC,96367,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Concurrent infusion (once per encounter)-Fac,743,CDM,450,RC,96368,HCPCS,outpatient,,,157.01,117.76,,141.31,90,,,percent of total billed charges,90% of total billed charges,146.02,93,,,percent of total billed charges,93% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,133.46,85,,,percent of total billed charges,85% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,127.81,81.4,,,percent of total billed charges,81.4% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,117.76,75,,,percent of total billed charges,75% of total billed charges,133.46,85,,,percent of total billed charges,85% of total billed charges,59.66,146.02,
IM injection/SQ injection-Fac,744,CDM,450,RC,96372,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
IM injection/SQ injection-Fac,745,CDM,450,RC,96372,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
IM injection/SQ injection-Fac,746,CDM,450,RC,96372,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
IM injection/SQ injection-Fac,747,CDM,450,RC,96372,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
IM injection/SQ injection-Fac,748,CDM,450,RC,96372,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
"IV push, single or initial drug",749,CDM,450,RC,96374,HCPCS,outpatient,,,159.34,119.51,,143.41,90,,,percent of total billed charges,90% of total billed charges,148.19,93,,,percent of total billed charges,93% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,135.44,85,,,percent of total billed charges,85% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,129.7,81.4,,,percent of total billed charges,81.4% of total billed charges,143.41,90,,,percent of total billed charges,90% of total billed charges,143.41,90,,,percent of total billed charges,90% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,119.51,75,,,percent of total billed charges,75% of total billed charges,135.44,85,,,percent of total billed charges,85% of total billed charges,60.55,148.19,
"IV push, Each additional new drug",750,CDM,450,RC,96375,HCPCS,outpatient,,,104.31,78.23,,93.88,90,,,percent of total billed charges,90% of total billed charges,97.01,93,,,percent of total billed charges,93% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,88.66,85,,,percent of total billed charges,85% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,84.91,81.4,,,percent of total billed charges,81.4% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,78.23,75,,,percent of total billed charges,75% of total billed charges,88.66,85,,,percent of total billed charges,85% of total billed charges,39.64,97.01,
"IV push each add, same drug",751,CDM,450,RC,96376,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
Mod sedation 1st 15min <5y Fac,752,CDM,450,RC,99151,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
Mod sedation  1st 15 min ea,753,CDM,964,RC,99152,HCPCS,outpatient,,,344.6,258.45,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,12.44,100,,,fee schedule,Pays 100% Medicare OPPS,12.44,100,,,fee schedule,Pays 100% Medicare OPPS,15.05,119,,,fee schedule,119% of fee schedule,12.44,100,,,fee schedule,Pays 100% Medicare OPPS,12.44,100,,,fee schedule,100% of fee schedule,310.14,90,,,percent of total billed charges,90% of total billed charges,12.44,100,,,fee schedule,Pays 100% Medicare OPPS,12.44,100,,,fee schedule,Pays 100% Medicare OPPS,12.44,100,,,fee schedule,Pays 100% Medicare OPPS,12.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,12.44,100,,,fee schedule,100% of fee schedule,12.44,310.14,
Mod sedation  1st 15 min Fac,754,CDM,450,RC,99152,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
Mod sedation each add 15 min,755,CDM,964,RC,99153,HCPCS,outpatient,,,114.86,86.15,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,11.57,100,,,fee schedule,Pays 100% Medicare OPPS,11.57,100,,,fee schedule,Pays 100% Medicare OPPS,13.24,119,,,fee schedule,119% of fee schedule,11.57,100,,,fee schedule,Pays 100% Medicare OPPS,11.57,100,,,fee schedule,100% of fee schedule,103.37,90,,,percent of total billed charges,90% of total billed charges,11.57,100,,,fee schedule,Pays 100% Medicare OPPS,11.57,100,,,fee schedule,Pays 100% Medicare OPPS,11.57,100,,,fee schedule,Pays 100% Medicare OPPS,11.57,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,11.57,100,,,fee schedule,100% of fee schedule,11.57,103.37,
Mod sedation-other addt 15 min,756,CDM,450,RC,99153,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
Mod sedation-other <5yr 15min,757,CDM,450,RC,99155,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
Mod sedation -other 5+yrs 15 min,758,CDM,450,RC,99156,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
ED Visit Minor-Fac,759,CDM,450,RC,99281,HCPCS,outpatient,,,135.92,101.94,,122.33,90,,,percent of total billed charges,90% of total billed charges,126.41,93,,,percent of total billed charges,93% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,115.53,85,,,percent of total billed charges,85% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,110.64,81.4,,,percent of total billed charges,81.4% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,101.94,75,,,percent of total billed charges,75% of total billed charges,201,100,,,case rate,100% of UHC case rate,51.65,201,
"ED Visit, Low Mod.-Fac",760,CDM,450,RC,99282,HCPCS,outpatient,,,257.79,193.34,,232.01,90,,,percent of total billed charges,90% of total billed charges,239.74,93,,,percent of total billed charges,93% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,209.84,81.4,,,percent of total billed charges,81.4% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,193.34,75,,,percent of total billed charges,75% of total billed charges,353,100,,,case rate,100% of UHC case rate,97.96,353,
ED Visit Moderate-Fac,761,CDM,450,RC,99283,HCPCS,outpatient,,,356.21,267.16,,320.59,90,,,percent of total billed charges,90% of total billed charges,331.28,93,,,percent of total billed charges,93% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,302.78,85,,,percent of total billed charges,85% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,289.95,81.4,,,percent of total billed charges,81.4% of total billed charges,320.59,90,,,percent of total billed charges,90% of total billed charges,320.59,90,,,percent of total billed charges,90% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,267.16,75,,,percent of total billed charges,75% of total billed charges,892,100,,,case rate,100% of UHC case rate,135.36,892,
ED Visit Moderate Complex-Fac,762,CDM,450,RC,99284,HCPCS,outpatient,,,625.71,469.28,,563.14,90,,,percent of total billed charges,90% of total billed charges,581.91,93,,,percent of total billed charges,93% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,531.85,85,,,percent of total billed charges,85% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,509.33,81.4,,,percent of total billed charges,81.4% of total billed charges,563.14,90,,,percent of total billed charges,90% of total billed charges,563.14,90,,,percent of total billed charges,90% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,469.28,75,,,percent of total billed charges,75% of total billed charges,2508,100,,,case rate,100% of UHC case rate,237.77,2508,
ED Visit High Complex-Fac,763,CDM,450,RC,99285,HCPCS,outpatient,,,1380.33,1035.25,,1242.3,90,,,percent of total billed charges,90% of total billed charges,1283.71,93,,,percent of total billed charges,93% of total billed charges,524.53,38,,,percent of total billed charges,38% of total billed charges,524.53,38,,,percent of total billed charges,38% of total billed charges,1000,85,,,percent of total billed charges,85% of total billed charges,524.53,38,,,percent of total billed charges,38% of total billed charges,1123.59,81.4,,,percent of total billed charges,81.4% of total billed charges,1242.3,90,,,percent of total billed charges,90% of total billed charges,1242.3,90,,,percent of total billed charges,90% of total billed charges,524.53,38,,,percent of total billed charges,38% of total billed charges,524.53,38,,,percent of total billed charges,38% of total billed charges,524.53,38,,,percent of total billed charges,38% of total billed charges,1035.25,75,,,percent of total billed charges,75% of total billed charges,5920,100,,,case rate,100% of UHC case rate,524.53,5920,
CRITICAL CARE; First Hour-Fac,764,CDM,450,RC,99291,HCPCS,outpatient,,,1499.87,1124.9,,1349.88,90,,,percent of total billed charges,90% of total billed charges,1394.88,93,,,percent of total billed charges,93% of total billed charges,569.95,38,,,percent of total billed charges,38% of total billed charges,569.95,38,,,percent of total billed charges,38% of total billed charges,1000,85,,,percent of total billed charges,85% of total billed charges,569.95,38,,,percent of total billed charges,38% of total billed charges,1220.89,81.4,,,percent of total billed charges,81.4% of total billed charges,1349.88,90,,,percent of total billed charges,90% of total billed charges,1349.88,90,,,percent of total billed charges,90% of total billed charges,569.95,38,,,percent of total billed charges,38% of total billed charges,569.95,38,,,percent of total billed charges,38% of total billed charges,569.95,38,,,percent of total billed charges,38% of total billed charges,1124.9,75,,,percent of total billed charges,75% of total billed charges,5920,100,,,case rate,100% of UHC case rate,569.95,5920,
CRITICAL CARE-Fac,765,CDM,450,RC,99292,HCPCS,outpatient,,,333.95,250.46,,300.56,90,,,percent of total billed charges,90% of total billed charges,310.57,93,,,percent of total billed charges,93% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,283.86,85,,,percent of total billed charges,85% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,271.84,81.4,,,percent of total billed charges,81.4% of total billed charges,300.56,90,,,percent of total billed charges,90% of total billed charges,300.56,90,,,percent of total billed charges,90% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,250.46,75,,,percent of total billed charges,75% of total billed charges,283.86,85,,,percent of total billed charges,85% of total billed charges,126.9,310.57,
Attemdamce at Delivery-newborn,766,CDM,450,RC,99464,HCPCS,outpatient,,,580.08,435.06,,522.07,90,,,percent of total billed charges,90% of total billed charges,539.47,93,,,percent of total billed charges,93% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,493.07,85,,,percent of total billed charges,85% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,472.19,81.4,,,percent of total billed charges,81.4% of total billed charges,522.07,90,,,percent of total billed charges,90% of total billed charges,522.07,90,,,percent of total billed charges,90% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,435.06,75,,,percent of total billed charges,75% of total billed charges,493.07,85,,,percent of total billed charges,85% of total billed charges,220.43,539.47,
Dislocation TX-Jaw[Package],767,CDM,450,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,5920,100,,,case rate,100% of UHC case rate,5920,5920,
Inpatient Bed Charges,768,CDM,120,RC,1346,HCPCS,inpatient,,,1593.07,1194.8,,1433.76,90,,,percent of total billed charges,90% of total billed charges,1481.56,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1433.76,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1333.4,83.7,,,percent of total billed charges,83.7% of total billed charges,1433.76,90,,,percent of total billed charges,90% of total billed charges,1433.76,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
"(RES) PCA1 (YO) AB, LB",769,CDM,300,RC,84182,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,328.98,
HCG Quant.-Serum (Quest),770,CDM,300,RC,84702,HCPCS,outpatient,,,167.78,125.84,,151,90,,,percent of total billed charges,90% of total billed charges,156.04,93,,,percent of total billed charges,93% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,136.57,81.4,,,percent of total billed charges,81.4% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,125.84,75,,,percent of total billed charges,75% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,156.04,
Profile - Myco. Pneum. AB (IgM),771,CDM,300,RC,86738,HCPCS,outpatient,,,108.75,81.56,,97.88,90,,,percent of total billed charges,90% of total billed charges,101.14,93,,,percent of total billed charges,93% of total billed charges,41.33,38,,,percent of total billed charges,38% of total billed charges,41.33,38,,,percent of total billed charges,38% of total billed charges,92.44,85,,,percent of total billed charges,85% of total billed charges,41.33,38,,,percent of total billed charges,38% of total billed charges,88.52,81.4,,,percent of total billed charges,81.4% of total billed charges,97.88,90,,,percent of total billed charges,90% of total billed charges,97.88,90,,,percent of total billed charges,90% of total billed charges,41.33,38,,,percent of total billed charges,38% of total billed charges,41.33,38,,,percent of total billed charges,38% of total billed charges,41.33,38,,,percent of total billed charges,38% of total billed charges,81.56,75,,,percent of total billed charges,75% of total billed charges,92.44,85,,,percent of total billed charges,85% of total billed charges,41.33,101.14,
Compatibility Screen (Vitalant),772,CDM,300,RC,86885,HCPCS,outpatient,,,132.65,99.49,,119.39,90,,,percent of total billed charges,90% of total billed charges,123.36,93,,,percent of total billed charges,93% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,112.75,85,,,percent of total billed charges,85% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,107.98,81.4,,,percent of total billed charges,81.4% of total billed charges,119.39,90,,,percent of total billed charges,90% of total billed charges,119.39,90,,,percent of total billed charges,90% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,99.49,75,,,percent of total billed charges,75% of total billed charges,112.75,85,,,percent of total billed charges,85% of total billed charges,50.41,123.36,
Consult Ext Inpatient,773,CDM,988,RC,99214,HCPCS,outpatient,,,216.48,162.36,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,194.83,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,194.83,
Inpatient Consultation 80 Min,774,CDM,988,RC,99255,HCPCS,outpatient,,,510,382.5,,251.97,130,,,fee schedule,130% of fee schedule,251.97,130,,,fee schedule,130% of fee schedule,188.63,100,,,fee schedule,Pays 100% Medicare OPPS,188.63,100,,,fee schedule,Pays 100% Medicare OPPS,248.1,119,,,fee schedule,119% of fee schedule,188.63,100,,,fee schedule,Pays 100% Medicare OPPS,188.63,100,,,fee schedule,100% of fee schedule,459,90,,,percent of total billed charges,90% of total billed charges,188.63,100,,,fee schedule,Pays 100% Medicare OPPS,188.63,100,,,fee schedule,Pays 100% Medicare OPPS,188.63,100,,,fee schedule,Pays 100% Medicare OPPS,188.63,100,,,fee schedule,Pays 100% Medicare OPPS,287.6,100,,,fee schedule,100% of fee schedule,188.63,100,,,fee schedule,100% of fee schedule,188.63,459,
Smoking cessation education-IP,775,CDM,942,RC,99406,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
complete bed rest HOB elevated > 30 degrees,777,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
OS-Peds-Bronchiolitis or Influenza[Package],778,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Consult Hospitalist,779,CDM,121,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Out of bed to chair for meals TID,780,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
CPM Machine,784,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
"Ischemic CVA, no lytics, allow BP up to 220/120 1st 24hr",785,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Call MD for change in neuro status,786,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
"Call MD for BP less than__, greater than___",787,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Call MD for HR <50bpm or >150,788,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
CALL MD for Temp >101.1 F,789,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Discontinue Foley Cath,791,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Discontinue IV,792,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Drain,793,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Dressing changes,794,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Elevate Infected extremity,795,CDM,121,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Extension Pillow,796,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Fall Precautions,797,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Influenza vaccine prior to DC if Indicated,798,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Sepsis Flowsheet,799,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Hemovac,800,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Heplock IV,801,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Call MD for pre-heparin test,802,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Hospice Bed Charge,803,CDM,120,RC,,,inpatient,,,754.11,565.58,,678.7,90,,,percent of total billed charges,90% of total billed charges,701.32,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,678.7,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,631.19,83.7,,,percent of total billed charges,83.7% of total billed charges,678.7,90,,,percent of total billed charges,90% of total billed charges,678.7,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,631.19,2506,
Isolation per protocols,805,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Transfer Devices/Assistive Devices,806,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Dicsontinue/Remove NG tube,807,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
"Anticoagulated, no need for prophylaxis",808,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Respite/Hospice Day Charges,822,CDM,120,RC,,,inpatient,,,388.65,291.49,,349.79,90,,,percent of total billed charges,90% of total billed charges,361.44,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,349.79,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,325.3,83.7,,,percent of total billed charges,83.7% of total billed charges,349.79,90,,,percent of total billed charges,90% of total billed charges,349.79,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,325.3,2506,
Suction - continuous,823,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Suction- intermittent,824,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Suction - PRN,825,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
SCD  sequential compression device app,827,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Mobility Restrictions,828,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
TED Hose,829,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Wound Care per protocol,832,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
**DO NOT Stool Culture,833,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
**Stool Culture Shiga Toxin 2(result),834,CDM,300,RC,**874,HCPCS,outpatient,,,41,30.75,,36.9,90,,,percent of total billed charges,90% of total billed charges,38.13,93,,,percent of total billed charges,93% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,34.85,85,,,percent of total billed charges,85% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,33.37,81.4,,,percent of total billed charges,81.4% of total billed charges,36.9,90,,,percent of total billed charges,90% of total billed charges,36.9,90,,,percent of total billed charges,90% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,30.75,75,,,percent of total billed charges,75% of total billed charges,34.85,85,,,percent of total billed charges,85% of total billed charges,15.58,38.13,
"GONORRHOEAE RNA, TMA(not Working)",835,CDM,300,RC,**875,HCPCS,outpatient,,,103.12,77.34,,92.81,90,,,percent of total billed charges,90% of total billed charges,95.9,93,,,percent of total billed charges,93% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,83.94,81.4,,,percent of total billed charges,81.4% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,77.34,75,,,percent of total billed charges,75% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,95.9,
HF-CBC[Package],836,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HFP(Health Fair Profile)[Package],837,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HF-PSA,838,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HF-A1C,839,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HF-VITD25,840,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
YY - Crossmatch for # of Units,841,CDM,300,RC,5,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Specimen Handling,842,CDM,300,RC,222,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) RT-QUIC, CSF",843,CDM,300,RC,0035U,HCPCS,outpatient,,,204,153,,183.6,90,,,percent of total billed charges,90% of total billed charges,189.72,93,,,percent of total billed charges,93% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,173.4,85,,,percent of total billed charges,85% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,166.06,81.4,,,percent of total billed charges,81.4% of total billed charges,183.6,90,,,percent of total billed charges,90% of total billed charges,183.6,90,,,percent of total billed charges,90% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,153,75,,,percent of total billed charges,75% of total billed charges,173.4,85,,,percent of total billed charges,85% of total billed charges,77.52,189.72,
"RESP Panel4, COVID,FLUA,B, RSV",844,CDM,300,RC,0241U,HCPCS,outpatient,,,460.03,345.02,,414.03,90,,,percent of total billed charges,90% of total billed charges,427.83,93,,,percent of total billed charges,93% of total billed charges,174.81,38,,,percent of total billed charges,38% of total billed charges,174.81,38,,,percent of total billed charges,38% of total billed charges,391.03,85,,,percent of total billed charges,85% of total billed charges,174.81,38,,,percent of total billed charges,38% of total billed charges,374.46,81.4,,,percent of total billed charges,81.4% of total billed charges,414.03,90,,,percent of total billed charges,90% of total billed charges,414.03,90,,,percent of total billed charges,90% of total billed charges,174.81,38,,,percent of total billed charges,38% of total billed charges,174.81,38,,,percent of total billed charges,38% of total billed charges,174.81,38,,,percent of total billed charges,38% of total billed charges,345.02,75,,,percent of total billed charges,75% of total billed charges,391.03,85,,,percent of total billed charges,85% of total billed charges,174.81,427.83,
"Tissue Transglutaminase (IgG, IgA)",845,CDM,300,RC,11073,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) C. ALBICANS IG A,846,CDM,300,RC,12345,HCPCS,outpatient,,,79.59,59.69,,71.63,90,,,percent of total billed charges,90% of total billed charges,74.02,93,,,percent of total billed charges,93% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,67.65,85,,,percent of total billed charges,85% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,64.79,81.4,,,percent of total billed charges,81.4% of total billed charges,71.63,90,,,percent of total billed charges,90% of total billed charges,71.63,90,,,percent of total billed charges,90% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,59.69,75,,,percent of total billed charges,75% of total billed charges,67.65,85,,,percent of total billed charges,85% of total billed charges,30.24,74.02,
"17-hydroxy, 17 ketosteroids, 24 hr urine ORDER",847,CDM,300,RC,,,outpatient,,,1.15,0.86,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.07,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.98,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.86,75,,,percent of total billed charges,75% of total billed charges,0.98,85,,,percent of total billed charges,85% of total billed charges,0.44,1.07,
24 HOUR Calcium Urine w Creatinine,848,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Hemoglobinopathy Evaluation,849,CDM,300,RC,35489,HCPCS,outpatient,,,17,12.75,,15.3,90,,,percent of total billed charges,90% of total billed charges,15.81,93,,,percent of total billed charges,93% of total billed charges,6.46,38,,,percent of total billed charges,38% of total billed charges,6.46,38,,,percent of total billed charges,38% of total billed charges,14.45,85,,,percent of total billed charges,85% of total billed charges,6.46,38,,,percent of total billed charges,38% of total billed charges,13.84,81.4,,,percent of total billed charges,81.4% of total billed charges,15.3,90,,,percent of total billed charges,90% of total billed charges,15.3,90,,,percent of total billed charges,90% of total billed charges,6.46,38,,,percent of total billed charges,38% of total billed charges,6.46,38,,,percent of total billed charges,38% of total billed charges,6.46,38,,,percent of total billed charges,38% of total billed charges,12.75,75,,,percent of total billed charges,75% of total billed charges,14.45,85,,,percent of total billed charges,85% of total billed charges,6.46,15.81,
"Venipuncture, Routine",850,CDM,300,RC,36415,HCPCS,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
"Venipuncture, Routine",851,CDM,300,RC,36415,HCPCS,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
"LIPOPROTEIN FRACTIONATION, NMR",852,CDM,300,RC,37847,HCPCS,outpatient,,,53.04,39.78,,47.74,90,,,percent of total billed charges,90% of total billed charges,49.33,93,,,percent of total billed charges,93% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,45.08,85,,,percent of total billed charges,85% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,43.17,81.4,,,percent of total billed charges,81.4% of total billed charges,47.74,90,,,percent of total billed charges,90% of total billed charges,47.74,90,,,percent of total billed charges,90% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,20.16,38,,,percent of total billed charges,38% of total billed charges,39.78,75,,,percent of total billed charges,75% of total billed charges,45.08,85,,,percent of total billed charges,85% of total billed charges,20.16,49.33,
5 Hydroxyindoleacelic Acid w/ Creat. 24 HR Urine,853,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Herpes Simplex Virus 1,2 IgG",854,CDM,300,RC,-6447,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) Urea Clearance Calculation,855,CDM,300,RC,7329,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
BMP (ISTAT),856,CDM,300,RC,80047,HCPCS,outpatient,,,99.59,74.69,,89.63,90,,,percent of total billed charges,90% of total billed charges,92.62,93,,,percent of total billed charges,93% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,84.65,85,,,percent of total billed charges,85% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,81.07,81.4,,,percent of total billed charges,81.4% of total billed charges,89.63,90,,,percent of total billed charges,90% of total billed charges,89.63,90,,,percent of total billed charges,90% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,74.69,75,,,percent of total billed charges,75% of total billed charges,84.65,85,,,percent of total billed charges,85% of total billed charges,37.84,92.62,
BMP (Basic Metab Panel),857,CDM,300,RC,80048,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Quest - BMP,858,CDM,300,RC,80048,HCPCS,outpatient,,,76.86,57.65,,69.17,90,,,percent of total billed charges,90% of total billed charges,71.48,93,,,percent of total billed charges,93% of total billed charges,29.21,38,,,percent of total billed charges,38% of total billed charges,29.21,38,,,percent of total billed charges,38% of total billed charges,65.33,85,,,percent of total billed charges,85% of total billed charges,29.21,38,,,percent of total billed charges,38% of total billed charges,62.56,81.4,,,percent of total billed charges,81.4% of total billed charges,69.17,90,,,percent of total billed charges,90% of total billed charges,69.17,90,,,percent of total billed charges,90% of total billed charges,29.21,38,,,percent of total billed charges,38% of total billed charges,29.21,38,,,percent of total billed charges,38% of total billed charges,29.21,38,,,percent of total billed charges,38% of total billed charges,57.65,75,,,percent of total billed charges,75% of total billed charges,65.33,85,,,percent of total billed charges,85% of total billed charges,29.21,71.48,
General Health Panel[Panel],859,CDM,300,RC,80050,HCPCS,outpatient,,,379.06,284.3,,341.15,90,,,percent of total billed charges,90% of total billed charges,352.53,93,,,percent of total billed charges,93% of total billed charges,144.04,38,,,percent of total billed charges,38% of total billed charges,144.04,38,,,percent of total billed charges,38% of total billed charges,322.2,85,,,percent of total billed charges,85% of total billed charges,144.04,38,,,percent of total billed charges,38% of total billed charges,308.55,81.4,,,percent of total billed charges,81.4% of total billed charges,341.15,90,,,percent of total billed charges,90% of total billed charges,341.15,90,,,percent of total billed charges,90% of total billed charges,144.04,38,,,percent of total billed charges,38% of total billed charges,144.04,38,,,percent of total billed charges,38% of total billed charges,144.04,38,,,percent of total billed charges,38% of total billed charges,284.3,75,,,percent of total billed charges,75% of total billed charges,322.2,85,,,percent of total billed charges,85% of total billed charges,144.04,352.53,
ELECTROLYTES,860,CDM,300,RC,80051,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
YY - Electrolyte Panel,861,CDM,300,RC,80051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
CMP - Comp Metab Panel,862,CDM,300,RC,80053,HCPCS,outpatient,,,195.71,146.78,,176.14,90,,,percent of total billed charges,90% of total billed charges,182.01,93,,,percent of total billed charges,93% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,166.35,85,,,percent of total billed charges,85% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,159.31,81.4,,,percent of total billed charges,81.4% of total billed charges,176.14,90,,,percent of total billed charges,90% of total billed charges,176.14,90,,,percent of total billed charges,90% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,146.78,75,,,percent of total billed charges,75% of total billed charges,166.35,85,,,percent of total billed charges,85% of total billed charges,74.37,182.01,
CMP - Comp Metab Panel,863,CDM,300,RC,80053,HCPCS,outpatient,,,195.71,146.78,,176.14,90,,,percent of total billed charges,90% of total billed charges,182.01,93,,,percent of total billed charges,93% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,166.35,85,,,percent of total billed charges,85% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,159.31,81.4,,,percent of total billed charges,81.4% of total billed charges,176.14,90,,,percent of total billed charges,90% of total billed charges,176.14,90,,,percent of total billed charges,90% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,146.78,75,,,percent of total billed charges,75% of total billed charges,166.35,85,,,percent of total billed charges,85% of total billed charges,74.37,182.01,
Bun/Creat Ratio,864,CDM,300,RC,80053,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Osmolality, Serum",865,CDM,300,RC,80053,HCPCS,outpatient,,,86.12,64.59,,77.51,90,,,percent of total billed charges,90% of total billed charges,80.09,93,,,percent of total billed charges,93% of total billed charges,32.73,38,,,percent of total billed charges,38% of total billed charges,32.73,38,,,percent of total billed charges,38% of total billed charges,73.2,85,,,percent of total billed charges,85% of total billed charges,32.73,38,,,percent of total billed charges,38% of total billed charges,70.1,81.4,,,percent of total billed charges,81.4% of total billed charges,77.51,90,,,percent of total billed charges,90% of total billed charges,77.51,90,,,percent of total billed charges,90% of total billed charges,32.73,38,,,percent of total billed charges,38% of total billed charges,32.73,38,,,percent of total billed charges,38% of total billed charges,32.73,38,,,percent of total billed charges,38% of total billed charges,64.59,75,,,percent of total billed charges,75% of total billed charges,73.2,85,,,percent of total billed charges,85% of total billed charges,32.73,80.09,
Quest - CMP,866,CDM,300,RC,80053,HCPCS,outpatient,,,97.42,73.07,,87.68,90,,,percent of total billed charges,90% of total billed charges,90.6,93,,,percent of total billed charges,93% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,82.81,85,,,percent of total billed charges,85% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,79.3,81.4,,,percent of total billed charges,81.4% of total billed charges,87.68,90,,,percent of total billed charges,90% of total billed charges,87.68,90,,,percent of total billed charges,90% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,73.07,75,,,percent of total billed charges,75% of total billed charges,82.81,85,,,percent of total billed charges,85% of total billed charges,37.02,90.6,
Anion Gap,867,CDM,300,RC,80053,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Lab) CMP - Additional Tests,868,CDM,300,RC,80053,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Lab) CMP - Additional Tests,869,CDM,300,RC,80053,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
OBSTETRIC PANEL,870,CDM,300,RC,80055,HCPCS,outpatient,,,201.54,151.16,,181.39,90,,,percent of total billed charges,90% of total billed charges,187.43,93,,,percent of total billed charges,93% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,171.31,85,,,percent of total billed charges,85% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,164.05,81.4,,,percent of total billed charges,81.4% of total billed charges,181.39,90,,,percent of total billed charges,90% of total billed charges,181.39,90,,,percent of total billed charges,90% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,151.16,75,,,percent of total billed charges,75% of total billed charges,171.31,85,,,percent of total billed charges,85% of total billed charges,76.59,187.43,
LIPID PROFILE,871,CDM,300,RC,80061,HCPCS,outpatient,,,124.03,93.02,,111.63,90,,,percent of total billed charges,90% of total billed charges,115.35,93,,,percent of total billed charges,93% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,105.43,85,,,percent of total billed charges,85% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,100.96,81.4,,,percent of total billed charges,81.4% of total billed charges,111.63,90,,,percent of total billed charges,90% of total billed charges,111.63,90,,,percent of total billed charges,90% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,93.02,75,,,percent of total billed charges,75% of total billed charges,105.43,85,,,percent of total billed charges,85% of total billed charges,47.13,115.35,
LDL,872,CDM,300,RC,80061,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HDL Risk Factor,873,CDM,300,RC,80061,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
LIPID W/ VLDL - REF,874,CDM,300,RC,80061,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
CHOL/HDL Risk Ratio,875,CDM,300,RC,80061,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Lipid Panel (TGL/HDL Chol),876,CDM,300,RC,80061,HCPCS,outpatient,,,56.1,42.08,,50.49,90,,,percent of total billed charges,90% of total billed charges,52.17,93,,,percent of total billed charges,93% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,45.67,81.4,,,percent of total billed charges,81.4% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,42.08,75,,,percent of total billed charges,75% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,52.17,
(RES) Cardio IQ Cholesterol,877,CDM,300,RC,80061,HCPCS,outpatient,,,124.03,93.02,,111.63,90,,,percent of total billed charges,90% of total billed charges,115.35,93,,,percent of total billed charges,93% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,105.43,85,,,percent of total billed charges,85% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,100.96,81.4,,,percent of total billed charges,81.4% of total billed charges,111.63,90,,,percent of total billed charges,90% of total billed charges,111.63,90,,,percent of total billed charges,90% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,47.13,38,,,percent of total billed charges,38% of total billed charges,93.02,75,,,percent of total billed charges,75% of total billed charges,105.43,85,,,percent of total billed charges,85% of total billed charges,47.13,115.35,
YY - Lipid Panel,878,CDM,300,RC,80061,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
RENAL PANEL,879,CDM,300,RC,80069,HCPCS,outpatient,,,71.47,53.6,,64.32,90,,,percent of total billed charges,90% of total billed charges,66.47,93,,,percent of total billed charges,93% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,58.18,81.4,,,percent of total billed charges,81.4% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,53.6,75,,,percent of total billed charges,75% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,66.47,
YY - Renal Panel,880,CDM,300,RC,80069,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Hepatitis A,B,C Panel",881,CDM,300,RC,80074,HCPCS,outpatient,,,568.49,426.37,,511.64,90,,,percent of total billed charges,90% of total billed charges,528.7,93,,,percent of total billed charges,93% of total billed charges,216.03,38,,,percent of total billed charges,38% of total billed charges,216.03,38,,,percent of total billed charges,38% of total billed charges,483.22,85,,,percent of total billed charges,85% of total billed charges,216.03,38,,,percent of total billed charges,38% of total billed charges,462.75,81.4,,,percent of total billed charges,81.4% of total billed charges,511.64,90,,,percent of total billed charges,90% of total billed charges,511.64,90,,,percent of total billed charges,90% of total billed charges,216.03,38,,,percent of total billed charges,38% of total billed charges,216.03,38,,,percent of total billed charges,38% of total billed charges,216.03,38,,,percent of total billed charges,38% of total billed charges,426.37,75,,,percent of total billed charges,75% of total billed charges,483.22,85,,,percent of total billed charges,85% of total billed charges,216.03,528.7,
(RES) SIGNAL TO CUT-OFF,882,CDM,300,RC,80074,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
LIVER PROFILE,883,CDM,300,RC,80076,HCPCS,outpatient,,,128.89,96.67,,116,90,,,percent of total billed charges,90% of total billed charges,119.87,93,,,percent of total billed charges,93% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,109.56,85,,,percent of total billed charges,85% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,104.92,81.4,,,percent of total billed charges,81.4% of total billed charges,116,90,,,percent of total billed charges,90% of total billed charges,116,90,,,percent of total billed charges,90% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,96.67,75,,,percent of total billed charges,75% of total billed charges,109.56,85,,,percent of total billed charges,85% of total billed charges,48.98,119.87,
Globulin-C,884,CDM,300,RC,80076,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
A/G Ratio,885,CDM,300,RC,80076,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
YY - GGT,886,CDM,300,RC,80076,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
YY - Liver Panel,887,CDM,300,RC,80076,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS AMPHETAMINES,888,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS AMPHETAMINES,889,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS BUPRENORPHINE,890,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS BUPRENORPHINE,891,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHAMPHETAMINE,892,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHAMPHETAMINE,893,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHYLENEDIOXYMETH,894,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHYLENEDIOXYMETH,895,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS PROPOXYPHENE,896,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS PROPOXYPHENE,897,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS OXYCODONE,898,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS OXYCODONE,899,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHADONE METABOLITE,900,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS BARBITURATES,901,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS BARBITURATES,902,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS BENZODIAZEPNS,903,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS BENZODIAZEPNS,904,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS COCAINE,905,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS COCAINE,906,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS CANNABINOIDS,907,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS CANNABINOIDS,908,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS OPIATES,909,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS OPIATES,910,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS PHENCYCLIDINE,911,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS PHENCYCLIDINE,912,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS TRICYCLIC ANTIDEPRES,913,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS TRICYCLIC ANTIDEPRES,914,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHADONE,915,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHADONE,916,CDM,300,RC,80100,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Benzodiazepines Screen(serum),917,CDM,300,RC,80101,HCPCS,outpatient,,,140.62,105.47,,126.56,90,,,percent of total billed charges,90% of total billed charges,130.78,93,,,percent of total billed charges,93% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,114.46,81.4,,,percent of total billed charges,81.4% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,105.47,75,,,percent of total billed charges,75% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,130.78,
Adalimumab Level for IBD,918,CDM,300,RC,80145,HCPCS,outpatient,,,343.95,257.96,,309.56,90,,,percent of total billed charges,90% of total billed charges,319.87,93,,,percent of total billed charges,93% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,292.36,85,,,percent of total billed charges,85% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,279.98,81.4,,,percent of total billed charges,81.4% of total billed charges,309.56,90,,,percent of total billed charges,90% of total billed charges,309.56,90,,,percent of total billed charges,90% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,257.96,75,,,percent of total billed charges,75% of total billed charges,292.36,85,,,percent of total billed charges,85% of total billed charges,130.7,319.87,
"(RES) ADALIMUMAB LEVEL, IBD",919,CDM,300,RC,80145,HCPCS,outpatient,,,343.95,257.96,,309.56,90,,,percent of total billed charges,90% of total billed charges,319.87,93,,,percent of total billed charges,93% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,292.36,85,,,percent of total billed charges,85% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,279.98,81.4,,,percent of total billed charges,81.4% of total billed charges,309.56,90,,,percent of total billed charges,90% of total billed charges,309.56,90,,,percent of total billed charges,90% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,130.7,38,,,percent of total billed charges,38% of total billed charges,257.96,75,,,percent of total billed charges,75% of total billed charges,292.36,85,,,percent of total billed charges,85% of total billed charges,130.7,319.87,
Amiodarone,920,CDM,300,RC,80151,HCPCS,outpatient,,,192.19,144.14,,172.97,90,,,percent of total billed charges,90% of total billed charges,178.74,93,,,percent of total billed charges,93% of total billed charges,73.03,38,,,percent of total billed charges,38% of total billed charges,73.03,38,,,percent of total billed charges,38% of total billed charges,163.36,85,,,percent of total billed charges,85% of total billed charges,73.03,38,,,percent of total billed charges,38% of total billed charges,156.44,81.4,,,percent of total billed charges,81.4% of total billed charges,172.97,90,,,percent of total billed charges,90% of total billed charges,172.97,90,,,percent of total billed charges,90% of total billed charges,73.03,38,,,percent of total billed charges,38% of total billed charges,73.03,38,,,percent of total billed charges,38% of total billed charges,73.03,38,,,percent of total billed charges,38% of total billed charges,144.14,75,,,percent of total billed charges,75% of total billed charges,163.36,85,,,percent of total billed charges,85% of total billed charges,73.03,178.74,
(Result) Amitriptyline,921,CDM,300,RC,80152,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Nortriptyline,922,CDM,300,RC,80152,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Combined Total (Amitrptyline),923,CDM,300,RC,80152,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Clozapine,924,CDM,300,RC,80154,HCPCS,outpatient,,,212.1,159.08,,190.89,90,,,percent of total billed charges,90% of total billed charges,197.25,93,,,percent of total billed charges,93% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,172.65,81.4,,,percent of total billed charges,81.4% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,159.08,75,,,percent of total billed charges,75% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,80.6,197.25,
"Carbamazepine, Total(Tegretol)",925,CDM,300,RC,80156,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
"Carbamazepine, Free Serum",926,CDM,300,RC,80157,HCPCS,outpatient,,,119.43,89.57,,107.49,90,,,percent of total billed charges,90% of total billed charges,111.07,93,,,percent of total billed charges,93% of total billed charges,45.38,38,,,percent of total billed charges,38% of total billed charges,45.38,38,,,percent of total billed charges,38% of total billed charges,101.52,85,,,percent of total billed charges,85% of total billed charges,45.38,38,,,percent of total billed charges,38% of total billed charges,97.22,81.4,,,percent of total billed charges,81.4% of total billed charges,107.49,90,,,percent of total billed charges,90% of total billed charges,107.49,90,,,percent of total billed charges,90% of total billed charges,45.38,38,,,percent of total billed charges,38% of total billed charges,45.38,38,,,percent of total billed charges,38% of total billed charges,45.38,38,,,percent of total billed charges,38% of total billed charges,89.57,75,,,percent of total billed charges,75% of total billed charges,101.52,85,,,percent of total billed charges,85% of total billed charges,45.38,111.07,
cyclosporine A trough-blood,927,CDM,300,RC,80158,HCPCS,outpatient,,,287.17,215.38,,258.45,90,,,percent of total billed charges,90% of total billed charges,267.07,93,,,percent of total billed charges,93% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,244.09,85,,,percent of total billed charges,85% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,233.76,81.4,,,percent of total billed charges,81.4% of total billed charges,258.45,90,,,percent of total billed charges,90% of total billed charges,258.45,90,,,percent of total billed charges,90% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,215.38,75,,,percent of total billed charges,75% of total billed charges,244.09,85,,,percent of total billed charges,85% of total billed charges,109.12,267.07,
Cyclosporine A Peak,928,CDM,300,RC,80158,HCPCS,outpatient,,,298.43,223.82,,268.59,90,,,percent of total billed charges,90% of total billed charges,277.54,93,,,percent of total billed charges,93% of total billed charges,113.4,38,,,percent of total billed charges,38% of total billed charges,113.4,38,,,percent of total billed charges,38% of total billed charges,253.67,85,,,percent of total billed charges,85% of total billed charges,113.4,38,,,percent of total billed charges,38% of total billed charges,242.92,81.4,,,percent of total billed charges,81.4% of total billed charges,268.59,90,,,percent of total billed charges,90% of total billed charges,268.59,90,,,percent of total billed charges,90% of total billed charges,113.4,38,,,percent of total billed charges,38% of total billed charges,113.4,38,,,percent of total billed charges,38% of total billed charges,113.4,38,,,percent of total billed charges,38% of total billed charges,223.82,75,,,percent of total billed charges,75% of total billed charges,253.67,85,,,percent of total billed charges,85% of total billed charges,113.4,277.54,
Digoxin (SLVRMC),929,CDM,300,RC,80162,HCPCS,outpatient,,,104.04,78.03,,93.64,90,,,percent of total billed charges,90% of total billed charges,96.76,93,,,percent of total billed charges,93% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,88.43,85,,,percent of total billed charges,85% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,84.69,81.4,,,percent of total billed charges,81.4% of total billed charges,93.64,90,,,percent of total billed charges,90% of total billed charges,93.64,90,,,percent of total billed charges,90% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,39.54,38,,,percent of total billed charges,38% of total billed charges,78.03,75,,,percent of total billed charges,75% of total billed charges,88.43,85,,,percent of total billed charges,85% of total billed charges,39.54,96.76,
"DIGOXIN, SERUM",930,CDM,300,RC,80162,HCPCS,outpatient,,,111.42,83.57,,100.28,90,,,percent of total billed charges,90% of total billed charges,103.62,93,,,percent of total billed charges,93% of total billed charges,42.34,38,,,percent of total billed charges,38% of total billed charges,42.34,38,,,percent of total billed charges,38% of total billed charges,94.71,85,,,percent of total billed charges,85% of total billed charges,42.34,38,,,percent of total billed charges,38% of total billed charges,90.7,81.4,,,percent of total billed charges,81.4% of total billed charges,100.28,90,,,percent of total billed charges,90% of total billed charges,100.28,90,,,percent of total billed charges,90% of total billed charges,42.34,38,,,percent of total billed charges,38% of total billed charges,42.34,38,,,percent of total billed charges,38% of total billed charges,42.34,38,,,percent of total billed charges,38% of total billed charges,83.57,75,,,percent of total billed charges,75% of total billed charges,94.71,85,,,percent of total billed charges,85% of total billed charges,42.34,103.62,
(RES) Valproic Acid Total,931,CDM,300,RC,80164,HCPCS,outpatient,,,98.7,74.03,,88.83,90,,,percent of total billed charges,90% of total billed charges,91.79,93,,,percent of total billed charges,93% of total billed charges,37.51,38,,,percent of total billed charges,38% of total billed charges,37.51,38,,,percent of total billed charges,38% of total billed charges,83.9,85,,,percent of total billed charges,85% of total billed charges,37.51,38,,,percent of total billed charges,38% of total billed charges,80.34,81.4,,,percent of total billed charges,81.4% of total billed charges,88.83,90,,,percent of total billed charges,90% of total billed charges,88.83,90,,,percent of total billed charges,90% of total billed charges,37.51,38,,,percent of total billed charges,38% of total billed charges,37.51,38,,,percent of total billed charges,38% of total billed charges,37.51,38,,,percent of total billed charges,38% of total billed charges,74.03,75,,,percent of total billed charges,75% of total billed charges,83.9,85,,,percent of total billed charges,85% of total billed charges,37.51,91.79,
Valproic Acid (DEPAKOTE),932,CDM,300,RC,80164,HCPCS,outpatient,,,53.92,40.44,,48.53,90,,,percent of total billed charges,90% of total billed charges,50.15,93,,,percent of total billed charges,93% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,43.89,81.4,,,percent of total billed charges,81.4% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,40.44,75,,,percent of total billed charges,75% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,50.15,
"(RES) VALPROIC ACID, FREE",933,CDM,300,RC,80165,HCPCS,outpatient,,,89.99,67.49,,80.99,90,,,percent of total billed charges,90% of total billed charges,83.69,93,,,percent of total billed charges,93% of total billed charges,34.2,38,,,percent of total billed charges,38% of total billed charges,34.2,38,,,percent of total billed charges,38% of total billed charges,76.49,85,,,percent of total billed charges,85% of total billed charges,34.2,38,,,percent of total billed charges,38% of total billed charges,73.25,81.4,,,percent of total billed charges,81.4% of total billed charges,80.99,90,,,percent of total billed charges,90% of total billed charges,80.99,90,,,percent of total billed charges,90% of total billed charges,34.2,38,,,percent of total billed charges,38% of total billed charges,34.2,38,,,percent of total billed charges,38% of total billed charges,34.2,38,,,percent of total billed charges,38% of total billed charges,67.49,75,,,percent of total billed charges,75% of total billed charges,76.49,85,,,percent of total billed charges,85% of total billed charges,34.2,83.69,
Doxepin/Nordoxepin,934,CDM,300,RC,80166,HCPCS,outpatient,,,148.81,111.61,,133.93,90,,,percent of total billed charges,90% of total billed charges,138.39,93,,,percent of total billed charges,93% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,126.49,85,,,percent of total billed charges,85% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,121.13,81.4,,,percent of total billed charges,81.4% of total billed charges,133.93,90,,,percent of total billed charges,90% of total billed charges,133.93,90,,,percent of total billed charges,90% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,111.61,75,,,percent of total billed charges,75% of total billed charges,126.49,85,,,percent of total billed charges,85% of total billed charges,56.55,138.39,
(Result) Doxepin,935,CDM,300,RC,80166,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Nordoxepin,936,CDM,300,RC,80166,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Doxepin/Nordoxepin Combined Total,937,CDM,300,RC,80166,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Everolimus,938,CDM,300,RC,80169,HCPCS,outpatient,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,201.61,
Gentamicin-peak,939,CDM,300,RC,80170,HCPCS,outpatient,,,180.18,135.14,,162.16,90,,,percent of total billed charges,90% of total billed charges,167.57,93,,,percent of total billed charges,93% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,153.15,85,,,percent of total billed charges,85% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,146.67,81.4,,,percent of total billed charges,81.4% of total billed charges,162.16,90,,,percent of total billed charges,90% of total billed charges,162.16,90,,,percent of total billed charges,90% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,135.14,75,,,percent of total billed charges,75% of total billed charges,153.15,85,,,percent of total billed charges,85% of total billed charges,68.47,167.57,
Gentamicin-trough,940,CDM,300,RC,80170,HCPCS,outpatient,,,185.81,139.36,,167.23,90,,,percent of total billed charges,90% of total billed charges,172.8,93,,,percent of total billed charges,93% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,157.94,85,,,percent of total billed charges,85% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,151.25,81.4,,,percent of total billed charges,81.4% of total billed charges,167.23,90,,,percent of total billed charges,90% of total billed charges,167.23,90,,,percent of total billed charges,90% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,139.36,75,,,percent of total billed charges,75% of total billed charges,157.94,85,,,percent of total billed charges,85% of total billed charges,70.61,172.8,
"Levetiracetam, IA KEPPRA",941,CDM,300,RC,80177,HCPCS,outpatient,,,79.59,59.69,,71.63,90,,,percent of total billed charges,90% of total billed charges,74.02,93,,,percent of total billed charges,93% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,67.65,85,,,percent of total billed charges,85% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,64.79,81.4,,,percent of total billed charges,81.4% of total billed charges,71.63,90,,,percent of total billed charges,90% of total billed charges,71.63,90,,,percent of total billed charges,90% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,59.69,75,,,percent of total billed charges,75% of total billed charges,67.65,85,,,percent of total billed charges,85% of total billed charges,30.24,74.02,
Lithium,942,CDM,300,RC,80178,HCPCS,outpatient,,,78.4,58.8,,70.56,90,,,percent of total billed charges,90% of total billed charges,72.91,93,,,percent of total billed charges,93% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,66.64,85,,,percent of total billed charges,85% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,63.82,81.4,,,percent of total billed charges,81.4% of total billed charges,70.56,90,,,percent of total billed charges,90% of total billed charges,70.56,90,,,percent of total billed charges,90% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,58.8,75,,,percent of total billed charges,75% of total billed charges,66.64,85,,,percent of total billed charges,85% of total billed charges,29.79,72.91,
"(Result) Lithium, Serum",943,CDM,300,RC,80178,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Lithium (SLVRMC),944,CDM,300,RC,80178,HCPCS,outpatient,,,127.35,95.51,,114.62,90,,,percent of total billed charges,90% of total billed charges,118.44,93,,,percent of total billed charges,93% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,108.25,85,,,percent of total billed charges,85% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,103.66,81.4,,,percent of total billed charges,81.4% of total billed charges,114.62,90,,,percent of total billed charges,90% of total billed charges,114.62,90,,,percent of total billed charges,90% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,95.51,75,,,percent of total billed charges,75% of total billed charges,108.25,85,,,percent of total billed charges,85% of total billed charges,48.39,118.44,
Mycophenolic,945,CDM,300,RC,80180,HCPCS,outpatient,,,196.87,147.65,,177.18,90,,,percent of total billed charges,90% of total billed charges,183.09,93,,,percent of total billed charges,93% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,167.34,85,,,percent of total billed charges,85% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,160.25,81.4,,,percent of total billed charges,81.4% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,147.65,75,,,percent of total billed charges,75% of total billed charges,167.34,85,,,percent of total billed charges,85% of total billed charges,74.81,183.09,
Phenobarbital,946,CDM,300,RC,80184,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Phenytoin (dilantin),947,CDM,300,RC,80185,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
Phenytoin - Free,948,CDM,300,RC,80186,HCPCS,outpatient,,,137.09,102.82,,123.38,90,,,percent of total billed charges,90% of total billed charges,127.49,93,,,percent of total billed charges,93% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,111.59,81.4,,,percent of total billed charges,81.4% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,102.82,75,,,percent of total billed charges,75% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,127.49,
"(Result) Phenytoin, Free",949,CDM,300,RC,80186,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Primidone,950,CDM,300,RC,80188,HCPCS,outpatient,,,148.31,111.23,,133.48,90,,,percent of total billed charges,90% of total billed charges,137.93,93,,,percent of total billed charges,93% of total billed charges,56.36,38,,,percent of total billed charges,38% of total billed charges,56.36,38,,,percent of total billed charges,38% of total billed charges,126.06,85,,,percent of total billed charges,85% of total billed charges,56.36,38,,,percent of total billed charges,38% of total billed charges,120.72,81.4,,,percent of total billed charges,81.4% of total billed charges,133.48,90,,,percent of total billed charges,90% of total billed charges,133.48,90,,,percent of total billed charges,90% of total billed charges,56.36,38,,,percent of total billed charges,38% of total billed charges,56.36,38,,,percent of total billed charges,38% of total billed charges,56.36,38,,,percent of total billed charges,38% of total billed charges,111.23,75,,,percent of total billed charges,75% of total billed charges,126.06,85,,,percent of total billed charges,85% of total billed charges,56.36,137.93,
Sirolimus LC/MS/MS,951,CDM,300,RC,80195,HCPCS,outpatient,,,203.32,152.49,,182.99,90,,,percent of total billed charges,90% of total billed charges,189.09,93,,,percent of total billed charges,93% of total billed charges,77.26,38,,,percent of total billed charges,38% of total billed charges,77.26,38,,,percent of total billed charges,38% of total billed charges,172.82,85,,,percent of total billed charges,85% of total billed charges,77.26,38,,,percent of total billed charges,38% of total billed charges,165.5,81.4,,,percent of total billed charges,81.4% of total billed charges,182.99,90,,,percent of total billed charges,90% of total billed charges,182.99,90,,,percent of total billed charges,90% of total billed charges,77.26,38,,,percent of total billed charges,38% of total billed charges,77.26,38,,,percent of total billed charges,38% of total billed charges,77.26,38,,,percent of total billed charges,38% of total billed charges,152.49,75,,,percent of total billed charges,75% of total billed charges,172.82,85,,,percent of total billed charges,85% of total billed charges,77.26,189.09,
"(Result) Tacrolimus, Highly Sensitive",952,CDM,300,RC,80197,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Tacrolimus - Highly Sensitive,953,CDM,300,RC,80197,HCPCS,outpatient,,,270.67,203,,243.6,90,,,percent of total billed charges,90% of total billed charges,251.72,93,,,percent of total billed charges,93% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,230.07,85,,,percent of total billed charges,85% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,220.33,81.4,,,percent of total billed charges,81.4% of total billed charges,243.6,90,,,percent of total billed charges,90% of total billed charges,243.6,90,,,percent of total billed charges,90% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,203,75,,,percent of total billed charges,75% of total billed charges,230.07,85,,,percent of total billed charges,85% of total billed charges,102.85,251.72,
Theophylline Level,954,CDM,300,RC,80198,HCPCS,outpatient,,,87.44,65.58,,78.7,90,,,percent of total billed charges,90% of total billed charges,81.32,93,,,percent of total billed charges,93% of total billed charges,33.23,38,,,percent of total billed charges,38% of total billed charges,33.23,38,,,percent of total billed charges,38% of total billed charges,74.32,85,,,percent of total billed charges,85% of total billed charges,33.23,38,,,percent of total billed charges,38% of total billed charges,71.18,81.4,,,percent of total billed charges,81.4% of total billed charges,78.7,90,,,percent of total billed charges,90% of total billed charges,78.7,90,,,percent of total billed charges,90% of total billed charges,33.23,38,,,percent of total billed charges,38% of total billed charges,33.23,38,,,percent of total billed charges,38% of total billed charges,33.23,38,,,percent of total billed charges,38% of total billed charges,65.58,75,,,percent of total billed charges,75% of total billed charges,74.32,85,,,percent of total billed charges,85% of total billed charges,33.23,81.32,
Tobramycin Peak OR Trough,955,CDM,300,RC,80200,HCPCS,outpatient,,,182.8,137.1,,164.52,90,,,percent of total billed charges,90% of total billed charges,170,93,,,percent of total billed charges,93% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,148.8,81.4,,,percent of total billed charges,81.4% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,137.1,75,,,percent of total billed charges,75% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,170,
Topiramate,956,CDM,300,RC,80201,HCPCS,outpatient,,,100.11,75.08,,90.1,90,,,percent of total billed charges,90% of total billed charges,93.1,93,,,percent of total billed charges,93% of total billed charges,38.04,38,,,percent of total billed charges,38% of total billed charges,38.04,38,,,percent of total billed charges,38% of total billed charges,85.09,85,,,percent of total billed charges,85% of total billed charges,38.04,38,,,percent of total billed charges,38% of total billed charges,81.49,81.4,,,percent of total billed charges,81.4% of total billed charges,90.1,90,,,percent of total billed charges,90% of total billed charges,90.1,90,,,percent of total billed charges,90% of total billed charges,38.04,38,,,percent of total billed charges,38% of total billed charges,38.04,38,,,percent of total billed charges,38% of total billed charges,38.04,38,,,percent of total billed charges,38% of total billed charges,75.08,75,,,percent of total billed charges,75% of total billed charges,85.09,85,,,percent of total billed charges,85% of total billed charges,38.04,93.1,
Vancomycin (Peak),957,CDM,300,RC,80202,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
Vancomycin (Trough),958,CDM,300,RC,80202,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
LACOSAMIDE,959,CDM,300,RC,80235,HCPCS,outpatient,,,213.26,159.95,,191.93,90,,,percent of total billed charges,90% of total billed charges,198.33,93,,,percent of total billed charges,93% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,181.27,85,,,percent of total billed charges,85% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,173.59,81.4,,,percent of total billed charges,81.4% of total billed charges,191.93,90,,,percent of total billed charges,90% of total billed charges,191.93,90,,,percent of total billed charges,90% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,159.95,75,,,percent of total billed charges,75% of total billed charges,181.27,85,,,percent of total billed charges,85% of total billed charges,81.04,198.33,
Cycloserine Level,960,CDM,300,RC,80299,HCPCS,outpatient,,,137.29,102.97,,123.56,90,,,percent of total billed charges,90% of total billed charges,127.68,93,,,percent of total billed charges,93% of total billed charges,52.17,38,,,percent of total billed charges,38% of total billed charges,52.17,38,,,percent of total billed charges,38% of total billed charges,116.7,85,,,percent of total billed charges,85% of total billed charges,52.17,38,,,percent of total billed charges,38% of total billed charges,111.75,81.4,,,percent of total billed charges,81.4% of total billed charges,123.56,90,,,percent of total billed charges,90% of total billed charges,123.56,90,,,percent of total billed charges,90% of total billed charges,52.17,38,,,percent of total billed charges,38% of total billed charges,52.17,38,,,percent of total billed charges,38% of total billed charges,52.17,38,,,percent of total billed charges,38% of total billed charges,102.97,75,,,percent of total billed charges,75% of total billed charges,116.7,85,,,percent of total billed charges,85% of total billed charges,52.17,127.68,
(Result) Keppra,961,CDM,300,RC,80299,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Seroquel(Quetiapine),962,CDM,300,RC,80299,HCPCS,outpatient,,,186.31,139.73,,167.68,90,,,percent of total billed charges,90% of total billed charges,173.27,93,,,percent of total billed charges,93% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,151.66,81.4,,,percent of total billed charges,81.4% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,139.73,75,,,percent of total billed charges,75% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,173.27,
Dexamethasone,963,CDM,300,RC,80299,HCPCS,outpatient,,,155.96,116.97,,140.36,90,,,percent of total billed charges,90% of total billed charges,145.04,93,,,percent of total billed charges,93% of total billed charges,59.26,38,,,percent of total billed charges,38% of total billed charges,59.26,38,,,percent of total billed charges,38% of total billed charges,132.57,85,,,percent of total billed charges,85% of total billed charges,59.26,38,,,percent of total billed charges,38% of total billed charges,126.95,81.4,,,percent of total billed charges,81.4% of total billed charges,140.36,90,,,percent of total billed charges,90% of total billed charges,140.36,90,,,percent of total billed charges,90% of total billed charges,59.26,38,,,percent of total billed charges,38% of total billed charges,59.26,38,,,percent of total billed charges,38% of total billed charges,59.26,38,,,percent of total billed charges,38% of total billed charges,116.97,75,,,percent of total billed charges,75% of total billed charges,132.57,85,,,percent of total billed charges,85% of total billed charges,59.26,145.04,
Amiodarone level,964,CDM,300,RC,80299,HCPCS,outpatient,,,203.04,152.28,,182.74,90,,,percent of total billed charges,90% of total billed charges,188.83,93,,,percent of total billed charges,93% of total billed charges,77.16,38,,,percent of total billed charges,38% of total billed charges,77.16,38,,,percent of total billed charges,38% of total billed charges,172.58,85,,,percent of total billed charges,85% of total billed charges,77.16,38,,,percent of total billed charges,38% of total billed charges,165.27,81.4,,,percent of total billed charges,81.4% of total billed charges,182.74,90,,,percent of total billed charges,90% of total billed charges,182.74,90,,,percent of total billed charges,90% of total billed charges,77.16,38,,,percent of total billed charges,38% of total billed charges,77.16,38,,,percent of total billed charges,38% of total billed charges,77.16,38,,,percent of total billed charges,38% of total billed charges,152.28,75,,,percent of total billed charges,75% of total billed charges,172.58,85,,,percent of total billed charges,85% of total billed charges,77.16,188.83,
Methotrexate,965,CDM,300,RC,80299,HCPCS,outpatient,,,155.42,116.57,,139.88,90,,,percent of total billed charges,90% of total billed charges,144.54,93,,,percent of total billed charges,93% of total billed charges,59.06,38,,,percent of total billed charges,38% of total billed charges,59.06,38,,,percent of total billed charges,38% of total billed charges,132.11,85,,,percent of total billed charges,85% of total billed charges,59.06,38,,,percent of total billed charges,38% of total billed charges,126.51,81.4,,,percent of total billed charges,81.4% of total billed charges,139.88,90,,,percent of total billed charges,90% of total billed charges,139.88,90,,,percent of total billed charges,90% of total billed charges,59.06,38,,,percent of total billed charges,38% of total billed charges,59.06,38,,,percent of total billed charges,38% of total billed charges,59.06,38,,,percent of total billed charges,38% of total billed charges,116.57,75,,,percent of total billed charges,75% of total billed charges,132.11,85,,,percent of total billed charges,85% of total billed charges,59.06,144.54,
"Lamictal (Lamotrigine), Serum",966,CDM,300,RC,80299,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
Eslicarbazepine,967,CDM,300,RC,80299,HCPCS,outpatient,,,251.13,188.35,,226.02,90,,,percent of total billed charges,90% of total billed charges,233.55,93,,,percent of total billed charges,93% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,213.46,85,,,percent of total billed charges,85% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,204.42,81.4,,,percent of total billed charges,81.4% of total billed charges,226.02,90,,,percent of total billed charges,90% of total billed charges,226.02,90,,,percent of total billed charges,90% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,188.35,75,,,percent of total billed charges,75% of total billed charges,213.46,85,,,percent of total billed charges,85% of total billed charges,95.43,233.55,
(Result) Lamotrigine (Lamictal),968,CDM,300,RC,80299,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Zonisamide,969,CDM,300,RC,80299,HCPCS,outpatient,,,146.47,109.85,,131.82,90,,,percent of total billed charges,90% of total billed charges,136.22,93,,,percent of total billed charges,93% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,119.23,81.4,,,percent of total billed charges,81.4% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,109.85,75,,,percent of total billed charges,75% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,136.22,
(Result) Zonisamide,970,CDM,300,RC,80299,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
FLECAINIDE,971,CDM,300,RC,80299,HCPCS,outpatient,,,157.01,117.76,,141.31,90,,,percent of total billed charges,90% of total billed charges,146.02,93,,,percent of total billed charges,93% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,133.46,85,,,percent of total billed charges,85% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,127.81,81.4,,,percent of total billed charges,81.4% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,117.76,75,,,percent of total billed charges,75% of total billed charges,133.46,85,,,percent of total billed charges,85% of total billed charges,59.66,146.02,
Paliperidone,972,CDM,300,RC,80299,HCPCS,outpatient,,,162.36,121.77,,146.12,90,,,percent of total billed charges,90% of total billed charges,150.99,93,,,percent of total billed charges,93% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,132.16,81.4,,,percent of total billed charges,81.4% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,121.77,75,,,percent of total billed charges,75% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,150.99,
Coumadin,973,CDM,300,RC,80299,HCPCS,outpatient,,,111.52,83.64,,100.37,90,,,percent of total billed charges,90% of total billed charges,103.71,93,,,percent of total billed charges,93% of total billed charges,42.38,38,,,percent of total billed charges,38% of total billed charges,42.38,38,,,percent of total billed charges,38% of total billed charges,94.79,85,,,percent of total billed charges,85% of total billed charges,42.38,38,,,percent of total billed charges,38% of total billed charges,90.78,81.4,,,percent of total billed charges,81.4% of total billed charges,100.37,90,,,percent of total billed charges,90% of total billed charges,100.37,90,,,percent of total billed charges,90% of total billed charges,42.38,38,,,percent of total billed charges,38% of total billed charges,42.38,38,,,percent of total billed charges,38% of total billed charges,42.38,38,,,percent of total billed charges,38% of total billed charges,83.64,75,,,percent of total billed charges,75% of total billed charges,94.79,85,,,percent of total billed charges,85% of total billed charges,42.38,103.71,
Clinic drug testing,974,CDM,300,RC,80303,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
Clinic drug testing,975,CDM,300,RC,80303,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
Urine Drug Screen[Panel],976,CDM,300,RC,80305,HCPCS,outpatient,,,260.13,195.1,,234.12,90,,,percent of total billed charges,90% of total billed charges,241.92,93,,,percent of total billed charges,93% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,211.75,81.4,,,percent of total billed charges,81.4% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,195.1,75,,,percent of total billed charges,75% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,241.92,
Urine Drug Screen[Panel],977,CDM,300,RC,80305,HCPCS,outpatient,,,260.13,195.1,,234.12,90,,,percent of total billed charges,90% of total billed charges,241.92,93,,,percent of total billed charges,93% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,211.75,81.4,,,percent of total billed charges,81.4% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,195.1,75,,,percent of total billed charges,75% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,241.92,
Urine Drug Screen[Panel],978,CDM,300,RC,80305,HCPCS,outpatient,,,260.13,195.1,,234.12,90,,,percent of total billed charges,90% of total billed charges,241.92,93,,,percent of total billed charges,93% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,211.75,81.4,,,percent of total billed charges,81.4% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,195.1,75,,,percent of total billed charges,75% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,241.92,
Pain Management Pro 1 w/o urine,979,CDM,300,RC,80307,HCPCS,outpatient,,,382.51,286.88,,344.26,90,,,percent of total billed charges,90% of total billed charges,355.73,93,,,percent of total billed charges,93% of total billed charges,145.35,38,,,percent of total billed charges,38% of total billed charges,145.35,38,,,percent of total billed charges,38% of total billed charges,325.13,85,,,percent of total billed charges,85% of total billed charges,145.35,38,,,percent of total billed charges,38% of total billed charges,311.36,81.4,,,percent of total billed charges,81.4% of total billed charges,344.26,90,,,percent of total billed charges,90% of total billed charges,344.26,90,,,percent of total billed charges,90% of total billed charges,145.35,38,,,percent of total billed charges,38% of total billed charges,145.35,38,,,percent of total billed charges,38% of total billed charges,145.35,38,,,percent of total billed charges,38% of total billed charges,286.88,75,,,percent of total billed charges,75% of total billed charges,325.13,85,,,percent of total billed charges,85% of total billed charges,145.35,355.73,
Drug Monitoring - Benzodiazepines (U),980,CDM,300,RC,80307,HCPCS,outpatient,,,93.09,69.82,,83.78,90,,,percent of total billed charges,90% of total billed charges,86.57,93,,,percent of total billed charges,93% of total billed charges,35.37,38,,,percent of total billed charges,38% of total billed charges,35.37,38,,,percent of total billed charges,38% of total billed charges,79.13,85,,,percent of total billed charges,85% of total billed charges,35.37,38,,,percent of total billed charges,38% of total billed charges,75.78,81.4,,,percent of total billed charges,81.4% of total billed charges,83.78,90,,,percent of total billed charges,90% of total billed charges,83.78,90,,,percent of total billed charges,90% of total billed charges,35.37,38,,,percent of total billed charges,38% of total billed charges,35.37,38,,,percent of total billed charges,38% of total billed charges,35.37,38,,,percent of total billed charges,38% of total billed charges,69.82,75,,,percent of total billed charges,75% of total billed charges,79.13,85,,,percent of total billed charges,85% of total billed charges,35.37,86.57,
Buprenorphine with confirmation,981,CDM,300,RC,80307,HCPCS,outpatient,,,104.73,78.55,,94.26,90,,,percent of total billed charges,90% of total billed charges,97.4,93,,,percent of total billed charges,93% of total billed charges,39.8,38,,,percent of total billed charges,38% of total billed charges,39.8,38,,,percent of total billed charges,38% of total billed charges,89.02,85,,,percent of total billed charges,85% of total billed charges,39.8,38,,,percent of total billed charges,38% of total billed charges,85.25,81.4,,,percent of total billed charges,81.4% of total billed charges,94.26,90,,,percent of total billed charges,90% of total billed charges,94.26,90,,,percent of total billed charges,90% of total billed charges,39.8,38,,,percent of total billed charges,38% of total billed charges,39.8,38,,,percent of total billed charges,38% of total billed charges,39.8,38,,,percent of total billed charges,38% of total billed charges,78.55,75,,,percent of total billed charges,75% of total billed charges,89.02,85,,,percent of total billed charges,85% of total billed charges,39.8,97.4,
Cocaine Metabolites w Confirm,982,CDM,300,RC,80307,HCPCS,outpatient,,,246.64,184.98,,221.98,90,,,percent of total billed charges,90% of total billed charges,229.38,93,,,percent of total billed charges,93% of total billed charges,93.72,38,,,percent of total billed charges,38% of total billed charges,93.72,38,,,percent of total billed charges,38% of total billed charges,209.64,85,,,percent of total billed charges,85% of total billed charges,93.72,38,,,percent of total billed charges,38% of total billed charges,200.76,81.4,,,percent of total billed charges,81.4% of total billed charges,221.98,90,,,percent of total billed charges,90% of total billed charges,221.98,90,,,percent of total billed charges,90% of total billed charges,93.72,38,,,percent of total billed charges,38% of total billed charges,93.72,38,,,percent of total billed charges,38% of total billed charges,93.72,38,,,percent of total billed charges,38% of total billed charges,184.98,75,,,percent of total billed charges,75% of total billed charges,209.64,85,,,percent of total billed charges,85% of total billed charges,93.72,229.38,
Drug Monitor. Opioids Panel w Conf. Urine,983,CDM,300,RC,80307,HCPCS,outpatient,,,254.54,190.91,,229.09,90,,,percent of total billed charges,90% of total billed charges,236.72,93,,,percent of total billed charges,93% of total billed charges,96.73,38,,,percent of total billed charges,38% of total billed charges,96.73,38,,,percent of total billed charges,38% of total billed charges,216.36,85,,,percent of total billed charges,85% of total billed charges,96.73,38,,,percent of total billed charges,38% of total billed charges,207.2,81.4,,,percent of total billed charges,81.4% of total billed charges,229.09,90,,,percent of total billed charges,90% of total billed charges,229.09,90,,,percent of total billed charges,90% of total billed charges,96.73,38,,,percent of total billed charges,38% of total billed charges,96.73,38,,,percent of total billed charges,38% of total billed charges,96.73,38,,,percent of total billed charges,38% of total billed charges,190.91,75,,,percent of total billed charges,75% of total billed charges,216.36,85,,,percent of total billed charges,85% of total billed charges,96.73,236.72,
"Fentanyl, Urine (SLVRMC)",984,CDM,300,RC,80307,HCPCS,outpatient,,,81.6,61.2,,73.44,90,,,percent of total billed charges,90% of total billed charges,75.89,93,,,percent of total billed charges,93% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,66.42,81.4,,,percent of total billed charges,81.4% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,61.2,75,,,percent of total billed charges,75% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,75.89,
"Drug Monitor. Panel 1, Screen, Urine",985,CDM,300,RC,80307,HCPCS,outpatient,,,124.85,93.64,,112.37,90,,,percent of total billed charges,90% of total billed charges,116.11,93,,,percent of total billed charges,93% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,101.63,81.4,,,percent of total billed charges,81.4% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,93.64,75,,,percent of total billed charges,75% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,116.11,
Drug Abuse Screen 7 with confirm,986,CDM,300,RC,80307,HCPCS,outpatient,,,606.14,454.61,,545.53,90,,,percent of total billed charges,90% of total billed charges,563.71,93,,,percent of total billed charges,93% of total billed charges,230.33,38,,,percent of total billed charges,38% of total billed charges,230.33,38,,,percent of total billed charges,38% of total billed charges,515.22,85,,,percent of total billed charges,85% of total billed charges,230.33,38,,,percent of total billed charges,38% of total billed charges,493.4,81.4,,,percent of total billed charges,81.4% of total billed charges,545.53,90,,,percent of total billed charges,90% of total billed charges,545.53,90,,,percent of total billed charges,90% of total billed charges,230.33,38,,,percent of total billed charges,38% of total billed charges,230.33,38,,,percent of total billed charges,38% of total billed charges,230.33,38,,,percent of total billed charges,38% of total billed charges,454.61,75,,,percent of total billed charges,75% of total billed charges,515.22,85,,,percent of total billed charges,85% of total billed charges,230.33,563.71,
"Drug Monitor. Opiates, Screen Urine",987,CDM,300,RC,80307,HCPCS,outpatient,,,97.02,72.77,,87.32,90,,,percent of total billed charges,90% of total billed charges,90.23,93,,,percent of total billed charges,93% of total billed charges,36.87,38,,,percent of total billed charges,38% of total billed charges,36.87,38,,,percent of total billed charges,38% of total billed charges,82.47,85,,,percent of total billed charges,85% of total billed charges,36.87,38,,,percent of total billed charges,38% of total billed charges,78.97,81.4,,,percent of total billed charges,81.4% of total billed charges,87.32,90,,,percent of total billed charges,90% of total billed charges,87.32,90,,,percent of total billed charges,90% of total billed charges,36.87,38,,,percent of total billed charges,38% of total billed charges,36.87,38,,,percent of total billed charges,38% of total billed charges,36.87,38,,,percent of total billed charges,38% of total billed charges,72.77,75,,,percent of total billed charges,75% of total billed charges,82.47,85,,,percent of total billed charges,85% of total billed charges,36.87,90.23,
Drug monitoring Antipsychotics,988,CDM,300,RC,80307,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,154.02,
"Drug Monitor. Panel 5, Screen, Urine",989,CDM,300,RC,80307,HCPCS,outpatient,,,102.48,76.86,,92.23,90,,,percent of total billed charges,90% of total billed charges,95.31,93,,,percent of total billed charges,93% of total billed charges,38.94,38,,,percent of total billed charges,38% of total billed charges,38.94,38,,,percent of total billed charges,38% of total billed charges,87.11,85,,,percent of total billed charges,85% of total billed charges,38.94,38,,,percent of total billed charges,38% of total billed charges,83.42,81.4,,,percent of total billed charges,81.4% of total billed charges,92.23,90,,,percent of total billed charges,90% of total billed charges,92.23,90,,,percent of total billed charges,90% of total billed charges,38.94,38,,,percent of total billed charges,38% of total billed charges,38.94,38,,,percent of total billed charges,38% of total billed charges,38.94,38,,,percent of total billed charges,38% of total billed charges,76.86,75,,,percent of total billed charges,75% of total billed charges,87.11,85,,,percent of total billed charges,85% of total billed charges,38.94,95.31,
Gamma-Hydroxybutyric Acid Screen,990,CDM,300,RC,80307,HCPCS,outpatient,,,270.5,202.88,,243.45,90,,,percent of total billed charges,90% of total billed charges,251.57,93,,,percent of total billed charges,93% of total billed charges,102.79,38,,,percent of total billed charges,38% of total billed charges,102.79,38,,,percent of total billed charges,38% of total billed charges,229.93,85,,,percent of total billed charges,85% of total billed charges,102.79,38,,,percent of total billed charges,38% of total billed charges,220.19,81.4,,,percent of total billed charges,81.4% of total billed charges,243.45,90,,,percent of total billed charges,90% of total billed charges,243.45,90,,,percent of total billed charges,90% of total billed charges,102.79,38,,,percent of total billed charges,38% of total billed charges,102.79,38,,,percent of total billed charges,38% of total billed charges,102.79,38,,,percent of total billed charges,38% of total billed charges,202.88,75,,,percent of total billed charges,75% of total billed charges,229.93,85,,,percent of total billed charges,85% of total billed charges,102.79,251.57,
Blood Alcohol,991,CDM,300,RC,80320,HCPCS,outpatient,,,121.86,91.4,,109.67,90,,,percent of total billed charges,90% of total billed charges,113.33,93,,,percent of total billed charges,93% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,99.19,81.4,,,percent of total billed charges,81.4% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,91.4,75,,,percent of total billed charges,75% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,113.33,
Blood Alcohol,992,CDM,300,RC,80320,HCPCS,outpatient,,,121.86,91.4,,109.67,90,,,percent of total billed charges,90% of total billed charges,113.33,93,,,percent of total billed charges,93% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,99.19,81.4,,,percent of total billed charges,81.4% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,91.4,75,,,percent of total billed charges,75% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,113.33,
Volatiles,993,CDM,300,RC,80320,HCPCS,outpatient,,,161.06,120.8,,144.95,90,,,percent of total billed charges,90% of total billed charges,149.79,93,,,percent of total billed charges,93% of total billed charges,61.2,38,,,percent of total billed charges,38% of total billed charges,61.2,38,,,percent of total billed charges,38% of total billed charges,136.9,85,,,percent of total billed charges,85% of total billed charges,61.2,38,,,percent of total billed charges,38% of total billed charges,131.1,81.4,,,percent of total billed charges,81.4% of total billed charges,144.95,90,,,percent of total billed charges,90% of total billed charges,144.95,90,,,percent of total billed charges,90% of total billed charges,61.2,38,,,percent of total billed charges,38% of total billed charges,61.2,38,,,percent of total billed charges,38% of total billed charges,61.2,38,,,percent of total billed charges,38% of total billed charges,120.8,75,,,percent of total billed charges,75% of total billed charges,136.9,85,,,percent of total billed charges,85% of total billed charges,61.2,149.79,
Drug Tox - alcohol metabolites quant UR,994,CDM,300,RC,80321,HCPCS,outpatient,,,125,93.75,,112.5,90,,,percent of total billed charges,90% of total billed charges,116.25,93,,,percent of total billed charges,93% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,101.75,81.4,,,percent of total billed charges,81.4% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,93.75,75,,,percent of total billed charges,75% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,116.25,
Drug Tox - alcohol metabolites quant UR,995,CDM,300,RC,80321,HCPCS,outpatient,,,125,93.75,,112.5,90,,,percent of total billed charges,90% of total billed charges,116.25,93,,,percent of total billed charges,93% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,101.75,81.4,,,percent of total billed charges,81.4% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,93.75,75,,,percent of total billed charges,75% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,116.25,
"Drug Monitoring, Phosphatidylethanol, Blood",996,CDM,300,RC,80321,HCPCS,outpatient,,,161.26,120.95,,145.13,90,,,percent of total billed charges,90% of total billed charges,149.97,93,,,percent of total billed charges,93% of total billed charges,61.28,38,,,percent of total billed charges,38% of total billed charges,61.28,38,,,percent of total billed charges,38% of total billed charges,137.07,85,,,percent of total billed charges,85% of total billed charges,61.28,38,,,percent of total billed charges,38% of total billed charges,131.27,81.4,,,percent of total billed charges,81.4% of total billed charges,145.13,90,,,percent of total billed charges,90% of total billed charges,145.13,90,,,percent of total billed charges,90% of total billed charges,61.28,38,,,percent of total billed charges,38% of total billed charges,61.28,38,,,percent of total billed charges,38% of total billed charges,61.28,38,,,percent of total billed charges,38% of total billed charges,120.95,75,,,percent of total billed charges,75% of total billed charges,137.07,85,,,percent of total billed charges,85% of total billed charges,61.28,149.97,
"Nicotine and Cotinine, LC/MS/MS, Urine",997,CDM,300,RC,80323,HCPCS,outpatient,,,129.11,96.83,,116.2,90,,,percent of total billed charges,90% of total billed charges,120.07,93,,,percent of total billed charges,93% of total billed charges,49.06,38,,,percent of total billed charges,38% of total billed charges,49.06,38,,,percent of total billed charges,38% of total billed charges,109.74,85,,,percent of total billed charges,85% of total billed charges,49.06,38,,,percent of total billed charges,38% of total billed charges,105.1,81.4,,,percent of total billed charges,81.4% of total billed charges,116.2,90,,,percent of total billed charges,90% of total billed charges,116.2,90,,,percent of total billed charges,90% of total billed charges,49.06,38,,,percent of total billed charges,38% of total billed charges,49.06,38,,,percent of total billed charges,38% of total billed charges,49.06,38,,,percent of total billed charges,38% of total billed charges,96.83,75,,,percent of total billed charges,75% of total billed charges,109.74,85,,,percent of total billed charges,85% of total billed charges,49.06,120.07,
Nicotine and Cotinine serum,998,CDM,300,RC,80323,HCPCS,outpatient,,,137.87,103.4,,124.08,90,,,percent of total billed charges,90% of total billed charges,128.22,93,,,percent of total billed charges,93% of total billed charges,52.39,38,,,percent of total billed charges,38% of total billed charges,52.39,38,,,percent of total billed charges,38% of total billed charges,117.19,85,,,percent of total billed charges,85% of total billed charges,52.39,38,,,percent of total billed charges,38% of total billed charges,112.23,81.4,,,percent of total billed charges,81.4% of total billed charges,124.08,90,,,percent of total billed charges,90% of total billed charges,124.08,90,,,percent of total billed charges,90% of total billed charges,52.39,38,,,percent of total billed charges,38% of total billed charges,52.39,38,,,percent of total billed charges,38% of total billed charges,52.39,38,,,percent of total billed charges,38% of total billed charges,103.4,75,,,percent of total billed charges,75% of total billed charges,117.19,85,,,percent of total billed charges,85% of total billed charges,52.39,128.22,
"Nicotine & Expanded Metabolites, Urine",999,CDM,300,RC,80323,HCPCS,outpatient,,,126.53,94.9,,113.88,90,,,percent of total billed charges,90% of total billed charges,117.67,93,,,percent of total billed charges,93% of total billed charges,48.08,38,,,percent of total billed charges,38% of total billed charges,48.08,38,,,percent of total billed charges,38% of total billed charges,107.55,85,,,percent of total billed charges,85% of total billed charges,48.08,38,,,percent of total billed charges,38% of total billed charges,103,81.4,,,percent of total billed charges,81.4% of total billed charges,113.88,90,,,percent of total billed charges,90% of total billed charges,113.88,90,,,percent of total billed charges,90% of total billed charges,48.08,38,,,percent of total billed charges,38% of total billed charges,48.08,38,,,percent of total billed charges,38% of total billed charges,48.08,38,,,percent of total billed charges,38% of total billed charges,94.9,75,,,percent of total billed charges,75% of total billed charges,107.55,85,,,percent of total billed charges,85% of total billed charges,48.08,117.67,
(RES) AMPHETAMINE Conf.,1000,CDM,300,RC,80324,HCPCS,outpatient,,,156.77,117.58,,141.09,90,,,percent of total billed charges,90% of total billed charges,145.8,93,,,percent of total billed charges,93% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,127.61,81.4,,,percent of total billed charges,81.4% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,117.58,75,,,percent of total billed charges,75% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,145.8,
Amphetamine quant urine,1001,CDM,300,RC,80324,HCPCS,outpatient,,,156.77,117.58,,141.09,90,,,percent of total billed charges,90% of total billed charges,145.8,93,,,percent of total billed charges,93% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,127.61,81.4,,,percent of total billed charges,81.4% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,117.58,75,,,percent of total billed charges,75% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,145.8,
Amphetamine quant urine,1002,CDM,300,RC,80324,HCPCS,outpatient,,,156.77,117.58,,141.09,90,,,percent of total billed charges,90% of total billed charges,145.8,93,,,percent of total billed charges,93% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,127.61,81.4,,,percent of total billed charges,81.4% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,117.58,75,,,percent of total billed charges,75% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,145.8,
Salicylate,1003,CDM,300,RC,80329,HCPCS,outpatient,,,134.75,101.06,,121.28,90,,,percent of total billed charges,90% of total billed charges,125.32,93,,,percent of total billed charges,93% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,109.69,81.4,,,percent of total billed charges,81.4% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,101.06,75,,,percent of total billed charges,75% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,125.32,
Acetaminophen Level,1004,CDM,300,RC,80330,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
AMITRIPTYLINE,1005,CDM,300,RC,80335,HCPCS,outpatient,,,166.67,125,,150,90,,,percent of total billed charges,90% of total billed charges,155,93,,,percent of total billed charges,93% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,135.67,81.4,,,percent of total billed charges,81.4% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,125,75,,,percent of total billed charges,75% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,155,
AMITRIPTYLINE,1006,CDM,300,RC,80335,HCPCS,outpatient,,,166.67,125,,150,90,,,percent of total billed charges,90% of total billed charges,155,93,,,percent of total billed charges,93% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,135.67,81.4,,,percent of total billed charges,81.4% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,125,75,,,percent of total billed charges,75% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,155,
Drug Monitoring - Anti-psychotics confirm  1-3,1007,CDM,300,RC,80342,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,154.02,
Risperidone level,1008,CDM,300,RC,80342,HCPCS,outpatient,,,149.98,112.49,,134.98,90,,,percent of total billed charges,90% of total billed charges,139.48,93,,,percent of total billed charges,93% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,127.48,85,,,percent of total billed charges,85% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,122.08,81.4,,,percent of total billed charges,81.4% of total billed charges,134.98,90,,,percent of total billed charges,90% of total billed charges,134.98,90,,,percent of total billed charges,90% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,112.49,75,,,percent of total billed charges,75% of total billed charges,127.48,85,,,percent of total billed charges,85% of total billed charges,56.99,139.48,
Clobazam,1009,CDM,300,RC,80346,HCPCS,outpatient,,,193.34,145.01,,174.01,90,,,percent of total billed charges,90% of total billed charges,179.81,93,,,percent of total billed charges,93% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,164.34,85,,,percent of total billed charges,85% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,157.38,81.4,,,percent of total billed charges,81.4% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,145.01,75,,,percent of total billed charges,75% of total billed charges,164.34,85,,,percent of total billed charges,85% of total billed charges,73.47,179.81,
"Flunitrazepam, Metabolites, QNT",1010,CDM,300,RC,80346,HCPCS,outpatient,,,297.91,223.43,,268.12,90,,,percent of total billed charges,90% of total billed charges,277.06,93,,,percent of total billed charges,93% of total billed charges,113.21,38,,,percent of total billed charges,38% of total billed charges,113.21,38,,,percent of total billed charges,38% of total billed charges,253.22,85,,,percent of total billed charges,85% of total billed charges,113.21,38,,,percent of total billed charges,38% of total billed charges,242.5,81.4,,,percent of total billed charges,81.4% of total billed charges,268.12,90,,,percent of total billed charges,90% of total billed charges,268.12,90,,,percent of total billed charges,90% of total billed charges,113.21,38,,,percent of total billed charges,38% of total billed charges,113.21,38,,,percent of total billed charges,38% of total billed charges,113.21,38,,,percent of total billed charges,38% of total billed charges,223.43,75,,,percent of total billed charges,75% of total billed charges,253.22,85,,,percent of total billed charges,85% of total billed charges,113.21,277.06,
(RES) Buprenorphine Confirm.,1011,CDM,300,RC,80348,HCPCS,outpatient,,,124.85,93.64,,112.37,90,,,percent of total billed charges,90% of total billed charges,116.11,93,,,percent of total billed charges,93% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,101.63,81.4,,,percent of total billed charges,81.4% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,93.64,75,,,percent of total billed charges,75% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,116.11,
"Drug Monitor. Marijuana Metabolite, QNT, UR",1012,CDM,300,RC,80349,HCPCS,outpatient,,,124.85,93.64,,112.37,90,,,percent of total billed charges,90% of total billed charges,116.11,93,,,percent of total billed charges,93% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,101.63,81.4,,,percent of total billed charges,81.4% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,93.64,75,,,percent of total billed charges,75% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,116.11,
Cocaine confirmation (urine),1013,CDM,300,RC,80353,HCPCS,outpatient,,,172.3,129.23,,155.07,90,,,percent of total billed charges,90% of total billed charges,160.24,93,,,percent of total billed charges,93% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,146.46,85,,,percent of total billed charges,85% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,140.25,81.4,,,percent of total billed charges,81.4% of total billed charges,155.07,90,,,percent of total billed charges,90% of total billed charges,155.07,90,,,percent of total billed charges,90% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,65.47,38,,,percent of total billed charges,38% of total billed charges,129.23,75,,,percent of total billed charges,75% of total billed charges,146.46,85,,,percent of total billed charges,85% of total billed charges,65.47,160.24,
(RES) Fentanyl Confirm.,1014,CDM,300,RC,80354,HCPCS,outpatient,,,124.85,93.64,,112.37,90,,,percent of total billed charges,90% of total billed charges,116.11,93,,,percent of total billed charges,93% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,101.63,81.4,,,percent of total billed charges,81.4% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,93.64,75,,,percent of total billed charges,75% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,116.11,
"Acetyl Fentanyl, Qual, Blood",1015,CDM,300,RC,80354,HCPCS,outpatient,,,94.39,70.79,,84.95,90,,,percent of total billed charges,90% of total billed charges,87.78,93,,,percent of total billed charges,93% of total billed charges,35.87,38,,,percent of total billed charges,38% of total billed charges,35.87,38,,,percent of total billed charges,38% of total billed charges,80.23,85,,,percent of total billed charges,85% of total billed charges,35.87,38,,,percent of total billed charges,38% of total billed charges,76.83,81.4,,,percent of total billed charges,81.4% of total billed charges,84.95,90,,,percent of total billed charges,90% of total billed charges,84.95,90,,,percent of total billed charges,90% of total billed charges,35.87,38,,,percent of total billed charges,38% of total billed charges,35.87,38,,,percent of total billed charges,38% of total billed charges,35.87,38,,,percent of total billed charges,38% of total billed charges,70.79,75,,,percent of total billed charges,75% of total billed charges,80.23,85,,,percent of total billed charges,85% of total billed charges,35.87,87.78,
Drug monitoring - gabapentin quant UR,1016,CDM,300,RC,80355,HCPCS,outpatient,,,126.97,95.23,,114.27,90,,,percent of total billed charges,90% of total billed charges,118.08,93,,,percent of total billed charges,93% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,107.92,85,,,percent of total billed charges,85% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,103.35,81.4,,,percent of total billed charges,81.4% of total billed charges,114.27,90,,,percent of total billed charges,90% of total billed charges,114.27,90,,,percent of total billed charges,90% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,95.23,75,,,percent of total billed charges,75% of total billed charges,107.92,85,,,percent of total billed charges,85% of total billed charges,48.25,118.08,
Drug monitoring - gabapentin quant UR,1017,CDM,300,RC,80355,HCPCS,outpatient,,,126.97,95.23,,114.27,90,,,percent of total billed charges,90% of total billed charges,118.08,93,,,percent of total billed charges,93% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,107.92,85,,,percent of total billed charges,85% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,103.35,81.4,,,percent of total billed charges,81.4% of total billed charges,114.27,90,,,percent of total billed charges,90% of total billed charges,114.27,90,,,percent of total billed charges,90% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,95.23,75,,,percent of total billed charges,75% of total billed charges,107.92,85,,,percent of total billed charges,85% of total billed charges,48.25,118.08,
"Drug Monitor. Ketamine, Quant, Urine",1018,CDM,300,RC,80357,HCPCS,outpatient,,,124.78,93.59,,112.3,90,,,percent of total billed charges,90% of total billed charges,116.05,93,,,percent of total billed charges,93% of total billed charges,47.42,38,,,percent of total billed charges,38% of total billed charges,47.42,38,,,percent of total billed charges,38% of total billed charges,106.06,85,,,percent of total billed charges,85% of total billed charges,47.42,38,,,percent of total billed charges,38% of total billed charges,101.57,81.4,,,percent of total billed charges,81.4% of total billed charges,112.3,90,,,percent of total billed charges,90% of total billed charges,112.3,90,,,percent of total billed charges,90% of total billed charges,47.42,38,,,percent of total billed charges,38% of total billed charges,47.42,38,,,percent of total billed charges,38% of total billed charges,47.42,38,,,percent of total billed charges,38% of total billed charges,93.59,75,,,percent of total billed charges,75% of total billed charges,106.06,85,,,percent of total billed charges,85% of total billed charges,47.42,116.05,
(RES) METHAMPHETAMINE Conf,1019,CDM,300,RC,80359,HCPCS,outpatient,,,156.12,117.09,,140.51,90,,,percent of total billed charges,90% of total billed charges,145.19,93,,,percent of total billed charges,93% of total billed charges,59.33,38,,,percent of total billed charges,38% of total billed charges,59.33,38,,,percent of total billed charges,38% of total billed charges,132.7,85,,,percent of total billed charges,85% of total billed charges,59.33,38,,,percent of total billed charges,38% of total billed charges,127.08,81.4,,,percent of total billed charges,81.4% of total billed charges,140.51,90,,,percent of total billed charges,90% of total billed charges,140.51,90,,,percent of total billed charges,90% of total billed charges,59.33,38,,,percent of total billed charges,38% of total billed charges,59.33,38,,,percent of total billed charges,38% of total billed charges,59.33,38,,,percent of total billed charges,38% of total billed charges,117.09,75,,,percent of total billed charges,75% of total billed charges,132.7,85,,,percent of total billed charges,85% of total billed charges,59.33,145.19,
(RES) Naloxone Confirm.,1020,CDM,300,RC,80362,HCPCS,outpatient,,,124.85,93.64,,112.37,90,,,percent of total billed charges,90% of total billed charges,116.11,93,,,percent of total billed charges,93% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,101.63,81.4,,,percent of total billed charges,81.4% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,93.64,75,,,percent of total billed charges,75% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,116.11,
Oxycodone and Metabolites,1021,CDM,300,RC,80364,HCPCS,outpatient,,,149.98,112.49,,134.98,90,,,percent of total billed charges,90% of total billed charges,139.48,93,,,percent of total billed charges,93% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,127.48,85,,,percent of total billed charges,85% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,122.08,81.4,,,percent of total billed charges,81.4% of total billed charges,134.98,90,,,percent of total billed charges,90% of total billed charges,134.98,90,,,percent of total billed charges,90% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,112.49,75,,,percent of total billed charges,75% of total billed charges,127.48,85,,,percent of total billed charges,85% of total billed charges,56.99,139.48,
Oxy Drug Classess Confirmation,1022,CDM,300,RC,80365,HCPCS,outpatient,,,129.51,97.13,,116.56,90,,,percent of total billed charges,90% of total billed charges,120.44,93,,,percent of total billed charges,93% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,110.08,85,,,percent of total billed charges,85% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,105.42,81.4,,,percent of total billed charges,81.4% of total billed charges,116.56,90,,,percent of total billed charges,90% of total billed charges,116.56,90,,,percent of total billed charges,90% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,97.13,75,,,percent of total billed charges,75% of total billed charges,110.08,85,,,percent of total billed charges,85% of total billed charges,49.21,120.44,
Oxy Drug Classess Confirmation,1023,CDM,300,RC,80365,HCPCS,outpatient,,,129.51,97.13,,116.56,90,,,percent of total billed charges,90% of total billed charges,120.44,93,,,percent of total billed charges,93% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,110.08,85,,,percent of total billed charges,85% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,105.42,81.4,,,percent of total billed charges,81.4% of total billed charges,116.56,90,,,percent of total billed charges,90% of total billed charges,116.56,90,,,percent of total billed charges,90% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,97.13,75,,,percent of total billed charges,75% of total billed charges,110.08,85,,,percent of total billed charges,85% of total billed charges,49.21,120.44,
Tramadol & Metabolite,1024,CDM,300,RC,80373,HCPCS,outpatient,,,162.36,121.77,,146.12,90,,,percent of total billed charges,90% of total billed charges,150.99,93,,,percent of total billed charges,93% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,132.16,81.4,,,percent of total billed charges,81.4% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,121.77,75,,,percent of total billed charges,75% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,150.99,
"Drug Monitor. Tramadol, QNT, Urine",1025,CDM,300,RC,80373,HCPCS,outpatient,,,124.85,93.64,,112.37,90,,,percent of total billed charges,90% of total billed charges,116.11,93,,,percent of total billed charges,93% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,101.63,81.4,,,percent of total billed charges,81.4% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,93.64,75,,,percent of total billed charges,75% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,116.11,
Thiopurine metabolites,1026,CDM,300,RC,80375,HCPCS,outpatient,,,132.25,99.19,,119.03,90,,,percent of total billed charges,90% of total billed charges,122.99,93,,,percent of total billed charges,93% of total billed charges,50.26,38,,,percent of total billed charges,38% of total billed charges,50.26,38,,,percent of total billed charges,38% of total billed charges,112.41,85,,,percent of total billed charges,85% of total billed charges,50.26,38,,,percent of total billed charges,38% of total billed charges,107.65,81.4,,,percent of total billed charges,81.4% of total billed charges,119.03,90,,,percent of total billed charges,90% of total billed charges,119.03,90,,,percent of total billed charges,90% of total billed charges,50.26,38,,,percent of total billed charges,38% of total billed charges,50.26,38,,,percent of total billed charges,38% of total billed charges,50.26,38,,,percent of total billed charges,38% of total billed charges,99.19,75,,,percent of total billed charges,75% of total billed charges,112.41,85,,,percent of total billed charges,85% of total billed charges,50.26,122.99,
UA Chemstrip,1027,CDM,300,RC,81000,HCPCS,outpatient,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
Clinic US- with Micro,1028,CDM,300,RC,81000,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
Urinalysis Panel,1029,CDM,300,RC,81001,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
Clinic- UA Chemstrip,1030,CDM,300,RC,81002,HCPCS,outpatient,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
UA Color,1031,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Appearance,1032,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Specific Gravity,1033,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA pH,1034,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Glucose,1035,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Bilirubin,1036,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Ketone,1037,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Blood,1038,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Protein,1039,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Nitrite,1040,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
YY - Urinalysis,1041,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Leukocytes,1042,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Urobilinogen,1043,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro WBC,1044,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro RBC,1045,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Sq. Epithelial Cells,1046,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Bacteria,1047,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Mucus,1048,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Casts,1049,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Crystals,1050,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Amophous Urates,1051,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Amorph Phosphates,1052,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Renal Epith. Cells,1053,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Granular Casts,1054,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro RBC Casts,1055,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro WBC Casts,1056,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Waxy Casts,1057,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Calcium Ox Crystls,1058,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Hyaline Casts,1059,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Ammonium Biurate,1060,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Uric Acid,1061,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Triple Phos Crystls,1062,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Starch,1063,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Specimen Source,1064,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Trichomonas,1065,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Spermatozoa,1066,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Yeast,1067,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
* Comment,1068,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
WBC CASTS,1069,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA Micro Fatty Casts,1070,CDM,300,RC,81003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HCG - Urine,1071,CDM,300,RC,81025,HCPCS,outpatient,,,80.43,60.32,,72.39,90,,,percent of total billed charges,90% of total billed charges,74.8,93,,,percent of total billed charges,93% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,68.37,85,,,percent of total billed charges,85% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,65.47,81.4,,,percent of total billed charges,81.4% of total billed charges,72.39,90,,,percent of total billed charges,90% of total billed charges,72.39,90,,,percent of total billed charges,90% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,60.32,75,,,percent of total billed charges,75% of total billed charges,68.37,85,,,percent of total billed charges,85% of total billed charges,30.56,74.8,
Clinic Pregnancy Test,1072,CDM,300,RC,81025,HCPCS,outpatient,,,80.43,60.32,,72.39,90,,,percent of total billed charges,90% of total billed charges,74.8,93,,,percent of total billed charges,93% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,68.37,85,,,percent of total billed charges,85% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,65.47,81.4,,,percent of total billed charges,81.4% of total billed charges,72.39,90,,,percent of total billed charges,90% of total billed charges,72.39,90,,,percent of total billed charges,90% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,60.32,75,,,percent of total billed charges,75% of total billed charges,68.37,85,,,percent of total billed charges,85% of total billed charges,30.56,74.8,
Urine Volume Measure - 24 hrs.,1073,CDM,300,RC,81050,HCPCS,outpatient,,,27.6,20.7,,24.84,90,,,percent of total billed charges,90% of total billed charges,25.67,93,,,percent of total billed charges,93% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,23.46,85,,,percent of total billed charges,85% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,22.47,81.4,,,percent of total billed charges,81.4% of total billed charges,24.84,90,,,percent of total billed charges,90% of total billed charges,24.84,90,,,percent of total billed charges,90% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,20.7,75,,,percent of total billed charges,75% of total billed charges,23.46,85,,,percent of total billed charges,85% of total billed charges,10.49,25.67,
"Profile - Urine, Total Volume",1074,CDM,300,RC,81050,HCPCS,outpatient,,,27.6,20.7,,24.84,90,,,percent of total billed charges,90% of total billed charges,25.67,93,,,percent of total billed charges,93% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,23.46,85,,,percent of total billed charges,85% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,22.47,81.4,,,percent of total billed charges,81.4% of total billed charges,24.84,90,,,percent of total billed charges,90% of total billed charges,24.84,90,,,percent of total billed charges,90% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,20.7,75,,,percent of total billed charges,75% of total billed charges,23.46,85,,,percent of total billed charges,85% of total billed charges,10.49,25.67,
(RES) TOTAL VOLUME-Urine 24hr.,1075,CDM,300,RC,81050,HCPCS,outpatient,,,27.6,20.7,,24.84,90,,,percent of total billed charges,90% of total billed charges,25.67,93,,,percent of total billed charges,93% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,23.46,85,,,percent of total billed charges,85% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,22.47,81.4,,,percent of total billed charges,81.4% of total billed charges,24.84,90,,,percent of total billed charges,90% of total billed charges,24.84,90,,,percent of total billed charges,90% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,10.49,38,,,percent of total billed charges,38% of total billed charges,20.7,75,,,percent of total billed charges,75% of total billed charges,23.46,85,,,percent of total billed charges,85% of total billed charges,10.49,25.67,
"BRCAvantage, Comp.",1076,CDM,300,RC,81162,HCPCS,outpatient,,,2936.86,2202.65,,2643.17,90,,,percent of total billed charges,90% of total billed charges,2731.28,93,,,percent of total billed charges,93% of total billed charges,1116.01,38,,,percent of total billed charges,38% of total billed charges,1116.01,38,,,percent of total billed charges,38% of total billed charges,2496.33,85,,,percent of total billed charges,85% of total billed charges,1116.01,38,,,percent of total billed charges,38% of total billed charges,2390.6,81.4,,,percent of total billed charges,81.4% of total billed charges,2643.17,90,,,percent of total billed charges,90% of total billed charges,2643.17,90,,,percent of total billed charges,90% of total billed charges,1116.01,38,,,percent of total billed charges,38% of total billed charges,1116.01,38,,,percent of total billed charges,38% of total billed charges,1116.01,38,,,percent of total billed charges,38% of total billed charges,2202.65,75,,,percent of total billed charges,75% of total billed charges,2496.33,85,,,percent of total billed charges,85% of total billed charges,1116.01,2731.28,
BCR-ABL1 Gene Rearrengement,1077,CDM,300,RC,81206,HCPCS,outpatient,,,812.03,609.02,,730.83,90,,,percent of total billed charges,90% of total billed charges,755.19,93,,,percent of total billed charges,93% of total billed charges,308.57,38,,,percent of total billed charges,38% of total billed charges,308.57,38,,,percent of total billed charges,38% of total billed charges,690.23,85,,,percent of total billed charges,85% of total billed charges,308.57,38,,,percent of total billed charges,38% of total billed charges,660.99,81.4,,,percent of total billed charges,81.4% of total billed charges,730.83,90,,,percent of total billed charges,90% of total billed charges,730.83,90,,,percent of total billed charges,90% of total billed charges,308.57,38,,,percent of total billed charges,38% of total billed charges,308.57,38,,,percent of total billed charges,38% of total billed charges,308.57,38,,,percent of total billed charges,38% of total billed charges,609.02,75,,,percent of total billed charges,75% of total billed charges,690.23,85,,,percent of total billed charges,85% of total billed charges,308.57,755.19,
P210 BCR ABL1,1078,CDM,300,RC,81206,HCPCS,outpatient,,,175.67,131.75,,158.1,90,,,percent of total billed charges,90% of total billed charges,163.37,93,,,percent of total billed charges,93% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,149.32,85,,,percent of total billed charges,85% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,143,81.4,,,percent of total billed charges,81.4% of total billed charges,158.1,90,,,percent of total billed charges,90% of total billed charges,158.1,90,,,percent of total billed charges,90% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,131.75,75,,,percent of total billed charges,75% of total billed charges,149.32,85,,,percent of total billed charges,85% of total billed charges,66.75,163.37,
P190 BCR-ABL1,1079,CDM,300,RC,81207,HCPCS,outpatient,,,175.67,131.75,,158.1,90,,,percent of total billed charges,90% of total billed charges,163.37,93,,,percent of total billed charges,93% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,149.32,85,,,percent of total billed charges,85% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,143,81.4,,,percent of total billed charges,81.4% of total billed charges,158.1,90,,,percent of total billed charges,90% of total billed charges,158.1,90,,,percent of total billed charges,90% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,66.75,38,,,percent of total billed charges,38% of total billed charges,131.75,75,,,percent of total billed charges,75% of total billed charges,149.32,85,,,percent of total billed charges,85% of total billed charges,66.75,163.37,
(RES) CEBPA MUTATION,1080,CDM,300,RC,81218,HCPCS,outpatient,,,349.89,262.42,,314.9,90,,,percent of total billed charges,90% of total billed charges,325.4,93,,,percent of total billed charges,93% of total billed charges,132.96,38,,,percent of total billed charges,38% of total billed charges,132.96,38,,,percent of total billed charges,38% of total billed charges,297.41,85,,,percent of total billed charges,85% of total billed charges,132.96,38,,,percent of total billed charges,38% of total billed charges,284.81,81.4,,,percent of total billed charges,81.4% of total billed charges,314.9,90,,,percent of total billed charges,90% of total billed charges,314.9,90,,,percent of total billed charges,90% of total billed charges,132.96,38,,,percent of total billed charges,38% of total billed charges,132.96,38,,,percent of total billed charges,38% of total billed charges,132.96,38,,,percent of total billed charges,38% of total billed charges,262.42,75,,,percent of total billed charges,75% of total billed charges,297.41,85,,,percent of total billed charges,85% of total billed charges,132.96,325.4,
Calreticulin (CALR) Mutation Analysis,1081,CDM,300,RC,81219,HCPCS,outpatient,,,371.42,278.57,,334.28,90,,,percent of total billed charges,90% of total billed charges,345.42,93,,,percent of total billed charges,93% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,315.71,85,,,percent of total billed charges,85% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,302.34,81.4,,,percent of total billed charges,81.4% of total billed charges,334.28,90,,,percent of total billed charges,90% of total billed charges,334.28,90,,,percent of total billed charges,90% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,141.14,38,,,percent of total billed charges,38% of total billed charges,278.57,75,,,percent of total billed charges,75% of total billed charges,315.71,85,,,percent of total billed charges,85% of total billed charges,141.14,345.42,
Cystic Fib D1152H mutation,1082,CDM,300,RC,81221,HCPCS,outpatient,,,271.41,203.56,,244.27,90,,,percent of total billed charges,90% of total billed charges,252.41,93,,,percent of total billed charges,93% of total billed charges,103.14,38,,,percent of total billed charges,38% of total billed charges,103.14,38,,,percent of total billed charges,38% of total billed charges,230.7,85,,,percent of total billed charges,85% of total billed charges,103.14,38,,,percent of total billed charges,38% of total billed charges,220.93,81.4,,,percent of total billed charges,81.4% of total billed charges,244.27,90,,,percent of total billed charges,90% of total billed charges,244.27,90,,,percent of total billed charges,90% of total billed charges,103.14,38,,,percent of total billed charges,38% of total billed charges,103.14,38,,,percent of total billed charges,38% of total billed charges,103.14,38,,,percent of total billed charges,38% of total billed charges,203.56,75,,,percent of total billed charges,75% of total billed charges,230.7,85,,,percent of total billed charges,85% of total billed charges,103.14,252.41,
(RES) CYP2C19 Gene,1083,CDM,300,RC,81225,HCPCS,outpatient,,,78.63,58.97,,70.77,90,,,percent of total billed charges,90% of total billed charges,73.13,93,,,percent of total billed charges,93% of total billed charges,29.88,38,,,percent of total billed charges,38% of total billed charges,29.88,38,,,percent of total billed charges,38% of total billed charges,66.84,85,,,percent of total billed charges,85% of total billed charges,29.88,38,,,percent of total billed charges,38% of total billed charges,64,81.4,,,percent of total billed charges,81.4% of total billed charges,70.77,90,,,percent of total billed charges,90% of total billed charges,70.77,90,,,percent of total billed charges,90% of total billed charges,29.88,38,,,percent of total billed charges,38% of total billed charges,29.88,38,,,percent of total billed charges,38% of total billed charges,29.88,38,,,percent of total billed charges,38% of total billed charges,58.97,75,,,percent of total billed charges,75% of total billed charges,66.84,85,,,percent of total billed charges,85% of total billed charges,29.88,73.13,
(RES) CYP2D6 Gene,1084,CDM,300,RC,81226,HCPCS,outpatient,,,81.4,61.05,,73.26,90,,,percent of total billed charges,90% of total billed charges,75.7,93,,,percent of total billed charges,93% of total billed charges,30.93,38,,,percent of total billed charges,38% of total billed charges,30.93,38,,,percent of total billed charges,38% of total billed charges,69.19,85,,,percent of total billed charges,85% of total billed charges,30.93,38,,,percent of total billed charges,38% of total billed charges,66.26,81.4,,,percent of total billed charges,81.4% of total billed charges,73.26,90,,,percent of total billed charges,90% of total billed charges,73.26,90,,,percent of total billed charges,90% of total billed charges,30.93,38,,,percent of total billed charges,38% of total billed charges,30.93,38,,,percent of total billed charges,38% of total billed charges,30.93,38,,,percent of total billed charges,38% of total billed charges,61.05,75,,,percent of total billed charges,75% of total billed charges,69.19,85,,,percent of total billed charges,85% of total billed charges,30.93,75.7,
(RES) CYP2C9 Gene,1085,CDM,300,RC,81227,HCPCS,outpatient,,,82.75,62.06,,74.48,90,,,percent of total billed charges,90% of total billed charges,76.96,93,,,percent of total billed charges,93% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,70.34,85,,,percent of total billed charges,85% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,67.36,81.4,,,percent of total billed charges,81.4% of total billed charges,74.48,90,,,percent of total billed charges,90% of total billed charges,74.48,90,,,percent of total billed charges,90% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,62.06,75,,,percent of total billed charges,75% of total billed charges,70.34,85,,,percent of total billed charges,85% of total billed charges,31.45,76.96,
(RES) CYP3A4 Gene,1086,CDM,300,RC,81230,HCPCS,outpatient,,,64.78,48.59,,58.3,90,,,percent of total billed charges,90% of total billed charges,60.25,93,,,percent of total billed charges,93% of total billed charges,24.62,38,,,percent of total billed charges,38% of total billed charges,24.62,38,,,percent of total billed charges,38% of total billed charges,55.06,85,,,percent of total billed charges,85% of total billed charges,24.62,38,,,percent of total billed charges,38% of total billed charges,52.73,81.4,,,percent of total billed charges,81.4% of total billed charges,58.3,90,,,percent of total billed charges,90% of total billed charges,58.3,90,,,percent of total billed charges,90% of total billed charges,24.62,38,,,percent of total billed charges,38% of total billed charges,24.62,38,,,percent of total billed charges,38% of total billed charges,24.62,38,,,percent of total billed charges,38% of total billed charges,48.59,75,,,percent of total billed charges,75% of total billed charges,55.06,85,,,percent of total billed charges,85% of total billed charges,24.62,60.25,
(RES) CYP3A5 Gene,1087,CDM,300,RC,81231,HCPCS,outpatient,,,78.09,58.57,,70.28,90,,,percent of total billed charges,90% of total billed charges,72.62,93,,,percent of total billed charges,93% of total billed charges,29.67,38,,,percent of total billed charges,38% of total billed charges,29.67,38,,,percent of total billed charges,38% of total billed charges,66.38,85,,,percent of total billed charges,85% of total billed charges,29.67,38,,,percent of total billed charges,38% of total billed charges,63.57,81.4,,,percent of total billed charges,81.4% of total billed charges,70.28,90,,,percent of total billed charges,90% of total billed charges,70.28,90,,,percent of total billed charges,90% of total billed charges,29.67,38,,,percent of total billed charges,38% of total billed charges,29.67,38,,,percent of total billed charges,38% of total billed charges,29.67,38,,,percent of total billed charges,38% of total billed charges,58.57,75,,,percent of total billed charges,75% of total billed charges,66.38,85,,,percent of total billed charges,85% of total billed charges,29.67,72.62,
(RES) DPYD Gene,1088,CDM,300,RC,81232,HCPCS,outpatient,,,81.61,61.21,,73.45,90,,,percent of total billed charges,90% of total billed charges,75.9,93,,,percent of total billed charges,93% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,69.37,85,,,percent of total billed charges,85% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,66.43,81.4,,,percent of total billed charges,81.4% of total billed charges,73.45,90,,,percent of total billed charges,90% of total billed charges,73.45,90,,,percent of total billed charges,90% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,61.21,75,,,percent of total billed charges,75% of total billed charges,69.37,85,,,percent of total billed charges,85% of total billed charges,31.01,75.9,
(RES) Prothrombin (Factor II) 20210G Mut.,1089,CDM,300,RC,81240,HCPCS,outpatient,,,270.61,202.96,,243.55,90,,,percent of total billed charges,90% of total billed charges,251.67,93,,,percent of total billed charges,93% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,220.28,81.4,,,percent of total billed charges,81.4% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,202.96,75,,,percent of total billed charges,75% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,251.67,
PROTHROMBIN MUTATION 20210G - A,1090,CDM,300,RC,81240,HCPCS,outpatient,,,234.01,175.51,,210.61,90,,,percent of total billed charges,90% of total billed charges,217.63,93,,,percent of total billed charges,93% of total billed charges,88.92,38,,,percent of total billed charges,38% of total billed charges,88.92,38,,,percent of total billed charges,38% of total billed charges,198.91,85,,,percent of total billed charges,85% of total billed charges,88.92,38,,,percent of total billed charges,38% of total billed charges,190.48,81.4,,,percent of total billed charges,81.4% of total billed charges,210.61,90,,,percent of total billed charges,90% of total billed charges,210.61,90,,,percent of total billed charges,90% of total billed charges,88.92,38,,,percent of total billed charges,38% of total billed charges,88.92,38,,,percent of total billed charges,38% of total billed charges,88.92,38,,,percent of total billed charges,38% of total billed charges,175.51,75,,,percent of total billed charges,75% of total billed charges,198.91,85,,,percent of total billed charges,85% of total billed charges,88.92,217.63,
Factor V Leiden,1091,CDM,300,RC,81241,HCPCS,outpatient,,,437.56,328.17,,393.8,90,,,percent of total billed charges,90% of total billed charges,406.93,93,,,percent of total billed charges,93% of total billed charges,166.27,38,,,percent of total billed charges,38% of total billed charges,166.27,38,,,percent of total billed charges,38% of total billed charges,371.93,85,,,percent of total billed charges,85% of total billed charges,166.27,38,,,percent of total billed charges,38% of total billed charges,356.17,81.4,,,percent of total billed charges,81.4% of total billed charges,393.8,90,,,percent of total billed charges,90% of total billed charges,393.8,90,,,percent of total billed charges,90% of total billed charges,166.27,38,,,percent of total billed charges,38% of total billed charges,166.27,38,,,percent of total billed charges,38% of total billed charges,166.27,38,,,percent of total billed charges,38% of total billed charges,328.17,75,,,percent of total billed charges,75% of total billed charges,371.93,85,,,percent of total billed charges,85% of total billed charges,166.27,406.93,
(RES) FLT3 ITD,1092,CDM,300,RC,81245,HCPCS,outpatient,,,369.34,277.01,,332.41,90,,,percent of total billed charges,90% of total billed charges,343.49,93,,,percent of total billed charges,93% of total billed charges,140.35,38,,,percent of total billed charges,38% of total billed charges,140.35,38,,,percent of total billed charges,38% of total billed charges,313.94,85,,,percent of total billed charges,85% of total billed charges,140.35,38,,,percent of total billed charges,38% of total billed charges,300.64,81.4,,,percent of total billed charges,81.4% of total billed charges,332.41,90,,,percent of total billed charges,90% of total billed charges,332.41,90,,,percent of total billed charges,90% of total billed charges,140.35,38,,,percent of total billed charges,38% of total billed charges,140.35,38,,,percent of total billed charges,38% of total billed charges,140.35,38,,,percent of total billed charges,38% of total billed charges,277.01,75,,,percent of total billed charges,75% of total billed charges,313.94,85,,,percent of total billed charges,85% of total billed charges,140.35,343.49,
(RES) FLT3 TKD,1093,CDM,300,RC,81246,HCPCS,outpatient,,,344.72,258.54,,310.25,90,,,percent of total billed charges,90% of total billed charges,320.59,93,,,percent of total billed charges,93% of total billed charges,130.99,38,,,percent of total billed charges,38% of total billed charges,130.99,38,,,percent of total billed charges,38% of total billed charges,293.01,85,,,percent of total billed charges,85% of total billed charges,130.99,38,,,percent of total billed charges,38% of total billed charges,280.6,81.4,,,percent of total billed charges,81.4% of total billed charges,310.25,90,,,percent of total billed charges,90% of total billed charges,310.25,90,,,percent of total billed charges,90% of total billed charges,130.99,38,,,percent of total billed charges,38% of total billed charges,130.99,38,,,percent of total billed charges,38% of total billed charges,130.99,38,,,percent of total billed charges,38% of total billed charges,258.54,75,,,percent of total billed charges,75% of total billed charges,293.01,85,,,percent of total billed charges,85% of total billed charges,130.99,320.59,
(RES) G6PD Gene,1094,CDM,300,RC,81247,HCPCS,outpatient,,,76.11,57.08,,68.5,90,,,percent of total billed charges,90% of total billed charges,70.78,93,,,percent of total billed charges,93% of total billed charges,28.92,38,,,percent of total billed charges,38% of total billed charges,28.92,38,,,percent of total billed charges,38% of total billed charges,64.69,85,,,percent of total billed charges,85% of total billed charges,28.92,38,,,percent of total billed charges,38% of total billed charges,61.95,81.4,,,percent of total billed charges,81.4% of total billed charges,68.5,90,,,percent of total billed charges,90% of total billed charges,68.5,90,,,percent of total billed charges,90% of total billed charges,28.92,38,,,percent of total billed charges,38% of total billed charges,28.92,38,,,percent of total billed charges,38% of total billed charges,28.92,38,,,percent of total billed charges,38% of total billed charges,57.08,75,,,percent of total billed charges,75% of total billed charges,64.69,85,,,percent of total billed charges,85% of total billed charges,28.92,70.78,
Hereditary Hemochromatosis,1095,CDM,300,RC,81256,HCPCS,outpatient,,,568.3,426.23,,511.47,90,,,percent of total billed charges,90% of total billed charges,528.52,93,,,percent of total billed charges,93% of total billed charges,215.95,38,,,percent of total billed charges,38% of total billed charges,215.95,38,,,percent of total billed charges,38% of total billed charges,483.06,85,,,percent of total billed charges,85% of total billed charges,215.95,38,,,percent of total billed charges,38% of total billed charges,462.6,81.4,,,percent of total billed charges,81.4% of total billed charges,511.47,90,,,percent of total billed charges,90% of total billed charges,511.47,90,,,percent of total billed charges,90% of total billed charges,215.95,38,,,percent of total billed charges,38% of total billed charges,215.95,38,,,percent of total billed charges,38% of total billed charges,215.95,38,,,percent of total billed charges,38% of total billed charges,426.23,75,,,percent of total billed charges,75% of total billed charges,483.06,85,,,percent of total billed charges,85% of total billed charges,215.95,528.52,
Alpha Globulin mutation,1096,CDM,300,RC,81257,HCPCS,outpatient,,,714.79,536.09,,643.31,90,,,percent of total billed charges,90% of total billed charges,664.75,93,,,percent of total billed charges,93% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,607.57,85,,,percent of total billed charges,85% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,581.84,81.4,,,percent of total billed charges,81.4% of total billed charges,643.31,90,,,percent of total billed charges,90% of total billed charges,643.31,90,,,percent of total billed charges,90% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,536.09,75,,,percent of total billed charges,75% of total billed charges,607.57,85,,,percent of total billed charges,85% of total billed charges,271.62,664.75,
"Chronic Lymphocytic Leukemia, IgVH Mutation Status, Cell Based",1097,CDM,300,RC,81263,HCPCS,outpatient,,,648.59,486.44,,583.73,90,,,percent of total billed charges,90% of total billed charges,603.19,93,,,percent of total billed charges,93% of total billed charges,246.46,38,,,percent of total billed charges,38% of total billed charges,246.46,38,,,percent of total billed charges,38% of total billed charges,551.3,85,,,percent of total billed charges,85% of total billed charges,246.46,38,,,percent of total billed charges,38% of total billed charges,527.95,81.4,,,percent of total billed charges,81.4% of total billed charges,583.73,90,,,percent of total billed charges,90% of total billed charges,583.73,90,,,percent of total billed charges,90% of total billed charges,246.46,38,,,percent of total billed charges,38% of total billed charges,246.46,38,,,percent of total billed charges,38% of total billed charges,246.46,38,,,percent of total billed charges,38% of total billed charges,486.44,75,,,percent of total billed charges,75% of total billed charges,551.3,85,,,percent of total billed charges,85% of total billed charges,246.46,603.19,
JAK2 V617F Mutation Analysis,1098,CDM,300,RC,81270,HCPCS,outpatient,,,750.64,562.98,,675.58,90,,,percent of total billed charges,90% of total billed charges,698.1,93,,,percent of total billed charges,93% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,638.04,85,,,percent of total billed charges,85% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,611.02,81.4,,,percent of total billed charges,81.4% of total billed charges,675.58,90,,,percent of total billed charges,90% of total billed charges,675.58,90,,,percent of total billed charges,90% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,562.98,75,,,percent of total billed charges,75% of total billed charges,638.04,85,,,percent of total billed charges,85% of total billed charges,285.24,698.1,
Huntington Disease Mutation analysis,1099,CDM,300,RC,81271,HCPCS,outpatient,,,526.72,395.04,,474.05,90,,,percent of total billed charges,90% of total billed charges,489.85,93,,,percent of total billed charges,93% of total billed charges,200.15,38,,,percent of total billed charges,38% of total billed charges,200.15,38,,,percent of total billed charges,38% of total billed charges,447.71,85,,,percent of total billed charges,85% of total billed charges,200.15,38,,,percent of total billed charges,38% of total billed charges,428.75,81.4,,,percent of total billed charges,81.4% of total billed charges,474.05,90,,,percent of total billed charges,90% of total billed charges,474.05,90,,,percent of total billed charges,90% of total billed charges,200.15,38,,,percent of total billed charges,38% of total billed charges,200.15,38,,,percent of total billed charges,38% of total billed charges,200.15,38,,,percent of total billed charges,38% of total billed charges,395.04,75,,,percent of total billed charges,75% of total billed charges,447.71,85,,,percent of total billed charges,85% of total billed charges,200.15,489.85,
(RES) IFNL3 Gene,1100,CDM,300,RC,81283,HCPCS,outpatient,,,60.51,45.38,,54.46,90,,,percent of total billed charges,90% of total billed charges,56.27,93,,,percent of total billed charges,93% of total billed charges,22.99,38,,,percent of total billed charges,38% of total billed charges,22.99,38,,,percent of total billed charges,38% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,22.99,38,,,percent of total billed charges,38% of total billed charges,49.26,81.4,,,percent of total billed charges,81.4% of total billed charges,54.46,90,,,percent of total billed charges,90% of total billed charges,54.46,90,,,percent of total billed charges,90% of total billed charges,22.99,38,,,percent of total billed charges,38% of total billed charges,22.99,38,,,percent of total billed charges,38% of total billed charges,22.99,38,,,percent of total billed charges,38% of total billed charges,45.38,75,,,percent of total billed charges,75% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,22.99,56.27,
MTHFR DNA Mutation Analysis,1101,CDM,300,RC,81291,HCPCS,outpatient,,,582.38,436.79,,524.14,90,,,percent of total billed charges,90% of total billed charges,541.61,93,,,percent of total billed charges,93% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,495.02,85,,,percent of total billed charges,85% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,474.06,81.4,,,percent of total billed charges,81.4% of total billed charges,524.14,90,,,percent of total billed charges,90% of total billed charges,524.14,90,,,percent of total billed charges,90% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,436.79,75,,,percent of total billed charges,75% of total billed charges,495.02,85,,,percent of total billed charges,85% of total billed charges,221.3,541.61,
MTHFR Reductase,1102,CDM,300,RC,81291,HCPCS,outpatient,,,392.89,294.67,,353.6,90,,,percent of total billed charges,90% of total billed charges,365.39,93,,,percent of total billed charges,93% of total billed charges,149.3,38,,,percent of total billed charges,38% of total billed charges,149.3,38,,,percent of total billed charges,38% of total billed charges,333.96,85,,,percent of total billed charges,85% of total billed charges,149.3,38,,,percent of total billed charges,38% of total billed charges,319.81,81.4,,,percent of total billed charges,81.4% of total billed charges,353.6,90,,,percent of total billed charges,90% of total billed charges,353.6,90,,,percent of total billed charges,90% of total billed charges,149.3,38,,,percent of total billed charges,38% of total billed charges,149.3,38,,,percent of total billed charges,38% of total billed charges,149.3,38,,,percent of total billed charges,38% of total billed charges,294.67,75,,,percent of total billed charges,75% of total billed charges,333.96,85,,,percent of total billed charges,85% of total billed charges,149.3,365.39,
(RES) MTHFR Gene,1103,CDM,300,RC,81291,HCPCS,outpatient,,,81.63,61.22,,73.47,90,,,percent of total billed charges,90% of total billed charges,75.92,93,,,percent of total billed charges,93% of total billed charges,31.02,38,,,percent of total billed charges,38% of total billed charges,31.02,38,,,percent of total billed charges,38% of total billed charges,69.39,85,,,percent of total billed charges,85% of total billed charges,31.02,38,,,percent of total billed charges,38% of total billed charges,66.45,81.4,,,percent of total billed charges,81.4% of total billed charges,73.47,90,,,percent of total billed charges,90% of total billed charges,73.47,90,,,percent of total billed charges,90% of total billed charges,31.02,38,,,percent of total billed charges,38% of total billed charges,31.02,38,,,percent of total billed charges,38% of total billed charges,31.02,38,,,percent of total billed charges,38% of total billed charges,61.22,75,,,percent of total billed charges,75% of total billed charges,69.39,85,,,percent of total billed charges,85% of total billed charges,31.02,75.92,
"(RES) NPM (EXON 12) MUTATION ANALYSIS, CELL BASED",1104,CDM,300,RC,81310,HCPCS,outpatient,,,350.09,262.57,,315.08,90,,,percent of total billed charges,90% of total billed charges,325.58,93,,,percent of total billed charges,93% of total billed charges,133.03,38,,,percent of total billed charges,38% of total billed charges,133.03,38,,,percent of total billed charges,38% of total billed charges,297.58,85,,,percent of total billed charges,85% of total billed charges,133.03,38,,,percent of total billed charges,38% of total billed charges,284.97,81.4,,,percent of total billed charges,81.4% of total billed charges,315.08,90,,,percent of total billed charges,90% of total billed charges,315.08,90,,,percent of total billed charges,90% of total billed charges,133.03,38,,,percent of total billed charges,38% of total billed charges,133.03,38,,,percent of total billed charges,38% of total billed charges,133.03,38,,,percent of total billed charges,38% of total billed charges,262.57,75,,,percent of total billed charges,75% of total billed charges,297.58,85,,,percent of total billed charges,85% of total billed charges,133.03,325.58,
(RES) SLCO1B1 Gene,1105,CDM,300,RC,81328,HCPCS,outpatient,,,68.21,51.16,,61.39,90,,,percent of total billed charges,90% of total billed charges,63.44,93,,,percent of total billed charges,93% of total billed charges,25.92,38,,,percent of total billed charges,38% of total billed charges,25.92,38,,,percent of total billed charges,38% of total billed charges,57.98,85,,,percent of total billed charges,85% of total billed charges,25.92,38,,,percent of total billed charges,38% of total billed charges,55.52,81.4,,,percent of total billed charges,81.4% of total billed charges,61.39,90,,,percent of total billed charges,90% of total billed charges,61.39,90,,,percent of total billed charges,90% of total billed charges,25.92,38,,,percent of total billed charges,38% of total billed charges,25.92,38,,,percent of total billed charges,38% of total billed charges,25.92,38,,,percent of total billed charges,38% of total billed charges,51.16,75,,,percent of total billed charges,75% of total billed charges,57.98,85,,,percent of total billed charges,85% of total billed charges,25.92,63.44,
Spinal Muscular Atrophy Carrier Screen,1106,CDM,300,RC,81329,HCPCS,outpatient,,,515,386.25,,463.5,90,,,percent of total billed charges,90% of total billed charges,478.95,93,,,percent of total billed charges,93% of total billed charges,195.7,38,,,percent of total billed charges,38% of total billed charges,195.7,38,,,percent of total billed charges,38% of total billed charges,437.75,85,,,percent of total billed charges,85% of total billed charges,195.7,38,,,percent of total billed charges,38% of total billed charges,419.21,81.4,,,percent of total billed charges,81.4% of total billed charges,463.5,90,,,percent of total billed charges,90% of total billed charges,463.5,90,,,percent of total billed charges,90% of total billed charges,195.7,38,,,percent of total billed charges,38% of total billed charges,195.7,38,,,percent of total billed charges,38% of total billed charges,195.7,38,,,percent of total billed charges,38% of total billed charges,386.25,75,,,percent of total billed charges,75% of total billed charges,437.75,85,,,percent of total billed charges,85% of total billed charges,195.7,478.95,
Alpha-1 Antitrypsin (AAT) Mutation Analysis,1107,CDM,300,RC,81332,HCPCS,outpatient,,,396.74,297.56,,357.07,90,,,percent of total billed charges,90% of total billed charges,368.97,93,,,percent of total billed charges,93% of total billed charges,150.76,38,,,percent of total billed charges,38% of total billed charges,150.76,38,,,percent of total billed charges,38% of total billed charges,337.23,85,,,percent of total billed charges,85% of total billed charges,150.76,38,,,percent of total billed charges,38% of total billed charges,322.95,81.4,,,percent of total billed charges,81.4% of total billed charges,357.07,90,,,percent of total billed charges,90% of total billed charges,357.07,90,,,percent of total billed charges,90% of total billed charges,150.76,38,,,percent of total billed charges,38% of total billed charges,150.76,38,,,percent of total billed charges,38% of total billed charges,150.76,38,,,percent of total billed charges,38% of total billed charges,297.56,75,,,percent of total billed charges,75% of total billed charges,337.23,85,,,percent of total billed charges,85% of total billed charges,150.76,368.97,
(RES) A-1 ANTITRYPSIN MUTATION ANALYSIS,1108,CDM,300,RC,81332,HCPCS,outpatient,,,416.16,312.12,,374.54,90,,,percent of total billed charges,90% of total billed charges,387.03,93,,,percent of total billed charges,93% of total billed charges,158.14,38,,,percent of total billed charges,38% of total billed charges,158.14,38,,,percent of total billed charges,38% of total billed charges,353.74,85,,,percent of total billed charges,85% of total billed charges,158.14,38,,,percent of total billed charges,38% of total billed charges,338.75,81.4,,,percent of total billed charges,81.4% of total billed charges,374.54,90,,,percent of total billed charges,90% of total billed charges,374.54,90,,,percent of total billed charges,90% of total billed charges,158.14,38,,,percent of total billed charges,38% of total billed charges,158.14,38,,,percent of total billed charges,38% of total billed charges,158.14,38,,,percent of total billed charges,38% of total billed charges,312.12,75,,,percent of total billed charges,75% of total billed charges,353.74,85,,,percent of total billed charges,85% of total billed charges,158.14,387.03,
Thiopurine S-Methyltransferase (TPMT) Genotype,1109,CDM,300,RC,81335,HCPCS,outpatient,,,609.42,457.07,,548.48,90,,,percent of total billed charges,90% of total billed charges,566.76,93,,,percent of total billed charges,93% of total billed charges,231.58,38,,,percent of total billed charges,38% of total billed charges,231.58,38,,,percent of total billed charges,38% of total billed charges,518.01,85,,,percent of total billed charges,85% of total billed charges,231.58,38,,,percent of total billed charges,38% of total billed charges,496.07,81.4,,,percent of total billed charges,81.4% of total billed charges,548.48,90,,,percent of total billed charges,90% of total billed charges,548.48,90,,,percent of total billed charges,90% of total billed charges,231.58,38,,,percent of total billed charges,38% of total billed charges,231.58,38,,,percent of total billed charges,38% of total billed charges,231.58,38,,,percent of total billed charges,38% of total billed charges,457.07,75,,,percent of total billed charges,75% of total billed charges,518.01,85,,,percent of total billed charges,85% of total billed charges,231.58,566.76,
(RES) TPMT Gene,1110,CDM,300,RC,81335,HCPCS,outpatient,,,85.74,64.31,,77.17,90,,,percent of total billed charges,90% of total billed charges,79.74,93,,,percent of total billed charges,93% of total billed charges,32.58,38,,,percent of total billed charges,38% of total billed charges,32.58,38,,,percent of total billed charges,38% of total billed charges,72.88,85,,,percent of total billed charges,85% of total billed charges,32.58,38,,,percent of total billed charges,38% of total billed charges,69.79,81.4,,,percent of total billed charges,81.4% of total billed charges,77.17,90,,,percent of total billed charges,90% of total billed charges,77.17,90,,,percent of total billed charges,90% of total billed charges,32.58,38,,,percent of total billed charges,38% of total billed charges,32.58,38,,,percent of total billed charges,38% of total billed charges,32.58,38,,,percent of total billed charges,38% of total billed charges,64.31,75,,,percent of total billed charges,75% of total billed charges,72.88,85,,,percent of total billed charges,85% of total billed charges,32.58,79.74,
(RES) UGT1A1 Gene,1111,CDM,300,RC,81350,HCPCS,outpatient,,,50.61,37.96,,45.55,90,,,percent of total billed charges,90% of total billed charges,47.07,93,,,percent of total billed charges,93% of total billed charges,19.23,38,,,percent of total billed charges,38% of total billed charges,19.23,38,,,percent of total billed charges,38% of total billed charges,43.02,85,,,percent of total billed charges,85% of total billed charges,19.23,38,,,percent of total billed charges,38% of total billed charges,41.2,81.4,,,percent of total billed charges,81.4% of total billed charges,45.55,90,,,percent of total billed charges,90% of total billed charges,45.55,90,,,percent of total billed charges,90% of total billed charges,19.23,38,,,percent of total billed charges,38% of total billed charges,19.23,38,,,percent of total billed charges,38% of total billed charges,19.23,38,,,percent of total billed charges,38% of total billed charges,37.96,75,,,percent of total billed charges,75% of total billed charges,43.02,85,,,percent of total billed charges,85% of total billed charges,19.23,47.07,
(RES) VKORC1 Gene,1112,CDM,300,RC,81355,HCPCS,outpatient,,,68.36,51.27,,61.52,90,,,percent of total billed charges,90% of total billed charges,63.57,93,,,percent of total billed charges,93% of total billed charges,25.98,38,,,percent of total billed charges,38% of total billed charges,25.98,38,,,percent of total billed charges,38% of total billed charges,58.11,85,,,percent of total billed charges,85% of total billed charges,25.98,38,,,percent of total billed charges,38% of total billed charges,55.65,81.4,,,percent of total billed charges,81.4% of total billed charges,61.52,90,,,percent of total billed charges,90% of total billed charges,61.52,90,,,percent of total billed charges,90% of total billed charges,25.98,38,,,percent of total billed charges,38% of total billed charges,25.98,38,,,percent of total billed charges,38% of total billed charges,25.98,38,,,percent of total billed charges,38% of total billed charges,51.27,75,,,percent of total billed charges,75% of total billed charges,58.11,85,,,percent of total billed charges,85% of total billed charges,25.98,63.57,
HLA-B27 DNA typing,1113,CDM,300,RC,81374,HCPCS,outpatient,,,297.31,222.98,,267.58,90,,,percent of total billed charges,90% of total billed charges,276.5,93,,,percent of total billed charges,93% of total billed charges,112.98,38,,,percent of total billed charges,38% of total billed charges,112.98,38,,,percent of total billed charges,38% of total billed charges,252.71,85,,,percent of total billed charges,85% of total billed charges,112.98,38,,,percent of total billed charges,38% of total billed charges,242.01,81.4,,,percent of total billed charges,81.4% of total billed charges,267.58,90,,,percent of total billed charges,90% of total billed charges,267.58,90,,,percent of total billed charges,90% of total billed charges,112.98,38,,,percent of total billed charges,38% of total billed charges,112.98,38,,,percent of total billed charges,38% of total billed charges,112.98,38,,,percent of total billed charges,38% of total billed charges,222.98,75,,,percent of total billed charges,75% of total billed charges,252.71,85,,,percent of total billed charges,85% of total billed charges,112.98,276.5,
HLA A29 Birdshot Retinochoroidopathy,1114,CDM,300,RC,81374,HCPCS,outpatient,,,148.57,111.43,,133.71,90,,,percent of total billed charges,90% of total billed charges,138.17,93,,,percent of total billed charges,93% of total billed charges,56.46,38,,,percent of total billed charges,38% of total billed charges,56.46,38,,,percent of total billed charges,38% of total billed charges,126.28,85,,,percent of total billed charges,85% of total billed charges,56.46,38,,,percent of total billed charges,38% of total billed charges,120.94,81.4,,,percent of total billed charges,81.4% of total billed charges,133.71,90,,,percent of total billed charges,90% of total billed charges,133.71,90,,,percent of total billed charges,90% of total billed charges,56.46,38,,,percent of total billed charges,38% of total billed charges,56.46,38,,,percent of total billed charges,38% of total billed charges,56.46,38,,,percent of total billed charges,38% of total billed charges,111.43,75,,,percent of total billed charges,75% of total billed charges,126.28,85,,,percent of total billed charges,85% of total billed charges,56.46,138.17,
(RES) HLA-DQA1,1115,CDM,300,RC,81376,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,100.66,
(RES) HLA-DQB1,1116,CDM,300,RC,81376,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,100.66,
(RES) DQB1,1117,CDM,300,RC,81376,HCPCS,outpatient,,,205.48,154.11,,184.93,90,,,percent of total billed charges,90% of total billed charges,191.1,93,,,percent of total billed charges,93% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,174.66,85,,,percent of total billed charges,85% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,167.26,81.4,,,percent of total billed charges,81.4% of total billed charges,184.93,90,,,percent of total billed charges,90% of total billed charges,184.93,90,,,percent of total billed charges,90% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,154.11,75,,,percent of total billed charges,75% of total billed charges,174.66,85,,,percent of total billed charges,85% of total billed charges,78.08,191.1,
(RES) DRB1,1118,CDM,300,RC,81376,HCPCS,outpatient,,,205.48,154.11,,184.93,90,,,percent of total billed charges,90% of total billed charges,191.1,93,,,percent of total billed charges,93% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,174.66,85,,,percent of total billed charges,85% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,167.26,81.4,,,percent of total billed charges,81.4% of total billed charges,184.93,90,,,percent of total billed charges,90% of total billed charges,184.93,90,,,percent of total billed charges,90% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,78.08,38,,,percent of total billed charges,38% of total billed charges,154.11,75,,,percent of total billed charges,75% of total billed charges,174.66,85,,,percent of total billed charges,85% of total billed charges,78.08,191.1,
HLA-B-1502,1119,CDM,300,RC,81381,HCPCS,outpatient,,,585.89,439.42,,527.3,90,,,percent of total billed charges,90% of total billed charges,544.88,93,,,percent of total billed charges,93% of total billed charges,222.64,38,,,percent of total billed charges,38% of total billed charges,222.64,38,,,percent of total billed charges,38% of total billed charges,498.01,85,,,percent of total billed charges,85% of total billed charges,222.64,38,,,percent of total billed charges,38% of total billed charges,476.91,81.4,,,percent of total billed charges,81.4% of total billed charges,527.3,90,,,percent of total billed charges,90% of total billed charges,527.3,90,,,percent of total billed charges,90% of total billed charges,222.64,38,,,percent of total billed charges,38% of total billed charges,222.64,38,,,percent of total billed charges,38% of total billed charges,222.64,38,,,percent of total billed charges,38% of total billed charges,439.42,75,,,percent of total billed charges,75% of total billed charges,498.01,85,,,percent of total billed charges,85% of total billed charges,222.64,544.88,
(RES) HLA-A 31:01,1120,CDM,300,RC,81381,HCPCS,outpatient,,,57.62,43.22,,51.86,90,,,percent of total billed charges,90% of total billed charges,53.59,93,,,percent of total billed charges,93% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,48.98,85,,,percent of total billed charges,85% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,46.9,81.4,,,percent of total billed charges,81.4% of total billed charges,51.86,90,,,percent of total billed charges,90% of total billed charges,51.86,90,,,percent of total billed charges,90% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,43.22,75,,,percent of total billed charges,75% of total billed charges,48.98,85,,,percent of total billed charges,85% of total billed charges,21.9,53.59,
HLA-B*5701 Typing,1121,CDM,300,RC,81381,HCPCS,outpatient,,,592.17,444.13,,532.95,90,,,percent of total billed charges,90% of total billed charges,550.72,93,,,percent of total billed charges,93% of total billed charges,225.02,38,,,percent of total billed charges,38% of total billed charges,225.02,38,,,percent of total billed charges,38% of total billed charges,503.34,85,,,percent of total billed charges,85% of total billed charges,225.02,38,,,percent of total billed charges,38% of total billed charges,482.03,81.4,,,percent of total billed charges,81.4% of total billed charges,532.95,90,,,percent of total billed charges,90% of total billed charges,532.95,90,,,percent of total billed charges,90% of total billed charges,225.02,38,,,percent of total billed charges,38% of total billed charges,225.02,38,,,percent of total billed charges,38% of total billed charges,225.02,38,,,percent of total billed charges,38% of total billed charges,444.13,75,,,percent of total billed charges,75% of total billed charges,503.34,85,,,percent of total billed charges,85% of total billed charges,225.02,550.72,
(RES) HLA-B 15:02,1122,CDM,300,RC,81381,HCPCS,outpatient,,,57.62,43.22,,51.86,90,,,percent of total billed charges,90% of total billed charges,53.59,93,,,percent of total billed charges,93% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,48.98,85,,,percent of total billed charges,85% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,46.9,81.4,,,percent of total billed charges,81.4% of total billed charges,51.86,90,,,percent of total billed charges,90% of total billed charges,51.86,90,,,percent of total billed charges,90% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,43.22,75,,,percent of total billed charges,75% of total billed charges,48.98,85,,,percent of total billed charges,85% of total billed charges,21.9,53.59,
(RES) HLA-B 57:01,1123,CDM,300,RC,81381,HCPCS,outpatient,,,57.62,43.22,,51.86,90,,,percent of total billed charges,90% of total billed charges,53.59,93,,,percent of total billed charges,93% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,48.98,85,,,percent of total billed charges,85% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,46.9,81.4,,,percent of total billed charges,81.4% of total billed charges,51.86,90,,,percent of total billed charges,90% of total billed charges,51.86,90,,,percent of total billed charges,90% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,43.22,75,,,percent of total billed charges,75% of total billed charges,48.98,85,,,percent of total billed charges,85% of total billed charges,21.9,53.59,
(RES) HLA-B 58:01,1124,CDM,300,RC,81381,HCPCS,outpatient,,,57.62,43.22,,51.86,90,,,percent of total billed charges,90% of total billed charges,53.59,93,,,percent of total billed charges,93% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,48.98,85,,,percent of total billed charges,85% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,46.9,81.4,,,percent of total billed charges,81.4% of total billed charges,51.86,90,,,percent of total billed charges,90% of total billed charges,51.86,90,,,percent of total billed charges,90% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,21.9,38,,,percent of total billed charges,38% of total billed charges,43.22,75,,,percent of total billed charges,75% of total billed charges,48.98,85,,,percent of total billed charges,85% of total billed charges,21.9,53.59,
(RES) HLA-DQ2,1125,CDM,300,RC,81382,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,100.66,
19911A - G MUTATION ANALYSIS,1126,CDM,300,RC,81400,HCPCS,outpatient,,,438.1,328.58,,394.29,90,,,percent of total billed charges,90% of total billed charges,407.43,93,,,percent of total billed charges,93% of total billed charges,166.48,38,,,percent of total billed charges,38% of total billed charges,166.48,38,,,percent of total billed charges,38% of total billed charges,372.39,85,,,percent of total billed charges,85% of total billed charges,166.48,38,,,percent of total billed charges,38% of total billed charges,356.61,81.4,,,percent of total billed charges,81.4% of total billed charges,394.29,90,,,percent of total billed charges,90% of total billed charges,394.29,90,,,percent of total billed charges,90% of total billed charges,166.48,38,,,percent of total billed charges,38% of total billed charges,166.48,38,,,percent of total billed charges,38% of total billed charges,166.48,38,,,percent of total billed charges,38% of total billed charges,328.58,75,,,percent of total billed charges,75% of total billed charges,372.39,85,,,percent of total billed charges,85% of total billed charges,166.48,407.43,
(RES) GENE ANALYSIS,1127,CDM,300,RC,81400,HCPCS,outpatient,,,115.94,86.96,,104.35,90,,,percent of total billed charges,90% of total billed charges,107.82,93,,,percent of total billed charges,93% of total billed charges,44.06,38,,,percent of total billed charges,38% of total billed charges,44.06,38,,,percent of total billed charges,38% of total billed charges,98.55,85,,,percent of total billed charges,85% of total billed charges,44.06,38,,,percent of total billed charges,38% of total billed charges,94.38,81.4,,,percent of total billed charges,81.4% of total billed charges,104.35,90,,,percent of total billed charges,90% of total billed charges,104.35,90,,,percent of total billed charges,90% of total billed charges,44.06,38,,,percent of total billed charges,38% of total billed charges,44.06,38,,,percent of total billed charges,38% of total billed charges,44.06,38,,,percent of total billed charges,38% of total billed charges,86.96,75,,,percent of total billed charges,75% of total billed charges,98.55,85,,,percent of total billed charges,85% of total billed charges,44.06,107.82,
TPMT Thiopurine S-Methyltransferase,1128,CDM,300,RC,81401,HCPCS,outpatient,,,648,486,,583.2,90,,,percent of total billed charges,90% of total billed charges,602.64,93,,,percent of total billed charges,93% of total billed charges,246.24,38,,,percent of total billed charges,38% of total billed charges,246.24,38,,,percent of total billed charges,38% of total billed charges,550.8,85,,,percent of total billed charges,85% of total billed charges,246.24,38,,,percent of total billed charges,38% of total billed charges,527.47,81.4,,,percent of total billed charges,81.4% of total billed charges,583.2,90,,,percent of total billed charges,90% of total billed charges,583.2,90,,,percent of total billed charges,90% of total billed charges,246.24,38,,,percent of total billed charges,38% of total billed charges,246.24,38,,,percent of total billed charges,38% of total billed charges,246.24,38,,,percent of total billed charges,38% of total billed charges,486,75,,,percent of total billed charges,75% of total billed charges,550.8,85,,,percent of total billed charges,85% of total billed charges,246.24,602.64,
Cardio IQ APOE Genotype,1129,CDM,300,RC,81401,HCPCS,outpatient,,,417.66,313.25,,375.89,90,,,percent of total billed charges,90% of total billed charges,388.42,93,,,percent of total billed charges,93% of total billed charges,158.71,38,,,percent of total billed charges,38% of total billed charges,158.71,38,,,percent of total billed charges,38% of total billed charges,355.01,85,,,percent of total billed charges,85% of total billed charges,158.71,38,,,percent of total billed charges,38% of total billed charges,339.98,81.4,,,percent of total billed charges,81.4% of total billed charges,375.89,90,,,percent of total billed charges,90% of total billed charges,375.89,90,,,percent of total billed charges,90% of total billed charges,158.71,38,,,percent of total billed charges,38% of total billed charges,158.71,38,,,percent of total billed charges,38% of total billed charges,158.71,38,,,percent of total billed charges,38% of total billed charges,313.25,75,,,percent of total billed charges,75% of total billed charges,355.01,85,,,percent of total billed charges,85% of total billed charges,158.71,388.42,
JAK2 EXON 12 and 13,1130,CDM,300,RC,81403,HCPCS,outpatient,,,750.64,562.98,,675.58,90,,,percent of total billed charges,90% of total billed charges,698.1,93,,,percent of total billed charges,93% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,638.04,85,,,percent of total billed charges,85% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,611.02,81.4,,,percent of total billed charges,81.4% of total billed charges,675.58,90,,,percent of total billed charges,90% of total billed charges,675.58,90,,,percent of total billed charges,90% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,285.24,38,,,percent of total billed charges,38% of total billed charges,562.98,75,,,percent of total billed charges,75% of total billed charges,638.04,85,,,percent of total billed charges,85% of total billed charges,285.24,698.1,
MPL Mutation Analysis,1131,CDM,300,RC,81403,HCPCS,outpatient,,,270.61,202.96,,243.55,90,,,percent of total billed charges,90% of total billed charges,251.67,93,,,percent of total billed charges,93% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,220.28,81.4,,,percent of total billed charges,81.4% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,202.96,75,,,percent of total billed charges,75% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,251.67,
Beta-Globulin Complete,1132,CDM,300,RC,81404,HCPCS,outpatient,,,1067.49,800.62,,960.74,90,,,percent of total billed charges,90% of total billed charges,992.77,93,,,percent of total billed charges,93% of total billed charges,405.65,38,,,percent of total billed charges,38% of total billed charges,405.65,38,,,percent of total billed charges,38% of total billed charges,907.37,85,,,percent of total billed charges,85% of total billed charges,405.65,38,,,percent of total billed charges,38% of total billed charges,868.94,81.4,,,percent of total billed charges,81.4% of total billed charges,960.74,90,,,percent of total billed charges,90% of total billed charges,960.74,90,,,percent of total billed charges,90% of total billed charges,405.65,38,,,percent of total billed charges,38% of total billed charges,405.65,38,,,percent of total billed charges,38% of total billed charges,405.65,38,,,percent of total billed charges,38% of total billed charges,800.62,75,,,percent of total billed charges,75% of total billed charges,907.37,85,,,percent of total billed charges,85% of total billed charges,405.65,992.77,
Panel LDLR Gene test,1133,CDM,300,RC,81405,HCPCS,outpatient,,,680.12,510.09,,612.11,90,,,percent of total billed charges,90% of total billed charges,632.51,93,,,percent of total billed charges,93% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,553.62,81.4,,,percent of total billed charges,81.4% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,510.09,75,,,percent of total billed charges,75% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,632.51,
(RES) LDLR VARIANT(S)-FH Panel,1134,CDM,300,RC,81405,HCPCS,outpatient,,,520.2,390.15,,468.18,90,,,percent of total billed charges,90% of total billed charges,483.79,93,,,percent of total billed charges,93% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,423.44,81.4,,,percent of total billed charges,81.4% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,390.15,75,,,percent of total billed charges,75% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,483.79,
Panel PCSK9 gene 1,1135,CDM,300,RC,81406,HCPCS,outpatient,,,680.12,510.09,,612.11,90,,,percent of total billed charges,90% of total billed charges,632.51,93,,,percent of total billed charges,93% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,553.62,81.4,,,percent of total billed charges,81.4% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,510.09,75,,,percent of total billed charges,75% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,632.51,
Panel PCSK9 gene 2,1136,CDM,300,RC,81406,HCPCS,outpatient,,,680.12,510.09,,612.11,90,,,percent of total billed charges,90% of total billed charges,632.51,93,,,percent of total billed charges,93% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,553.62,81.4,,,percent of total billed charges,81.4% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,510.09,75,,,percent of total billed charges,75% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,632.51,
PCSK9 VARIANT GENE 2,1137,CDM,300,RC,81406,HCPCS,outpatient,,,680.12,510.09,,612.11,90,,,percent of total billed charges,90% of total billed charges,632.51,93,,,percent of total billed charges,93% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,553.62,81.4,,,percent of total billed charges,81.4% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,510.09,75,,,percent of total billed charges,75% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,632.51,
(RES) PCSK9 VARIANT GENE,1138,CDM,300,RC,81406,HCPCS,outpatient,,,520.2,390.15,,468.18,90,,,percent of total billed charges,90% of total billed charges,483.79,93,,,percent of total billed charges,93% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,423.44,81.4,,,percent of total billed charges,81.4% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,390.15,75,,,percent of total billed charges,75% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,483.79,
(RES) Molecular Pathology Level 7,1139,CDM,300,RC,81406,HCPCS,outpatient,,,520.2,390.15,,468.18,90,,,percent of total billed charges,90% of total billed charges,483.79,93,,,percent of total billed charges,93% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,423.44,81.4,,,percent of total billed charges,81.4% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,390.15,75,,,percent of total billed charges,75% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,483.79,
(RES) Molecular Path.-APOB,1140,CDM,300,RC,81407,HCPCS,outpatient,,,520.2,390.15,,468.18,90,,,percent of total billed charges,90% of total billed charges,483.79,93,,,percent of total billed charges,93% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,423.44,81.4,,,percent of total billed charges,81.4% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,390.15,75,,,percent of total billed charges,75% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,483.79,
APOB VARIANT(S)-FH Panel,1141,CDM,300,RC,81407,HCPCS,outpatient,,,520.2,390.15,,468.18,90,,,percent of total billed charges,90% of total billed charges,483.79,93,,,percent of total billed charges,93% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,423.44,81.4,,,percent of total billed charges,81.4% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,390.15,75,,,percent of total billed charges,75% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,483.79,
Panel APOB gene,1142,CDM,300,RC,81479,HCPCS,outpatient,,,680.12,510.09,,612.11,90,,,percent of total billed charges,90% of total billed charges,632.51,93,,,percent of total billed charges,93% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,553.62,81.4,,,percent of total billed charges,81.4% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,612.11,90,,,percent of total billed charges,90% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,258.45,38,,,percent of total billed charges,38% of total billed charges,510.09,75,,,percent of total billed charges,75% of total billed charges,578.1,85,,,percent of total billed charges,85% of total billed charges,258.45,632.51,
CHEK2 Sequencing and Deletion/Duplication,1143,CDM,300,RC,81479,HCPCS,outpatient,,,487.09,365.32,,438.38,90,,,percent of total billed charges,90% of total billed charges,452.99,93,,,percent of total billed charges,93% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,414.03,85,,,percent of total billed charges,85% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,396.49,81.4,,,percent of total billed charges,81.4% of total billed charges,438.38,90,,,percent of total billed charges,90% of total billed charges,438.38,90,,,percent of total billed charges,90% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,365.32,75,,,percent of total billed charges,75% of total billed charges,414.03,85,,,percent of total billed charges,85% of total billed charges,185.09,452.99,
(RES) Unlisted Molecular Pathology,1144,CDM,300,RC,81479,HCPCS,outpatient,,,520.2,390.15,,468.18,90,,,percent of total billed charges,90% of total billed charges,483.79,93,,,percent of total billed charges,93% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,423.44,81.4,,,percent of total billed charges,81.4% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,390.15,75,,,percent of total billed charges,75% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,483.79,
(RES) CYP2B6 Gene,1145,CDM,300,RC,81479,HCPCS,outpatient,,,88.49,66.37,,79.64,90,,,percent of total billed charges,90% of total billed charges,82.3,93,,,percent of total billed charges,93% of total billed charges,33.63,38,,,percent of total billed charges,38% of total billed charges,33.63,38,,,percent of total billed charges,38% of total billed charges,75.22,85,,,percent of total billed charges,85% of total billed charges,33.63,38,,,percent of total billed charges,38% of total billed charges,72.03,81.4,,,percent of total billed charges,81.4% of total billed charges,79.64,90,,,percent of total billed charges,90% of total billed charges,79.64,90,,,percent of total billed charges,90% of total billed charges,33.63,38,,,percent of total billed charges,38% of total billed charges,33.63,38,,,percent of total billed charges,38% of total billed charges,33.63,38,,,percent of total billed charges,38% of total billed charges,66.37,75,,,percent of total billed charges,75% of total billed charges,75.22,85,,,percent of total billed charges,85% of total billed charges,33.63,82.3,
Quad Screen,1146,CDM,300,RC,81511,HCPCS,outpatient,,,756.62,567.47,,680.96,90,,,percent of total billed charges,90% of total billed charges,703.66,93,,,percent of total billed charges,93% of total billed charges,287.52,38,,,percent of total billed charges,38% of total billed charges,287.52,38,,,percent of total billed charges,38% of total billed charges,643.13,85,,,percent of total billed charges,85% of total billed charges,287.52,38,,,percent of total billed charges,38% of total billed charges,615.89,81.4,,,percent of total billed charges,81.4% of total billed charges,680.96,90,,,percent of total billed charges,90% of total billed charges,680.96,90,,,percent of total billed charges,90% of total billed charges,287.52,38,,,percent of total billed charges,38% of total billed charges,287.52,38,,,percent of total billed charges,38% of total billed charges,287.52,38,,,percent of total billed charges,38% of total billed charges,567.47,75,,,percent of total billed charges,75% of total billed charges,643.13,85,,,percent of total billed charges,85% of total billed charges,287.52,703.66,
"(RES) SURESWAB(R) ADV BACTERIAL VAGINOSIS (BV), TMA",1147,CDM,300,RC,81513,HCPCS,outpatient,,,291.83,218.87,,262.65,90,,,percent of total billed charges,90% of total billed charges,271.4,93,,,percent of total billed charges,93% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,248.06,85,,,percent of total billed charges,85% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,237.55,81.4,,,percent of total billed charges,81.4% of total billed charges,262.65,90,,,percent of total billed charges,90% of total billed charges,262.65,90,,,percent of total billed charges,90% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,218.87,75,,,percent of total billed charges,75% of total billed charges,248.06,85,,,percent of total billed charges,85% of total billed charges,110.9,271.4,
Liver Fibrosis Panel,1148,CDM,300,RC,81596,HCPCS,outpatient,,,405.91,304.43,,365.32,90,,,percent of total billed charges,90% of total billed charges,377.5,93,,,percent of total billed charges,93% of total billed charges,154.25,38,,,percent of total billed charges,38% of total billed charges,154.25,38,,,percent of total billed charges,38% of total billed charges,345.02,85,,,percent of total billed charges,85% of total billed charges,154.25,38,,,percent of total billed charges,38% of total billed charges,330.41,81.4,,,percent of total billed charges,81.4% of total billed charges,365.32,90,,,percent of total billed charges,90% of total billed charges,365.32,90,,,percent of total billed charges,90% of total billed charges,154.25,38,,,percent of total billed charges,38% of total billed charges,154.25,38,,,percent of total billed charges,38% of total billed charges,154.25,38,,,percent of total billed charges,38% of total billed charges,304.43,75,,,percent of total billed charges,75% of total billed charges,345.02,85,,,percent of total billed charges,85% of total billed charges,154.25,377.5,
Serum Ketone,1149,CDM,300,RC,82009,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
Beta-hydroxybutyrate,1150,CDM,300,RC,82010,HCPCS,outpatient,,,109.08,81.81,,98.17,90,,,percent of total billed charges,90% of total billed charges,101.44,93,,,percent of total billed charges,93% of total billed charges,41.45,38,,,percent of total billed charges,38% of total billed charges,41.45,38,,,percent of total billed charges,38% of total billed charges,92.72,85,,,percent of total billed charges,85% of total billed charges,41.45,38,,,percent of total billed charges,38% of total billed charges,88.79,81.4,,,percent of total billed charges,81.4% of total billed charges,98.17,90,,,percent of total billed charges,90% of total billed charges,98.17,90,,,percent of total billed charges,90% of total billed charges,41.45,38,,,percent of total billed charges,38% of total billed charges,41.45,38,,,percent of total billed charges,38% of total billed charges,41.45,38,,,percent of total billed charges,38% of total billed charges,81.81,75,,,percent of total billed charges,75% of total billed charges,92.72,85,,,percent of total billed charges,85% of total billed charges,41.45,101.44,
"Acylcarnitine, Plasma",1151,CDM,300,RC,82017,HCPCS,outpatient,,,256.3,192.23,,230.67,90,,,percent of total billed charges,90% of total billed charges,238.36,93,,,percent of total billed charges,93% of total billed charges,97.39,38,,,percent of total billed charges,38% of total billed charges,97.39,38,,,percent of total billed charges,38% of total billed charges,217.86,85,,,percent of total billed charges,85% of total billed charges,97.39,38,,,percent of total billed charges,38% of total billed charges,208.63,81.4,,,percent of total billed charges,81.4% of total billed charges,230.67,90,,,percent of total billed charges,90% of total billed charges,230.67,90,,,percent of total billed charges,90% of total billed charges,97.39,38,,,percent of total billed charges,38% of total billed charges,97.39,38,,,percent of total billed charges,38% of total billed charges,97.39,38,,,percent of total billed charges,38% of total billed charges,192.23,75,,,percent of total billed charges,75% of total billed charges,217.86,85,,,percent of total billed charges,85% of total billed charges,97.39,238.36,
ACTH Plasma,1152,CDM,300,RC,82024,HCPCS,outpatient,,,325.76,244.32,,293.18,90,,,percent of total billed charges,90% of total billed charges,302.96,93,,,percent of total billed charges,93% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,276.9,85,,,percent of total billed charges,85% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,265.17,81.4,,,percent of total billed charges,81.4% of total billed charges,293.18,90,,,percent of total billed charges,90% of total billed charges,293.18,90,,,percent of total billed charges,90% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,244.32,75,,,percent of total billed charges,75% of total billed charges,276.9,85,,,percent of total billed charges,85% of total billed charges,123.79,302.96,
Albumin,1153,CDM,300,RC,82040,HCPCS,outpatient,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
"Albumin, Peritoneal Fluid",1154,CDM,300,RC,82042,HCPCS,outpatient,,,46.43,34.82,,41.79,90,,,percent of total billed charges,90% of total billed charges,43.18,93,,,percent of total billed charges,93% of total billed charges,17.64,38,,,percent of total billed charges,38% of total billed charges,17.64,38,,,percent of total billed charges,38% of total billed charges,39.47,85,,,percent of total billed charges,85% of total billed charges,17.64,38,,,percent of total billed charges,38% of total billed charges,37.79,81.4,,,percent of total billed charges,81.4% of total billed charges,41.79,90,,,percent of total billed charges,90% of total billed charges,41.79,90,,,percent of total billed charges,90% of total billed charges,17.64,38,,,percent of total billed charges,38% of total billed charges,17.64,38,,,percent of total billed charges,38% of total billed charges,17.64,38,,,percent of total billed charges,38% of total billed charges,34.82,75,,,percent of total billed charges,75% of total billed charges,39.47,85,,,percent of total billed charges,85% of total billed charges,17.64,43.18,
URINE SODIUM W/CREAT RAND,1155,CDM,300,RC,82043,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Albumin/Creat Ratio,1156,CDM,300,RC,82043,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MICROALBUMIN,1157,CDM,300,RC,82043,HCPCS,outpatient,,,78.4,58.8,,70.56,90,,,percent of total billed charges,90% of total billed charges,72.91,93,,,percent of total billed charges,93% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,66.64,85,,,percent of total billed charges,85% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,63.82,81.4,,,percent of total billed charges,81.4% of total billed charges,70.56,90,,,percent of total billed charges,90% of total billed charges,70.56,90,,,percent of total billed charges,90% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,58.8,75,,,percent of total billed charges,75% of total billed charges,66.64,85,,,percent of total billed charges,85% of total billed charges,29.79,72.91,
Microalbumin 24 hr w/o creat,1158,CDM,300,RC,82043,HCPCS,outpatient,,,81.57,61.18,,73.41,90,,,percent of total billed charges,90% of total billed charges,75.86,93,,,percent of total billed charges,93% of total billed charges,31,38,,,percent of total billed charges,38% of total billed charges,31,38,,,percent of total billed charges,38% of total billed charges,69.33,85,,,percent of total billed charges,85% of total billed charges,31,38,,,percent of total billed charges,38% of total billed charges,66.4,81.4,,,percent of total billed charges,81.4% of total billed charges,73.41,90,,,percent of total billed charges,90% of total billed charges,73.41,90,,,percent of total billed charges,90% of total billed charges,31,38,,,percent of total billed charges,38% of total billed charges,31,38,,,percent of total billed charges,38% of total billed charges,31,38,,,percent of total billed charges,38% of total billed charges,61.18,75,,,percent of total billed charges,75% of total billed charges,69.33,85,,,percent of total billed charges,85% of total billed charges,31,75.86,
"Albumin, Random Urine w/o Creatinine",1159,CDM,300,RC,82043,HCPCS,outpatient,,,81.18,60.89,,73.06,90,,,percent of total billed charges,90% of total billed charges,75.5,93,,,percent of total billed charges,93% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,69,85,,,percent of total billed charges,85% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,66.08,81.4,,,percent of total billed charges,81.4% of total billed charges,73.06,90,,,percent of total billed charges,90% of total billed charges,73.06,90,,,percent of total billed charges,90% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,60.89,75,,,percent of total billed charges,75% of total billed charges,69,85,,,percent of total billed charges,85% of total billed charges,30.85,75.5,
Aldolase,1160,CDM,300,RC,82085,HCPCS,outpatient,,,155.85,116.89,,140.27,90,,,percent of total billed charges,90% of total billed charges,144.94,93,,,percent of total billed charges,93% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,126.86,81.4,,,percent of total billed charges,81.4% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,116.89,75,,,percent of total billed charges,75% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,144.94,
Alsosterone,1161,CDM,300,RC,82088,HCPCS,outpatient,,,165.21,123.91,,148.69,90,,,percent of total billed charges,90% of total billed charges,153.65,93,,,percent of total billed charges,93% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,134.48,81.4,,,percent of total billed charges,81.4% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,123.91,75,,,percent of total billed charges,75% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,153.65,
Aldosterone LC/MS/MS,1162,CDM,300,RC,82088,HCPCS,outpatient,,,165.21,123.91,,148.69,90,,,percent of total billed charges,90% of total billed charges,153.65,93,,,percent of total billed charges,93% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,134.48,81.4,,,percent of total billed charges,81.4% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,123.91,75,,,percent of total billed charges,75% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,153.65,
"Aldosterone, 24 hr Urine",1163,CDM,300,RC,82088,HCPCS,outpatient,,,160.52,120.39,,144.47,90,,,percent of total billed charges,90% of total billed charges,149.28,93,,,percent of total billed charges,93% of total billed charges,61,38,,,percent of total billed charges,38% of total billed charges,61,38,,,percent of total billed charges,38% of total billed charges,136.44,85,,,percent of total billed charges,85% of total billed charges,61,38,,,percent of total billed charges,38% of total billed charges,130.66,81.4,,,percent of total billed charges,81.4% of total billed charges,144.47,90,,,percent of total billed charges,90% of total billed charges,144.47,90,,,percent of total billed charges,90% of total billed charges,61,38,,,percent of total billed charges,38% of total billed charges,61,38,,,percent of total billed charges,38% of total billed charges,61,38,,,percent of total billed charges,38% of total billed charges,120.39,75,,,percent of total billed charges,75% of total billed charges,136.44,85,,,percent of total billed charges,85% of total billed charges,61,149.28,
"Alpha-1 Antitrypsin, Quantitative",1164,CDM,300,RC,82103,HCPCS,outpatient,,,135.92,101.94,,122.33,90,,,percent of total billed charges,90% of total billed charges,126.41,93,,,percent of total billed charges,93% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,115.53,85,,,percent of total billed charges,85% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,110.64,81.4,,,percent of total billed charges,81.4% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,101.94,75,,,percent of total billed charges,75% of total billed charges,115.53,85,,,percent of total billed charges,85% of total billed charges,51.65,126.41,
"Alpha-1-Antitrypsin, Random Feces",1165,CDM,300,RC,82103,HCPCS,outpatient,,,99.48,74.61,,89.53,90,,,percent of total billed charges,90% of total billed charges,92.52,93,,,percent of total billed charges,93% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,84.56,85,,,percent of total billed charges,85% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,80.98,81.4,,,percent of total billed charges,81.4% of total billed charges,89.53,90,,,percent of total billed charges,90% of total billed charges,89.53,90,,,percent of total billed charges,90% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,74.61,75,,,percent of total billed charges,75% of total billed charges,84.56,85,,,percent of total billed charges,85% of total billed charges,37.8,92.52,
Alpha-1-Antitrypsin (AAT) pheno,1166,CDM,300,RC,82104,HCPCS,outpatient,,,189.9,142.43,,170.91,90,,,percent of total billed charges,90% of total billed charges,176.61,93,,,percent of total billed charges,93% of total billed charges,72.16,38,,,percent of total billed charges,38% of total billed charges,72.16,38,,,percent of total billed charges,38% of total billed charges,161.42,85,,,percent of total billed charges,85% of total billed charges,72.16,38,,,percent of total billed charges,38% of total billed charges,154.58,81.4,,,percent of total billed charges,81.4% of total billed charges,170.91,90,,,percent of total billed charges,90% of total billed charges,170.91,90,,,percent of total billed charges,90% of total billed charges,72.16,38,,,percent of total billed charges,38% of total billed charges,72.16,38,,,percent of total billed charges,38% of total billed charges,72.16,38,,,percent of total billed charges,38% of total billed charges,142.43,75,,,percent of total billed charges,75% of total billed charges,161.42,85,,,percent of total billed charges,85% of total billed charges,72.16,176.61,
Alpha Fetoprotein (AFP),1167,CDM,300,RC,82105,HCPCS,outpatient,,,147.63,110.72,,132.87,90,,,percent of total billed charges,90% of total billed charges,137.3,93,,,percent of total billed charges,93% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,125.49,85,,,percent of total billed charges,85% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,120.17,81.4,,,percent of total billed charges,81.4% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,110.72,75,,,percent of total billed charges,75% of total billed charges,125.49,85,,,percent of total billed charges,85% of total billed charges,56.1,137.3,
Aluminum,1168,CDM,300,RC,82108,HCPCS,outpatient,,,169.91,127.43,,152.92,90,,,percent of total billed charges,90% of total billed charges,158.02,93,,,percent of total billed charges,93% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,144.42,85,,,percent of total billed charges,85% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,138.31,81.4,,,percent of total billed charges,81.4% of total billed charges,152.92,90,,,percent of total billed charges,90% of total billed charges,152.92,90,,,percent of total billed charges,90% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,127.43,75,,,percent of total billed charges,75% of total billed charges,144.42,85,,,percent of total billed charges,85% of total billed charges,64.57,158.02,
Aminolevulinic Acid,1169,CDM,300,RC,82135,HCPCS,outpatient,,,148.62,111.47,,133.76,90,,,percent of total billed charges,90% of total billed charges,138.22,93,,,percent of total billed charges,93% of total billed charges,56.48,38,,,percent of total billed charges,38% of total billed charges,56.48,38,,,percent of total billed charges,38% of total billed charges,126.33,85,,,percent of total billed charges,85% of total billed charges,56.48,38,,,percent of total billed charges,38% of total billed charges,120.98,81.4,,,percent of total billed charges,81.4% of total billed charges,133.76,90,,,percent of total billed charges,90% of total billed charges,133.76,90,,,percent of total billed charges,90% of total billed charges,56.48,38,,,percent of total billed charges,38% of total billed charges,56.48,38,,,percent of total billed charges,38% of total billed charges,56.48,38,,,percent of total billed charges,38% of total billed charges,111.47,75,,,percent of total billed charges,75% of total billed charges,126.33,85,,,percent of total billed charges,85% of total billed charges,56.48,138.22,
"Amino Acid Analysis, LC/MS Plasma",1170,CDM,300,RC,82139,HCPCS,outpatient,,,809.85,607.39,,728.87,90,,,percent of total billed charges,90% of total billed charges,753.16,93,,,percent of total billed charges,93% of total billed charges,307.74,38,,,percent of total billed charges,38% of total billed charges,307.74,38,,,percent of total billed charges,38% of total billed charges,688.37,85,,,percent of total billed charges,85% of total billed charges,307.74,38,,,percent of total billed charges,38% of total billed charges,659.22,81.4,,,percent of total billed charges,81.4% of total billed charges,728.87,90,,,percent of total billed charges,90% of total billed charges,728.87,90,,,percent of total billed charges,90% of total billed charges,307.74,38,,,percent of total billed charges,38% of total billed charges,307.74,38,,,percent of total billed charges,38% of total billed charges,307.74,38,,,percent of total billed charges,38% of total billed charges,607.39,75,,,percent of total billed charges,75% of total billed charges,688.37,85,,,percent of total billed charges,85% of total billed charges,307.74,753.16,
Ammonia,1171,CDM,300,RC,82140,HCPCS,outpatient,,,160.55,120.41,,144.5,90,,,percent of total billed charges,90% of total billed charges,149.31,93,,,percent of total billed charges,93% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,136.47,85,,,percent of total billed charges,85% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,130.69,81.4,,,percent of total billed charges,81.4% of total billed charges,144.5,90,,,percent of total billed charges,90% of total billed charges,144.5,90,,,percent of total billed charges,90% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,120.41,75,,,percent of total billed charges,75% of total billed charges,136.47,85,,,percent of total billed charges,85% of total billed charges,61.01,149.31,
24 Hr. Ammonia-Urine,1172,CDM,300,RC,82140,HCPCS,outpatient,,,45.25,33.94,,40.73,90,,,percent of total billed charges,90% of total billed charges,42.08,93,,,percent of total billed charges,93% of total billed charges,17.2,38,,,percent of total billed charges,38% of total billed charges,17.2,38,,,percent of total billed charges,38% of total billed charges,38.46,85,,,percent of total billed charges,85% of total billed charges,17.2,38,,,percent of total billed charges,38% of total billed charges,36.83,81.4,,,percent of total billed charges,81.4% of total billed charges,40.73,90,,,percent of total billed charges,90% of total billed charges,40.73,90,,,percent of total billed charges,90% of total billed charges,17.2,38,,,percent of total billed charges,38% of total billed charges,17.2,38,,,percent of total billed charges,38% of total billed charges,17.2,38,,,percent of total billed charges,38% of total billed charges,33.94,75,,,percent of total billed charges,75% of total billed charges,38.46,85,,,percent of total billed charges,85% of total billed charges,17.2,42.08,
Amylase,1173,CDM,300,RC,82150,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
"Amylase, Peritoneal Fluid",1174,CDM,300,RC,82150,HCPCS,outpatient,,,57.75,43.31,,51.98,90,,,percent of total billed charges,90% of total billed charges,53.71,93,,,percent of total billed charges,93% of total billed charges,21.95,38,,,percent of total billed charges,38% of total billed charges,21.95,38,,,percent of total billed charges,38% of total billed charges,49.09,85,,,percent of total billed charges,85% of total billed charges,21.95,38,,,percent of total billed charges,38% of total billed charges,47.01,81.4,,,percent of total billed charges,81.4% of total billed charges,51.98,90,,,percent of total billed charges,90% of total billed charges,51.98,90,,,percent of total billed charges,90% of total billed charges,21.95,38,,,percent of total billed charges,38% of total billed charges,21.95,38,,,percent of total billed charges,38% of total billed charges,21.95,38,,,percent of total billed charges,38% of total billed charges,43.31,75,,,percent of total billed charges,75% of total billed charges,49.09,85,,,percent of total billed charges,85% of total billed charges,21.95,53.71,
Androstenedione,1175,CDM,300,RC,82157,HCPCS,outpatient,,,336.29,252.22,,302.66,90,,,percent of total billed charges,90% of total billed charges,312.75,93,,,percent of total billed charges,93% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,285.85,85,,,percent of total billed charges,85% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,273.74,81.4,,,percent of total billed charges,81.4% of total billed charges,302.66,90,,,percent of total billed charges,90% of total billed charges,302.66,90,,,percent of total billed charges,90% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,252.22,75,,,percent of total billed charges,75% of total billed charges,285.85,85,,,percent of total billed charges,85% of total billed charges,127.79,312.75,
Angiotensin Converting Enzyme (ACE),1176,CDM,300,RC,82164,HCPCS,outpatient,,,141.8,106.35,,127.62,90,,,percent of total billed charges,90% of total billed charges,131.87,93,,,percent of total billed charges,93% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,115.43,81.4,,,percent of total billed charges,81.4% of total billed charges,127.62,90,,,percent of total billed charges,90% of total billed charges,127.62,90,,,percent of total billed charges,90% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,106.35,75,,,percent of total billed charges,75% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,53.88,131.87,
Cardio IQ Apolipoprotein A-1,1177,CDM,300,RC,82172,HCPCS,outpatient,,,28.7,21.53,,25.83,90,,,percent of total billed charges,90% of total billed charges,26.69,93,,,percent of total billed charges,93% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,24.4,85,,,percent of total billed charges,85% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,23.36,81.4,,,percent of total billed charges,81.4% of total billed charges,25.83,90,,,percent of total billed charges,90% of total billed charges,25.83,90,,,percent of total billed charges,90% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,21.53,75,,,percent of total billed charges,75% of total billed charges,24.4,85,,,percent of total billed charges,85% of total billed charges,10.91,26.69,
Cardio IQ Apolipoprotein B,1178,CDM,300,RC,82172,HCPCS,outpatient,,,28.7,21.53,,25.83,90,,,percent of total billed charges,90% of total billed charges,26.69,93,,,percent of total billed charges,93% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,24.4,85,,,percent of total billed charges,85% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,23.36,81.4,,,percent of total billed charges,81.4% of total billed charges,25.83,90,,,percent of total billed charges,90% of total billed charges,25.83,90,,,percent of total billed charges,90% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,21.53,75,,,percent of total billed charges,75% of total billed charges,24.4,85,,,percent of total billed charges,85% of total billed charges,10.91,26.69,
"(RES) Cardio IQ, Apolipoprotein B",1179,CDM,300,RC,82172,HCPCS,outpatient,,,39.06,29.3,,35.15,90,,,percent of total billed charges,90% of total billed charges,36.33,93,,,percent of total billed charges,93% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,33.2,85,,,percent of total billed charges,85% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,31.79,81.4,,,percent of total billed charges,81.4% of total billed charges,35.15,90,,,percent of total billed charges,90% of total billed charges,35.15,90,,,percent of total billed charges,90% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,29.3,75,,,percent of total billed charges,75% of total billed charges,33.2,85,,,percent of total billed charges,85% of total billed charges,14.84,36.33,
Apolipoprotein B,1180,CDM,300,RC,82172,HCPCS,outpatient,,,27.06,20.3,,24.35,90,,,percent of total billed charges,90% of total billed charges,25.17,93,,,percent of total billed charges,93% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,22.03,81.4,,,percent of total billed charges,81.4% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,20.3,75,,,percent of total billed charges,75% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,25.17,
(RES) Arsenic (HMP - Blood),1181,CDM,300,RC,82175,HCPCS,outpatient,,,162.36,121.77,,146.12,90,,,percent of total billed charges,90% of total billed charges,150.99,93,,,percent of total billed charges,93% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,132.16,81.4,,,percent of total billed charges,81.4% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,121.77,75,,,percent of total billed charges,75% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,150.99,
Arsenic,1182,CDM,300,RC,82175,HCPCS,outpatient,,,111.29,83.47,,100.16,90,,,percent of total billed charges,90% of total billed charges,103.5,93,,,percent of total billed charges,93% of total billed charges,42.29,38,,,percent of total billed charges,38% of total billed charges,42.29,38,,,percent of total billed charges,38% of total billed charges,94.6,85,,,percent of total billed charges,85% of total billed charges,42.29,38,,,percent of total billed charges,38% of total billed charges,90.59,81.4,,,percent of total billed charges,81.4% of total billed charges,100.16,90,,,percent of total billed charges,90% of total billed charges,100.16,90,,,percent of total billed charges,90% of total billed charges,42.29,38,,,percent of total billed charges,38% of total billed charges,42.29,38,,,percent of total billed charges,38% of total billed charges,42.29,38,,,percent of total billed charges,38% of total billed charges,83.47,75,,,percent of total billed charges,75% of total billed charges,94.6,85,,,percent of total billed charges,85% of total billed charges,42.29,103.5,
"(RES)ARSENIC, BLOOD",1183,CDM,300,RC,82175,HCPCS,outpatient,,,156.96,117.72,,141.26,90,,,percent of total billed charges,90% of total billed charges,145.97,93,,,percent of total billed charges,93% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,127.77,81.4,,,percent of total billed charges,81.4% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,117.72,75,,,percent of total billed charges,75% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,145.97,
"(RES) ARSENIC, URINE",1184,CDM,300,RC,82175,HCPCS,outpatient,,,169.95,127.46,,152.96,90,,,percent of total billed charges,90% of total billed charges,158.05,93,,,percent of total billed charges,93% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,144.46,85,,,percent of total billed charges,85% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,138.34,81.4,,,percent of total billed charges,81.4% of total billed charges,152.96,90,,,percent of total billed charges,90% of total billed charges,152.96,90,,,percent of total billed charges,90% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,127.46,75,,,percent of total billed charges,75% of total billed charges,144.46,85,,,percent of total billed charges,85% of total billed charges,64.58,158.05,
Vitamin C,1185,CDM,300,RC,82180,HCPCS,outpatient,,,111.49,83.62,,100.34,90,,,percent of total billed charges,90% of total billed charges,103.69,93,,,percent of total billed charges,93% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,90.75,81.4,,,percent of total billed charges,81.4% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,83.62,75,,,percent of total billed charges,75% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,103.69,
Beta 2 Microglobulin,1186,CDM,300,RC,82232,HCPCS,outpatient,,,158.18,118.64,,142.36,90,,,percent of total billed charges,90% of total billed charges,147.11,93,,,percent of total billed charges,93% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,134.45,85,,,percent of total billed charges,85% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,128.76,81.4,,,percent of total billed charges,81.4% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,118.64,75,,,percent of total billed charges,75% of total billed charges,134.45,85,,,percent of total billed charges,85% of total billed charges,60.11,147.11,
B2 Microglobulin,1187,CDM,300,RC,82232,HCPCS,outpatient,,,156.1,117.08,,140.49,90,,,percent of total billed charges,90% of total billed charges,145.17,93,,,percent of total billed charges,93% of total billed charges,59.32,38,,,percent of total billed charges,38% of total billed charges,59.32,38,,,percent of total billed charges,38% of total billed charges,132.69,85,,,percent of total billed charges,85% of total billed charges,59.32,38,,,percent of total billed charges,38% of total billed charges,127.07,81.4,,,percent of total billed charges,81.4% of total billed charges,140.49,90,,,percent of total billed charges,90% of total billed charges,140.49,90,,,percent of total billed charges,90% of total billed charges,59.32,38,,,percent of total billed charges,38% of total billed charges,59.32,38,,,percent of total billed charges,38% of total billed charges,59.32,38,,,percent of total billed charges,38% of total billed charges,117.08,75,,,percent of total billed charges,75% of total billed charges,132.69,85,,,percent of total billed charges,85% of total billed charges,59.32,145.17,
"Bile Acids, Total",1188,CDM,300,RC,82239,HCPCS,outpatient,,,94.2,70.65,,84.78,90,,,percent of total billed charges,90% of total billed charges,87.61,93,,,percent of total billed charges,93% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,76.68,81.4,,,percent of total billed charges,81.4% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,70.65,75,,,percent of total billed charges,75% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,35.8,87.61,
"Bilirubin, Total",1189,CDM,300,RC,82247,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
T. Bili newborn with cap,1190,CDM,300,RC,82247,HCPCS,outpatient,,,60.93,45.7,,54.84,90,,,percent of total billed charges,90% of total billed charges,56.66,93,,,percent of total billed charges,93% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,51.79,85,,,percent of total billed charges,85% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,49.6,81.4,,,percent of total billed charges,81.4% of total billed charges,54.84,90,,,percent of total billed charges,90% of total billed charges,54.84,90,,,percent of total billed charges,90% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,45.7,75,,,percent of total billed charges,75% of total billed charges,51.79,85,,,percent of total billed charges,85% of total billed charges,23.15,56.66,
"Bilirubin, Direct",1191,CDM,300,RC,82248,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Occult Blood-Guiac only,1192,CDM,300,RC,82270,HCPCS,outpatient,,,34.46,25.85,,31.01,90,,,percent of total billed charges,90% of total billed charges,32.05,93,,,percent of total billed charges,93% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,29.29,85,,,percent of total billed charges,85% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,28.05,81.4,,,percent of total billed charges,81.4% of total billed charges,31.01,90,,,percent of total billed charges,90% of total billed charges,31.01,90,,,percent of total billed charges,90% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,25.85,75,,,percent of total billed charges,75% of total billed charges,29.29,85,,,percent of total billed charges,85% of total billed charges,13.09,32.05,
"Clinic- Hemoccult, feces card",1193,CDM,300,RC,82270,HCPCS,outpatient,,,35.15,26.36,,31.64,90,,,percent of total billed charges,90% of total billed charges,32.69,93,,,percent of total billed charges,93% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,29.88,85,,,percent of total billed charges,85% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,28.61,81.4,,,percent of total billed charges,81.4% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,26.36,75,,,percent of total billed charges,75% of total billed charges,29.88,85,,,percent of total billed charges,85% of total billed charges,13.36,32.69,
Gastroccult,1194,CDM,300,RC,82271,HCPCS,outpatient,,,29.28,21.96,,26.35,90,,,percent of total billed charges,90% of total billed charges,27.23,93,,,percent of total billed charges,93% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,23.83,81.4,,,percent of total billed charges,81.4% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,21.96,75,,,percent of total billed charges,75% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,27.23,
Fecal Occult blood test,1195,CDM,302,RC,82274,HCPCS,outpatient,,,59.76,44.82,,53.78,90,,,percent of total billed charges,90% of total billed charges,55.58,93,,,percent of total billed charges,93% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,50.8,85,,,percent of total billed charges,85% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,48.64,81.4,,,percent of total billed charges,81.4% of total billed charges,53.78,90,,,percent of total billed charges,90% of total billed charges,53.78,90,,,percent of total billed charges,90% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,44.82,75,,,percent of total billed charges,75% of total billed charges,50.8,85,,,percent of total billed charges,85% of total billed charges,22.71,55.58,
"Cadmium, Blood",1196,CDM,300,RC,82300,HCPCS,outpatient,,,188.15,141.11,,169.34,90,,,percent of total billed charges,90% of total billed charges,174.98,93,,,percent of total billed charges,93% of total billed charges,71.5,38,,,percent of total billed charges,38% of total billed charges,71.5,38,,,percent of total billed charges,38% of total billed charges,159.93,85,,,percent of total billed charges,85% of total billed charges,71.5,38,,,percent of total billed charges,38% of total billed charges,153.15,81.4,,,percent of total billed charges,81.4% of total billed charges,169.34,90,,,percent of total billed charges,90% of total billed charges,169.34,90,,,percent of total billed charges,90% of total billed charges,71.5,38,,,percent of total billed charges,38% of total billed charges,71.5,38,,,percent of total billed charges,38% of total billed charges,71.5,38,,,percent of total billed charges,38% of total billed charges,141.11,75,,,percent of total billed charges,75% of total billed charges,159.93,85,,,percent of total billed charges,85% of total billed charges,71.5,174.98,
(Result) Vitamin D 25-OH Total,1197,CDM,300,RC,82306,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Vitamin D 25-OH D3,1198,CDM,300,RC,82306,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Vitamin D 25-OH D2,1199,CDM,300,RC,82306,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Vitamin D (D2,D3)",1200,CDM,300,RC,82306,HCPCS,outpatient,,,269.16,201.87,,242.24,90,,,percent of total billed charges,90% of total billed charges,250.32,93,,,percent of total billed charges,93% of total billed charges,102.28,38,,,percent of total billed charges,38% of total billed charges,102.28,38,,,percent of total billed charges,38% of total billed charges,228.79,85,,,percent of total billed charges,85% of total billed charges,102.28,38,,,percent of total billed charges,38% of total billed charges,219.1,81.4,,,percent of total billed charges,81.4% of total billed charges,242.24,90,,,percent of total billed charges,90% of total billed charges,242.24,90,,,percent of total billed charges,90% of total billed charges,102.28,38,,,percent of total billed charges,38% of total billed charges,102.28,38,,,percent of total billed charges,38% of total billed charges,102.28,38,,,percent of total billed charges,38% of total billed charges,201.87,75,,,percent of total billed charges,75% of total billed charges,228.79,85,,,percent of total billed charges,85% of total billed charges,102.28,250.32,
"VITAMIN D,25-OH,TOTAL,IA",1201,CDM,300,RC,82306,HCPCS,outpatient,,,225.23,168.92,,202.71,90,,,percent of total billed charges,90% of total billed charges,209.46,93,,,percent of total billed charges,93% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,191.45,85,,,percent of total billed charges,85% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,183.34,81.4,,,percent of total billed charges,81.4% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,168.92,75,,,percent of total billed charges,75% of total billed charges,191.45,85,,,percent of total billed charges,85% of total billed charges,85.59,209.46,
Calcitonin,1202,CDM,300,RC,82308,HCPCS,outpatient,,,240.48,180.36,,216.43,90,,,percent of total billed charges,90% of total billed charges,223.65,93,,,percent of total billed charges,93% of total billed charges,91.38,38,,,percent of total billed charges,38% of total billed charges,91.38,38,,,percent of total billed charges,38% of total billed charges,204.41,85,,,percent of total billed charges,85% of total billed charges,91.38,38,,,percent of total billed charges,38% of total billed charges,195.75,81.4,,,percent of total billed charges,81.4% of total billed charges,216.43,90,,,percent of total billed charges,90% of total billed charges,216.43,90,,,percent of total billed charges,90% of total billed charges,91.38,38,,,percent of total billed charges,38% of total billed charges,91.38,38,,,percent of total billed charges,38% of total billed charges,91.38,38,,,percent of total billed charges,38% of total billed charges,180.36,75,,,percent of total billed charges,75% of total billed charges,204.41,85,,,percent of total billed charges,85% of total billed charges,91.38,223.65,
Calcium,1203,CDM,300,RC,82310,HCPCS,outpatient,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
Urine Calcium - Random,1204,CDM,300,RC,82310,HCPCS,outpatient,,,70.31,52.73,,63.28,90,,,percent of total billed charges,90% of total billed charges,65.39,93,,,percent of total billed charges,93% of total billed charges,26.72,38,,,percent of total billed charges,38% of total billed charges,26.72,38,,,percent of total billed charges,38% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,26.72,38,,,percent of total billed charges,38% of total billed charges,57.23,81.4,,,percent of total billed charges,81.4% of total billed charges,63.28,90,,,percent of total billed charges,90% of total billed charges,63.28,90,,,percent of total billed charges,90% of total billed charges,26.72,38,,,percent of total billed charges,38% of total billed charges,26.72,38,,,percent of total billed charges,38% of total billed charges,26.72,38,,,percent of total billed charges,38% of total billed charges,52.73,75,,,percent of total billed charges,75% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,26.72,65.39,
"(RES) CALCIUM, PTH",1205,CDM,300,RC,82310,HCPCS,outpatient,,,33.98,25.49,,30.58,90,,,percent of total billed charges,90% of total billed charges,31.6,93,,,percent of total billed charges,93% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,28.88,85,,,percent of total billed charges,85% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,27.66,81.4,,,percent of total billed charges,81.4% of total billed charges,30.58,90,,,percent of total billed charges,90% of total billed charges,30.58,90,,,percent of total billed charges,90% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,25.49,75,,,percent of total billed charges,75% of total billed charges,28.88,85,,,percent of total billed charges,85% of total billed charges,12.91,31.6,
Ionized Calcium,1206,CDM,300,RC,82330,HCPCS,outpatient,,,165.21,123.91,,148.69,90,,,percent of total billed charges,90% of total billed charges,153.65,93,,,percent of total billed charges,93% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,134.48,81.4,,,percent of total billed charges,81.4% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,123.91,75,,,percent of total billed charges,75% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,153.65,
"Calcium, Ionized (Quest)",1207,CDM,300,RC,82330,HCPCS,outpatient,,,82.77,62.08,,74.49,90,,,percent of total billed charges,90% of total billed charges,76.98,93,,,percent of total billed charges,93% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,70.35,85,,,percent of total billed charges,85% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,67.37,81.4,,,percent of total billed charges,81.4% of total billed charges,74.49,90,,,percent of total billed charges,90% of total billed charges,74.49,90,,,percent of total billed charges,90% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,31.45,38,,,percent of total billed charges,38% of total billed charges,62.08,75,,,percent of total billed charges,75% of total billed charges,70.35,85,,,percent of total billed charges,85% of total billed charges,31.45,76.98,
(RES) 24hr Calcium Urine,1208,CDM,300,RC,82340,HCPCS,outpatient,,,58.49,43.87,,52.64,90,,,percent of total billed charges,90% of total billed charges,54.4,93,,,percent of total billed charges,93% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,49.72,85,,,percent of total billed charges,85% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,47.61,81.4,,,percent of total billed charges,81.4% of total billed charges,52.64,90,,,percent of total billed charges,90% of total billed charges,52.64,90,,,percent of total billed charges,90% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,43.87,75,,,percent of total billed charges,75% of total billed charges,49.72,85,,,percent of total billed charges,85% of total billed charges,22.23,54.4,
"Calcium, 24 Hr Ur, W/O Creat",1209,CDM,300,RC,82340,HCPCS,outpatient,,,62.42,46.82,,56.18,90,,,percent of total billed charges,90% of total billed charges,58.05,93,,,percent of total billed charges,93% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,53.06,85,,,percent of total billed charges,85% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,50.81,81.4,,,percent of total billed charges,81.4% of total billed charges,56.18,90,,,percent of total billed charges,90% of total billed charges,56.18,90,,,percent of total billed charges,90% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,46.82,75,,,percent of total billed charges,75% of total billed charges,53.06,85,,,percent of total billed charges,85% of total billed charges,23.72,58.05,
Stone Analysis w Image,1210,CDM,300,RC,82365,HCPCS,outpatient,,,143.53,107.65,,129.18,90,,,percent of total billed charges,90% of total billed charges,133.48,93,,,percent of total billed charges,93% of total billed charges,54.54,38,,,percent of total billed charges,38% of total billed charges,54.54,38,,,percent of total billed charges,38% of total billed charges,122,85,,,percent of total billed charges,85% of total billed charges,54.54,38,,,percent of total billed charges,38% of total billed charges,116.83,81.4,,,percent of total billed charges,81.4% of total billed charges,129.18,90,,,percent of total billed charges,90% of total billed charges,129.18,90,,,percent of total billed charges,90% of total billed charges,54.54,38,,,percent of total billed charges,38% of total billed charges,54.54,38,,,percent of total billed charges,38% of total billed charges,54.54,38,,,percent of total billed charges,38% of total billed charges,107.65,75,,,percent of total billed charges,75% of total billed charges,122,85,,,percent of total billed charges,85% of total billed charges,54.54,133.48,
Stone Analysis w/o Image,1211,CDM,300,RC,82365,HCPCS,outpatient,,,96.25,72.19,,86.63,90,,,percent of total billed charges,90% of total billed charges,89.51,93,,,percent of total billed charges,93% of total billed charges,36.58,38,,,percent of total billed charges,38% of total billed charges,36.58,38,,,percent of total billed charges,38% of total billed charges,81.81,85,,,percent of total billed charges,85% of total billed charges,36.58,38,,,percent of total billed charges,38% of total billed charges,78.35,81.4,,,percent of total billed charges,81.4% of total billed charges,86.63,90,,,percent of total billed charges,90% of total billed charges,86.63,90,,,percent of total billed charges,90% of total billed charges,36.58,38,,,percent of total billed charges,38% of total billed charges,36.58,38,,,percent of total billed charges,38% of total billed charges,36.58,38,,,percent of total billed charges,38% of total billed charges,72.19,75,,,percent of total billed charges,75% of total billed charges,81.81,85,,,percent of total billed charges,85% of total billed charges,36.58,89.51,
(RES) CDT,1212,CDM,300,RC,82373,HCPCS,outpatient,,,93.64,70.23,,84.28,90,,,percent of total billed charges,90% of total billed charges,87.09,93,,,percent of total billed charges,93% of total billed charges,35.58,38,,,percent of total billed charges,38% of total billed charges,35.58,38,,,percent of total billed charges,38% of total billed charges,79.59,85,,,percent of total billed charges,85% of total billed charges,35.58,38,,,percent of total billed charges,38% of total billed charges,76.22,81.4,,,percent of total billed charges,81.4% of total billed charges,84.28,90,,,percent of total billed charges,90% of total billed charges,84.28,90,,,percent of total billed charges,90% of total billed charges,35.58,38,,,percent of total billed charges,38% of total billed charges,35.58,38,,,percent of total billed charges,38% of total billed charges,35.58,38,,,percent of total billed charges,38% of total billed charges,70.23,75,,,percent of total billed charges,75% of total billed charges,79.59,85,,,percent of total billed charges,85% of total billed charges,35.58,87.09,
Carbon Dioxide,1213,CDM,300,RC,82374,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
(RES) Carboxyhemoglobin,1214,CDM,300,RC,82375,HCPCS,outpatient,,,107.16,80.37,,96.44,90,,,percent of total billed charges,90% of total billed charges,99.66,93,,,percent of total billed charges,93% of total billed charges,40.72,38,,,percent of total billed charges,38% of total billed charges,40.72,38,,,percent of total billed charges,38% of total billed charges,91.09,85,,,percent of total billed charges,85% of total billed charges,40.72,38,,,percent of total billed charges,38% of total billed charges,87.23,81.4,,,percent of total billed charges,81.4% of total billed charges,96.44,90,,,percent of total billed charges,90% of total billed charges,96.44,90,,,percent of total billed charges,90% of total billed charges,40.72,38,,,percent of total billed charges,38% of total billed charges,40.72,38,,,percent of total billed charges,38% of total billed charges,40.72,38,,,percent of total billed charges,38% of total billed charges,80.37,75,,,percent of total billed charges,75% of total billed charges,91.09,85,,,percent of total billed charges,85% of total billed charges,40.72,99.66,
"Carboxyhemoglobin, Blood",1215,CDM,300,RC,82375,HCPCS,outpatient,,,114.59,85.94,,103.13,90,,,percent of total billed charges,90% of total billed charges,106.57,93,,,percent of total billed charges,93% of total billed charges,43.54,38,,,percent of total billed charges,38% of total billed charges,43.54,38,,,percent of total billed charges,38% of total billed charges,97.4,85,,,percent of total billed charges,85% of total billed charges,43.54,38,,,percent of total billed charges,38% of total billed charges,93.28,81.4,,,percent of total billed charges,81.4% of total billed charges,103.13,90,,,percent of total billed charges,90% of total billed charges,103.13,90,,,percent of total billed charges,90% of total billed charges,43.54,38,,,percent of total billed charges,38% of total billed charges,43.54,38,,,percent of total billed charges,38% of total billed charges,43.54,38,,,percent of total billed charges,38% of total billed charges,85.94,75,,,percent of total billed charges,75% of total billed charges,97.4,85,,,percent of total billed charges,85% of total billed charges,43.54,106.57,
CEA,1216,CDM,300,RC,82378,HCPCS,outpatient,,,154.67,116,,139.2,90,,,percent of total billed charges,90% of total billed charges,143.84,93,,,percent of total billed charges,93% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,125.9,81.4,,,percent of total billed charges,81.4% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,116,75,,,percent of total billed charges,75% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,143.84,
(Result) CEA,1217,CDM,300,RC,82378,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Carnitine LC/MS/MS,1218,CDM,300,RC,82379,HCPCS,outpatient,,,272.56,204.42,,245.3,90,,,percent of total billed charges,90% of total billed charges,253.48,93,,,percent of total billed charges,93% of total billed charges,103.57,38,,,percent of total billed charges,38% of total billed charges,103.57,38,,,percent of total billed charges,38% of total billed charges,231.68,85,,,percent of total billed charges,85% of total billed charges,103.57,38,,,percent of total billed charges,38% of total billed charges,221.86,81.4,,,percent of total billed charges,81.4% of total billed charges,245.3,90,,,percent of total billed charges,90% of total billed charges,245.3,90,,,percent of total billed charges,90% of total billed charges,103.57,38,,,percent of total billed charges,38% of total billed charges,103.57,38,,,percent of total billed charges,38% of total billed charges,103.57,38,,,percent of total billed charges,38% of total billed charges,204.42,75,,,percent of total billed charges,75% of total billed charges,231.68,85,,,percent of total billed charges,85% of total billed charges,103.57,253.48,
Carnitine,1219,CDM,300,RC,82379,HCPCS,outpatient,,,256.64,192.48,,230.98,90,,,percent of total billed charges,90% of total billed charges,238.68,93,,,percent of total billed charges,93% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,218.14,85,,,percent of total billed charges,85% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,208.9,81.4,,,percent of total billed charges,81.4% of total billed charges,230.98,90,,,percent of total billed charges,90% of total billed charges,230.98,90,,,percent of total billed charges,90% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,192.48,75,,,percent of total billed charges,75% of total billed charges,218.14,85,,,percent of total billed charges,85% of total billed charges,97.52,238.68,
"24HR CATECHOLAMINES, FRACT URINE",1220,CDM,300,RC,82384,HCPCS,outpatient,,,168.79,126.59,,151.91,90,,,percent of total billed charges,90% of total billed charges,156.97,93,,,percent of total billed charges,93% of total billed charges,64.14,38,,,percent of total billed charges,38% of total billed charges,64.14,38,,,percent of total billed charges,38% of total billed charges,143.47,85,,,percent of total billed charges,85% of total billed charges,64.14,38,,,percent of total billed charges,38% of total billed charges,137.4,81.4,,,percent of total billed charges,81.4% of total billed charges,151.91,90,,,percent of total billed charges,90% of total billed charges,151.91,90,,,percent of total billed charges,90% of total billed charges,64.14,38,,,percent of total billed charges,38% of total billed charges,64.14,38,,,percent of total billed charges,38% of total billed charges,64.14,38,,,percent of total billed charges,38% of total billed charges,126.59,75,,,percent of total billed charges,75% of total billed charges,143.47,85,,,percent of total billed charges,85% of total billed charges,64.14,156.97,
24 hr Catecholamins Urine w/Creat,1221,CDM,300,RC,82384,HCPCS,outpatient,,,287.08,215.31,,258.37,90,,,percent of total billed charges,90% of total billed charges,266.98,93,,,percent of total billed charges,93% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,244.02,85,,,percent of total billed charges,85% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,233.68,81.4,,,percent of total billed charges,81.4% of total billed charges,258.37,90,,,percent of total billed charges,90% of total billed charges,258.37,90,,,percent of total billed charges,90% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,215.31,75,,,percent of total billed charges,75% of total billed charges,244.02,85,,,percent of total billed charges,85% of total billed charges,109.09,266.98,
"Catecholamines, Plasma",1222,CDM,300,RC,82384,HCPCS,outpatient,,,249.58,187.19,,224.62,90,,,percent of total billed charges,90% of total billed charges,232.11,93,,,percent of total billed charges,93% of total billed charges,94.84,38,,,percent of total billed charges,38% of total billed charges,94.84,38,,,percent of total billed charges,38% of total billed charges,212.14,85,,,percent of total billed charges,85% of total billed charges,94.84,38,,,percent of total billed charges,38% of total billed charges,203.16,81.4,,,percent of total billed charges,81.4% of total billed charges,224.62,90,,,percent of total billed charges,90% of total billed charges,224.62,90,,,percent of total billed charges,90% of total billed charges,94.84,38,,,percent of total billed charges,38% of total billed charges,94.84,38,,,percent of total billed charges,38% of total billed charges,94.84,38,,,percent of total billed charges,38% of total billed charges,187.19,75,,,percent of total billed charges,75% of total billed charges,212.14,85,,,percent of total billed charges,85% of total billed charges,94.84,232.11,
Ceruloplasmin level,1223,CDM,300,RC,82390,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
IGF Binding Protein-3,1224,CDM,300,RC,82397,HCPCS,outpatient,,,252.21,189.16,,226.99,90,,,percent of total billed charges,90% of total billed charges,234.56,93,,,percent of total billed charges,93% of total billed charges,95.84,38,,,percent of total billed charges,38% of total billed charges,95.84,38,,,percent of total billed charges,38% of total billed charges,214.38,85,,,percent of total billed charges,85% of total billed charges,95.84,38,,,percent of total billed charges,38% of total billed charges,205.3,81.4,,,percent of total billed charges,81.4% of total billed charges,226.99,90,,,percent of total billed charges,90% of total billed charges,226.99,90,,,percent of total billed charges,90% of total billed charges,95.84,38,,,percent of total billed charges,38% of total billed charges,95.84,38,,,percent of total billed charges,38% of total billed charges,95.84,38,,,percent of total billed charges,38% of total billed charges,189.16,75,,,percent of total billed charges,75% of total billed charges,214.38,85,,,percent of total billed charges,85% of total billed charges,95.84,234.56,
Chloride,1225,CDM,300,RC,82435,HCPCS,outpatient,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
"**Chloride, Urine - Random",1226,CDM,300,RC,82436,HCPCS,outpatient,,,52.72,39.54,,47.45,90,,,percent of total billed charges,90% of total billed charges,49.03,93,,,percent of total billed charges,93% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,42.91,81.4,,,percent of total billed charges,81.4% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,39.54,75,,,percent of total billed charges,75% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,49.03,
"Chloride Urine, Random",1227,CDM,300,RC,82436,HCPCS,outpatient,,,52.72,39.54,,47.45,90,,,percent of total billed charges,90% of total billed charges,49.03,93,,,percent of total billed charges,93% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,42.91,81.4,,,percent of total billed charges,81.4% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,39.54,75,,,percent of total billed charges,75% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,49.03,
Cholesterol serum or fluid,1228,CDM,300,RC,82465,HCPCS,outpatient,,,86.15,64.61,,77.54,90,,,percent of total billed charges,90% of total billed charges,80.12,93,,,percent of total billed charges,93% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,73.23,85,,,percent of total billed charges,85% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,70.13,81.4,,,percent of total billed charges,81.4% of total billed charges,77.54,90,,,percent of total billed charges,90% of total billed charges,77.54,90,,,percent of total billed charges,90% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,64.61,75,,,percent of total billed charges,75% of total billed charges,73.23,85,,,percent of total billed charges,85% of total billed charges,32.74,80.12,
"(RES) CHOLESTEROL, TOTAL",1229,CDM,300,RC,82465,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
Heroin Screen(serum),1230,CDM,300,RC,82486,HCPCS,outpatient,,,140.62,105.47,,126.56,90,,,percent of total billed charges,90% of total billed charges,130.78,93,,,percent of total billed charges,93% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,114.46,81.4,,,percent of total billed charges,81.4% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,105.47,75,,,percent of total billed charges,75% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,130.78,
(Result) Coenzyme Q10,1231,CDM,300,RC,82491,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(Result) Chromium, Plasma",1232,CDM,300,RC,82495,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(Result) Chromium, Serum",1233,CDM,300,RC,82495,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Chromium, Plasma",1234,CDM,300,RC,82495,HCPCS,outpatient,,,162.87,122.15,,146.58,90,,,percent of total billed charges,90% of total billed charges,151.47,93,,,percent of total billed charges,93% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,132.58,81.4,,,percent of total billed charges,81.4% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,122.15,75,,,percent of total billed charges,75% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,151.47,
"Chromium, Serum",1235,CDM,300,RC,82495,HCPCS,outpatient,,,162.87,122.15,,146.58,90,,,percent of total billed charges,90% of total billed charges,151.47,93,,,percent of total billed charges,93% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,132.58,81.4,,,percent of total billed charges,81.4% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,122.15,75,,,percent of total billed charges,75% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,151.47,
Citrate 24hr Urine,1236,CDM,300,RC,82507,HCPCS,outpatient,,,236.69,177.52,,213.02,90,,,percent of total billed charges,90% of total billed charges,220.12,93,,,percent of total billed charges,93% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,201.19,85,,,percent of total billed charges,85% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,192.67,81.4,,,percent of total billed charges,81.4% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,177.52,75,,,percent of total billed charges,75% of total billed charges,201.19,85,,,percent of total billed charges,85% of total billed charges,89.94,220.12,
(RES) Citric Acid 24 Hr Urine,1237,CDM,300,RC,82507,HCPCS,outpatient,,,80.04,60.03,,72.04,90,,,percent of total billed charges,90% of total billed charges,74.44,93,,,percent of total billed charges,93% of total billed charges,30.42,38,,,percent of total billed charges,38% of total billed charges,30.42,38,,,percent of total billed charges,38% of total billed charges,68.03,85,,,percent of total billed charges,85% of total billed charges,30.42,38,,,percent of total billed charges,38% of total billed charges,65.15,81.4,,,percent of total billed charges,81.4% of total billed charges,72.04,90,,,percent of total billed charges,90% of total billed charges,72.04,90,,,percent of total billed charges,90% of total billed charges,30.42,38,,,percent of total billed charges,38% of total billed charges,30.42,38,,,percent of total billed charges,38% of total billed charges,30.42,38,,,percent of total billed charges,38% of total billed charges,60.03,75,,,percent of total billed charges,75% of total billed charges,68.03,85,,,percent of total billed charges,85% of total billed charges,30.42,74.44,
C-Telopeptide,1238,CDM,300,RC,82523,HCPCS,outpatient,,,222.99,167.24,,200.69,90,,,percent of total billed charges,90% of total billed charges,207.38,93,,,percent of total billed charges,93% of total billed charges,84.74,38,,,percent of total billed charges,38% of total billed charges,84.74,38,,,percent of total billed charges,38% of total billed charges,189.54,85,,,percent of total billed charges,85% of total billed charges,84.74,38,,,percent of total billed charges,38% of total billed charges,181.51,81.4,,,percent of total billed charges,81.4% of total billed charges,200.69,90,,,percent of total billed charges,90% of total billed charges,200.69,90,,,percent of total billed charges,90% of total billed charges,84.74,38,,,percent of total billed charges,38% of total billed charges,84.74,38,,,percent of total billed charges,38% of total billed charges,84.74,38,,,percent of total billed charges,38% of total billed charges,167.24,75,,,percent of total billed charges,75% of total billed charges,189.54,85,,,percent of total billed charges,85% of total billed charges,84.74,207.38,
Collagen xlink N telopeptide urine,1239,CDM,300,RC,82523,HCPCS,outpatient,,,282.58,211.94,,254.32,90,,,percent of total billed charges,90% of total billed charges,262.8,93,,,percent of total billed charges,93% of total billed charges,107.38,38,,,percent of total billed charges,38% of total billed charges,107.38,38,,,percent of total billed charges,38% of total billed charges,240.19,85,,,percent of total billed charges,85% of total billed charges,107.38,38,,,percent of total billed charges,38% of total billed charges,230.02,81.4,,,percent of total billed charges,81.4% of total billed charges,254.32,90,,,percent of total billed charges,90% of total billed charges,254.32,90,,,percent of total billed charges,90% of total billed charges,107.38,38,,,percent of total billed charges,38% of total billed charges,107.38,38,,,percent of total billed charges,38% of total billed charges,107.38,38,,,percent of total billed charges,38% of total billed charges,211.94,75,,,percent of total billed charges,75% of total billed charges,240.19,85,,,percent of total billed charges,85% of total billed charges,107.38,262.8,
"N-Telopeptide, Cross-Linked, Serum (SLVRMC)",1240,CDM,300,RC,82523,HCPCS,outpatient,,,408,306,,367.2,90,,,percent of total billed charges,90% of total billed charges,379.44,93,,,percent of total billed charges,93% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,346.8,85,,,percent of total billed charges,85% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,332.11,81.4,,,percent of total billed charges,81.4% of total billed charges,367.2,90,,,percent of total billed charges,90% of total billed charges,367.2,90,,,percent of total billed charges,90% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,155.04,38,,,percent of total billed charges,38% of total billed charges,306,75,,,percent of total billed charges,75% of total billed charges,346.8,85,,,percent of total billed charges,85% of total billed charges,155.04,379.44,
"COPPER, SERUM",1241,CDM,300,RC,82525,HCPCS,outpatient,,,146.47,109.85,,131.82,90,,,percent of total billed charges,90% of total billed charges,136.22,93,,,percent of total billed charges,93% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,119.23,81.4,,,percent of total billed charges,81.4% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,109.85,75,,,percent of total billed charges,75% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,136.22,
Copper (blood),1242,CDM,300,RC,82525,HCPCS,outpatient,,,90.92,68.19,,81.83,90,,,percent of total billed charges,90% of total billed charges,84.56,93,,,percent of total billed charges,93% of total billed charges,34.55,38,,,percent of total billed charges,38% of total billed charges,34.55,38,,,percent of total billed charges,38% of total billed charges,77.28,85,,,percent of total billed charges,85% of total billed charges,34.55,38,,,percent of total billed charges,38% of total billed charges,74.01,81.4,,,percent of total billed charges,81.4% of total billed charges,81.83,90,,,percent of total billed charges,90% of total billed charges,81.83,90,,,percent of total billed charges,90% of total billed charges,34.55,38,,,percent of total billed charges,38% of total billed charges,34.55,38,,,percent of total billed charges,38% of total billed charges,34.55,38,,,percent of total billed charges,38% of total billed charges,68.19,75,,,percent of total billed charges,75% of total billed charges,77.28,85,,,percent of total billed charges,85% of total billed charges,34.55,84.56,
Copper 24 hr Urine,1243,CDM,300,RC,82525,HCPCS,outpatient,,,122.88,92.16,,110.59,90,,,percent of total billed charges,90% of total billed charges,114.28,93,,,percent of total billed charges,93% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,104.45,85,,,percent of total billed charges,85% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,100.02,81.4,,,percent of total billed charges,81.4% of total billed charges,110.59,90,,,percent of total billed charges,90% of total billed charges,110.59,90,,,percent of total billed charges,90% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,92.16,75,,,percent of total billed charges,75% of total billed charges,104.45,85,,,percent of total billed charges,85% of total billed charges,46.69,114.28,
Corticosterone,1244,CDM,300,RC,82528,HCPCS,outpatient,,,226.8,170.1,,204.12,90,,,percent of total billed charges,90% of total billed charges,210.92,93,,,percent of total billed charges,93% of total billed charges,86.18,38,,,percent of total billed charges,38% of total billed charges,86.18,38,,,percent of total billed charges,38% of total billed charges,192.78,85,,,percent of total billed charges,85% of total billed charges,86.18,38,,,percent of total billed charges,38% of total billed charges,184.62,81.4,,,percent of total billed charges,81.4% of total billed charges,204.12,90,,,percent of total billed charges,90% of total billed charges,204.12,90,,,percent of total billed charges,90% of total billed charges,86.18,38,,,percent of total billed charges,38% of total billed charges,86.18,38,,,percent of total billed charges,38% of total billed charges,86.18,38,,,percent of total billed charges,38% of total billed charges,170.1,75,,,percent of total billed charges,75% of total billed charges,192.78,85,,,percent of total billed charges,85% of total billed charges,86.18,210.92,
"Cortisol, Free",1245,CDM,300,RC,82530,HCPCS,outpatient,,,213.26,159.95,,191.93,90,,,percent of total billed charges,90% of total billed charges,198.33,93,,,percent of total billed charges,93% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,181.27,85,,,percent of total billed charges,85% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,173.59,81.4,,,percent of total billed charges,81.4% of total billed charges,191.93,90,,,percent of total billed charges,90% of total billed charges,191.93,90,,,percent of total billed charges,90% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,159.95,75,,,percent of total billed charges,75% of total billed charges,181.27,85,,,percent of total billed charges,85% of total billed charges,81.04,198.33,
CORTISOL FREE AND TOTAL,1246,CDM,300,RC,82530,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CORTISOL, SALIVA SAMPLE 1",1247,CDM,300,RC,82530,HCPCS,outpatient,,,109.82,82.37,,98.84,90,,,percent of total billed charges,90% of total billed charges,102.13,93,,,percent of total billed charges,93% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,93.35,85,,,percent of total billed charges,85% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,89.39,81.4,,,percent of total billed charges,81.4% of total billed charges,98.84,90,,,percent of total billed charges,90% of total billed charges,98.84,90,,,percent of total billed charges,90% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,82.37,75,,,percent of total billed charges,75% of total billed charges,93.35,85,,,percent of total billed charges,85% of total billed charges,41.73,102.13,
"(RES) CORTISOL, SALIVA SAMPLE 2",1248,CDM,300,RC,82530,HCPCS,outpatient,,,109.82,82.37,,98.84,90,,,percent of total billed charges,90% of total billed charges,102.13,93,,,percent of total billed charges,93% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,93.35,85,,,percent of total billed charges,85% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,89.39,81.4,,,percent of total billed charges,81.4% of total billed charges,98.84,90,,,percent of total billed charges,90% of total billed charges,98.84,90,,,percent of total billed charges,90% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,82.37,75,,,percent of total billed charges,75% of total billed charges,93.35,85,,,percent of total billed charges,85% of total billed charges,41.73,102.13,
"Profile - Cortisol, Saliva",1249,CDM,300,RC,82530,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
Cortisol Free 24hr Urine,1250,CDM,300,RC,82530,HCPCS,outpatient,,,185.11,138.83,,166.6,90,,,percent of total billed charges,90% of total billed charges,172.15,93,,,percent of total billed charges,93% of total billed charges,70.34,38,,,percent of total billed charges,38% of total billed charges,70.34,38,,,percent of total billed charges,38% of total billed charges,157.34,85,,,percent of total billed charges,85% of total billed charges,70.34,38,,,percent of total billed charges,38% of total billed charges,150.68,81.4,,,percent of total billed charges,81.4% of total billed charges,166.6,90,,,percent of total billed charges,90% of total billed charges,166.6,90,,,percent of total billed charges,90% of total billed charges,70.34,38,,,percent of total billed charges,38% of total billed charges,70.34,38,,,percent of total billed charges,38% of total billed charges,70.34,38,,,percent of total billed charges,38% of total billed charges,138.83,75,,,percent of total billed charges,75% of total billed charges,157.34,85,,,percent of total billed charges,85% of total billed charges,70.34,172.15,
"(RES) CORTISOL,FREE,LC/MS,S",1251,CDM,300,RC,82530,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,154.02,
"Cortisol, Saliva",1252,CDM,300,RC,82530,HCPCS,outpatient,,,109.82,82.37,,98.84,90,,,percent of total billed charges,90% of total billed charges,102.13,93,,,percent of total billed charges,93% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,93.35,85,,,percent of total billed charges,85% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,89.39,81.4,,,percent of total billed charges,81.4% of total billed charges,98.84,90,,,percent of total billed charges,90% of total billed charges,98.84,90,,,percent of total billed charges,90% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,41.73,38,,,percent of total billed charges,38% of total billed charges,82.37,75,,,percent of total billed charges,75% of total billed charges,93.35,85,,,percent of total billed charges,85% of total billed charges,41.73,102.13,
"Cortisol, P.M.",1253,CDM,300,RC,82533,HCPCS,outpatient,,,71.47,53.6,,64.32,90,,,percent of total billed charges,90% of total billed charges,66.47,93,,,percent of total billed charges,93% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,58.18,81.4,,,percent of total billed charges,81.4% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,53.6,75,,,percent of total billed charges,75% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,66.47,
"Cortisol, A.M.",1254,CDM,300,RC,82533,HCPCS,outpatient,,,71.47,53.6,,64.32,90,,,percent of total billed charges,90% of total billed charges,66.47,93,,,percent of total billed charges,93% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,58.18,81.4,,,percent of total billed charges,81.4% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,53.6,75,,,percent of total billed charges,75% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,66.47,
(RES) ACTH (SPECIMEN 3),1255,CDM,300,RC,82533,HCPCS,outpatient,,,128.12,96.09,,115.31,90,,,percent of total billed charges,90% of total billed charges,119.15,93,,,percent of total billed charges,93% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,108.9,85,,,percent of total billed charges,85% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,104.29,81.4,,,percent of total billed charges,81.4% of total billed charges,115.31,90,,,percent of total billed charges,90% of total billed charges,115.31,90,,,percent of total billed charges,90% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,96.09,75,,,percent of total billed charges,75% of total billed charges,108.9,85,,,percent of total billed charges,85% of total billed charges,48.69,119.15,
"Cortisol, Total",1256,CDM,300,RC,82533,HCPCS,outpatient,,,133.71,100.28,,120.34,90,,,percent of total billed charges,90% of total billed charges,124.35,93,,,percent of total billed charges,93% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,113.65,85,,,percent of total billed charges,85% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,108.84,81.4,,,percent of total billed charges,81.4% of total billed charges,120.34,90,,,percent of total billed charges,90% of total billed charges,120.34,90,,,percent of total billed charges,90% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,100.28,75,,,percent of total billed charges,75% of total billed charges,113.65,85,,,percent of total billed charges,85% of total billed charges,50.81,124.35,
"(RES) CORTISOL, TOTAL, LC/MS",1257,CDM,300,RC,82533,HCPCS,outpatient,,,193.21,144.91,,173.89,90,,,percent of total billed charges,90% of total billed charges,179.69,93,,,percent of total billed charges,93% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,164.23,85,,,percent of total billed charges,85% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,157.27,81.4,,,percent of total billed charges,81.4% of total billed charges,173.89,90,,,percent of total billed charges,90% of total billed charges,173.89,90,,,percent of total billed charges,90% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,144.91,75,,,percent of total billed charges,75% of total billed charges,164.23,85,,,percent of total billed charges,85% of total billed charges,73.42,179.69,
"Cortisol, Total (Random)",1258,CDM,300,RC,82533,HCPCS,outpatient,,,71.47,53.6,,64.32,90,,,percent of total billed charges,90% of total billed charges,66.47,93,,,percent of total billed charges,93% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,58.18,81.4,,,percent of total billed charges,81.4% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,53.6,75,,,percent of total billed charges,75% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,66.47,
Dexamethasone Suppression Test,1259,CDM,300,RC,82533,HCPCS,outpatient,,,134.88,101.16,,121.39,90,,,percent of total billed charges,90% of total billed charges,125.44,93,,,percent of total billed charges,93% of total billed charges,51.25,38,,,percent of total billed charges,38% of total billed charges,51.25,38,,,percent of total billed charges,38% of total billed charges,114.65,85,,,percent of total billed charges,85% of total billed charges,51.25,38,,,percent of total billed charges,38% of total billed charges,109.79,81.4,,,percent of total billed charges,81.4% of total billed charges,121.39,90,,,percent of total billed charges,90% of total billed charges,121.39,90,,,percent of total billed charges,90% of total billed charges,51.25,38,,,percent of total billed charges,38% of total billed charges,51.25,38,,,percent of total billed charges,38% of total billed charges,51.25,38,,,percent of total billed charges,38% of total billed charges,101.16,75,,,percent of total billed charges,75% of total billed charges,114.65,85,,,percent of total billed charges,85% of total billed charges,51.25,125.44,
RES) ACTH (SPECIMEN 1),1260,CDM,300,RC,82533,HCPCS,outpatient,,,128.12,96.09,,115.31,90,,,percent of total billed charges,90% of total billed charges,119.15,93,,,percent of total billed charges,93% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,108.9,85,,,percent of total billed charges,85% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,104.29,81.4,,,percent of total billed charges,81.4% of total billed charges,115.31,90,,,percent of total billed charges,90% of total billed charges,115.31,90,,,percent of total billed charges,90% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,96.09,75,,,percent of total billed charges,75% of total billed charges,108.9,85,,,percent of total billed charges,85% of total billed charges,48.69,119.15,
(RES) ACTH (SPECIMEN 2),1261,CDM,300,RC,82533,HCPCS,outpatient,,,128.12,96.09,,115.31,90,,,percent of total billed charges,90% of total billed charges,119.15,93,,,percent of total billed charges,93% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,108.9,85,,,percent of total billed charges,85% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,104.29,81.4,,,percent of total billed charges,81.4% of total billed charges,115.31,90,,,percent of total billed charges,90% of total billed charges,115.31,90,,,percent of total billed charges,90% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,48.69,38,,,percent of total billed charges,38% of total billed charges,96.09,75,,,percent of total billed charges,75% of total billed charges,108.9,85,,,percent of total billed charges,85% of total billed charges,48.69,119.15,
Cortisone - Serum,1262,CDM,300,RC,82542,HCPCS,outpatient,,,227.31,170.48,,204.58,90,,,percent of total billed charges,90% of total billed charges,211.4,93,,,percent of total billed charges,93% of total billed charges,86.38,38,,,percent of total billed charges,38% of total billed charges,86.38,38,,,percent of total billed charges,38% of total billed charges,193.21,85,,,percent of total billed charges,85% of total billed charges,86.38,38,,,percent of total billed charges,38% of total billed charges,185.03,81.4,,,percent of total billed charges,81.4% of total billed charges,204.58,90,,,percent of total billed charges,90% of total billed charges,204.58,90,,,percent of total billed charges,90% of total billed charges,86.38,38,,,percent of total billed charges,38% of total billed charges,86.38,38,,,percent of total billed charges,38% of total billed charges,86.38,38,,,percent of total billed charges,38% of total billed charges,170.48,75,,,percent of total billed charges,75% of total billed charges,193.21,85,,,percent of total billed charges,85% of total billed charges,86.38,211.4,
Omega-3 and -6 Fatty Acids,1263,CDM,300,RC,82542,HCPCS,outpatient,,,60.34,45.26,,54.31,90,,,percent of total billed charges,90% of total billed charges,56.12,93,,,percent of total billed charges,93% of total billed charges,22.93,38,,,percent of total billed charges,38% of total billed charges,22.93,38,,,percent of total billed charges,38% of total billed charges,51.29,85,,,percent of total billed charges,85% of total billed charges,22.93,38,,,percent of total billed charges,38% of total billed charges,49.12,81.4,,,percent of total billed charges,81.4% of total billed charges,54.31,90,,,percent of total billed charges,90% of total billed charges,54.31,90,,,percent of total billed charges,90% of total billed charges,22.93,38,,,percent of total billed charges,38% of total billed charges,22.93,38,,,percent of total billed charges,38% of total billed charges,22.93,38,,,percent of total billed charges,38% of total billed charges,45.26,75,,,percent of total billed charges,75% of total billed charges,51.29,85,,,percent of total billed charges,85% of total billed charges,22.93,56.12,
"Porphyrins, Total, Plasma",1264,CDM,300,RC,82542,HCPCS,outpatient,,,131.59,98.69,,118.43,90,,,percent of total billed charges,90% of total billed charges,122.38,93,,,percent of total billed charges,93% of total billed charges,50,38,,,percent of total billed charges,38% of total billed charges,50,38,,,percent of total billed charges,38% of total billed charges,111.85,85,,,percent of total billed charges,85% of total billed charges,50,38,,,percent of total billed charges,38% of total billed charges,107.11,81.4,,,percent of total billed charges,81.4% of total billed charges,118.43,90,,,percent of total billed charges,90% of total billed charges,118.43,90,,,percent of total billed charges,90% of total billed charges,50,38,,,percent of total billed charges,38% of total billed charges,50,38,,,percent of total billed charges,38% of total billed charges,50,38,,,percent of total billed charges,38% of total billed charges,98.69,75,,,percent of total billed charges,75% of total billed charges,111.85,85,,,percent of total billed charges,85% of total billed charges,50,122.38,
ADMA/SDMA,1265,CDM,300,RC,82542,HCPCS,outpatient,,,58.26,43.7,,52.43,90,,,percent of total billed charges,90% of total billed charges,54.18,93,,,percent of total billed charges,93% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,49.52,85,,,percent of total billed charges,85% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,47.42,81.4,,,percent of total billed charges,81.4% of total billed charges,52.43,90,,,percent of total billed charges,90% of total billed charges,52.43,90,,,percent of total billed charges,90% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,43.7,75,,,percent of total billed charges,75% of total billed charges,49.52,85,,,percent of total billed charges,85% of total billed charges,22.14,54.18,
Coenzyme Q10,1266,CDM,300,RC,82542,HCPCS,outpatient,,,431.23,323.42,,388.11,90,,,percent of total billed charges,90% of total billed charges,401.04,93,,,percent of total billed charges,93% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,366.55,85,,,percent of total billed charges,85% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,351.02,81.4,,,percent of total billed charges,81.4% of total billed charges,388.11,90,,,percent of total billed charges,90% of total billed charges,388.11,90,,,percent of total billed charges,90% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,323.42,75,,,percent of total billed charges,75% of total billed charges,366.55,85,,,percent of total billed charges,85% of total billed charges,163.87,401.04,
TMAO (Trimethylamine N-Oxide),1267,CDM,300,RC,82542,HCPCS,outpatient,,,58.26,43.7,,52.43,90,,,percent of total billed charges,90% of total billed charges,54.18,93,,,percent of total billed charges,93% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,49.52,85,,,percent of total billed charges,85% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,47.42,81.4,,,percent of total billed charges,81.4% of total billed charges,52.43,90,,,percent of total billed charges,90% of total billed charges,52.43,90,,,percent of total billed charges,90% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,43.7,75,,,percent of total billed charges,75% of total billed charges,49.52,85,,,percent of total billed charges,85% of total billed charges,22.14,54.18,
OmegaCheck,1268,CDM,300,RC,82542,HCPCS,outpatient,,,58.26,43.7,,52.43,90,,,percent of total billed charges,90% of total billed charges,54.18,93,,,percent of total billed charges,93% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,49.52,85,,,percent of total billed charges,85% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,47.42,81.4,,,percent of total billed charges,81.4% of total billed charges,52.43,90,,,percent of total billed charges,90% of total billed charges,52.43,90,,,percent of total billed charges,90% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,43.7,75,,,percent of total billed charges,75% of total billed charges,49.52,85,,,percent of total billed charges,85% of total billed charges,22.14,54.18,
CPK,1269,CDM,300,RC,82550,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Creatine Kinase Isoenzyme Panel(Quest),1270,CDM,300,RC,82552,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,162.37,
**CKMB(not done in lab any more),1271,CDM,300,RC,82553,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
CK-MB (CK-2),1272,CDM,300,RC,82553,HCPCS,outpatient,,,158.53,118.9,,142.68,90,,,percent of total billed charges,90% of total billed charges,147.43,93,,,percent of total billed charges,93% of total billed charges,60.24,38,,,percent of total billed charges,38% of total billed charges,60.24,38,,,percent of total billed charges,38% of total billed charges,134.75,85,,,percent of total billed charges,85% of total billed charges,60.24,38,,,percent of total billed charges,38% of total billed charges,129.04,81.4,,,percent of total billed charges,81.4% of total billed charges,142.68,90,,,percent of total billed charges,90% of total billed charges,142.68,90,,,percent of total billed charges,90% of total billed charges,60.24,38,,,percent of total billed charges,38% of total billed charges,60.24,38,,,percent of total billed charges,38% of total billed charges,60.24,38,,,percent of total billed charges,38% of total billed charges,118.9,75,,,percent of total billed charges,75% of total billed charges,134.75,85,,,percent of total billed charges,85% of total billed charges,60.24,147.43,
Creatinine,1273,CDM,300,RC,82565,HCPCS,outpatient,,,30.46,22.85,,27.41,90,,,percent of total billed charges,90% of total billed charges,28.33,93,,,percent of total billed charges,93% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,24.79,81.4,,,percent of total billed charges,81.4% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,22.85,75,,,percent of total billed charges,75% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,28.33,
Creatinine - Reference Lab,1274,CDM,300,RC,82565,HCPCS,outpatient,,,28.71,21.53,,25.84,90,,,percent of total billed charges,90% of total billed charges,26.7,93,,,percent of total billed charges,93% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,24.4,85,,,percent of total billed charges,85% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,23.37,81.4,,,percent of total billed charges,81.4% of total billed charges,25.84,90,,,percent of total billed charges,90% of total billed charges,25.84,90,,,percent of total billed charges,90% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,21.53,75,,,percent of total billed charges,75% of total billed charges,24.4,85,,,percent of total billed charges,85% of total billed charges,10.91,26.7,
(FENA) Creatinine,1275,CDM,300,RC,82565,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Urine Creatinine, Random",1276,CDM,300,RC,82570,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
"(RES) CREATININE, URINE (24 hr.)",1277,CDM,300,RC,82570,HCPCS,outpatient,,,63.48,47.61,,57.13,90,,,percent of total billed charges,90% of total billed charges,59.04,93,,,percent of total billed charges,93% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,53.96,85,,,percent of total billed charges,85% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,51.67,81.4,,,percent of total billed charges,81.4% of total billed charges,57.13,90,,,percent of total billed charges,90% of total billed charges,57.13,90,,,percent of total billed charges,90% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,47.61,75,,,percent of total billed charges,75% of total billed charges,53.96,85,,,percent of total billed charges,85% of total billed charges,24.12,59.04,
(RES) Urine Creatinine - Random,1278,CDM,300,RC,82570,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
"(RESULT) CREATININE, URINE",1279,CDM,300,RC,82570,HCPCS,outpatient,,,62.42,46.82,,56.18,90,,,percent of total billed charges,90% of total billed charges,58.05,93,,,percent of total billed charges,93% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,53.06,85,,,percent of total billed charges,85% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,50.81,81.4,,,percent of total billed charges,81.4% of total billed charges,56.18,90,,,percent of total billed charges,90% of total billed charges,56.18,90,,,percent of total billed charges,90% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,46.82,75,,,percent of total billed charges,75% of total billed charges,53.06,85,,,percent of total billed charges,85% of total billed charges,23.72,58.05,
(RES) Creatinine 24-hour urine,1280,CDM,300,RC,82570,HCPCS,outpatient,,,60.88,45.66,,54.79,90,,,percent of total billed charges,90% of total billed charges,56.62,93,,,percent of total billed charges,93% of total billed charges,23.13,38,,,percent of total billed charges,38% of total billed charges,23.13,38,,,percent of total billed charges,38% of total billed charges,51.75,85,,,percent of total billed charges,85% of total billed charges,23.13,38,,,percent of total billed charges,38% of total billed charges,49.56,81.4,,,percent of total billed charges,81.4% of total billed charges,54.79,90,,,percent of total billed charges,90% of total billed charges,54.79,90,,,percent of total billed charges,90% of total billed charges,23.13,38,,,percent of total billed charges,38% of total billed charges,23.13,38,,,percent of total billed charges,38% of total billed charges,23.13,38,,,percent of total billed charges,38% of total billed charges,45.66,75,,,percent of total billed charges,75% of total billed charges,51.75,85,,,percent of total billed charges,85% of total billed charges,23.13,56.62,
"Creatinine, 24 Hr Urine",1281,CDM,300,RC,82570,HCPCS,outpatient,,,60.93,45.7,,54.84,90,,,percent of total billed charges,90% of total billed charges,56.66,93,,,percent of total billed charges,93% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,51.79,85,,,percent of total billed charges,85% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,49.6,81.4,,,percent of total billed charges,81.4% of total billed charges,54.84,90,,,percent of total billed charges,90% of total billed charges,54.84,90,,,percent of total billed charges,90% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,45.7,75,,,percent of total billed charges,75% of total billed charges,51.79,85,,,percent of total billed charges,85% of total billed charges,23.15,56.66,
Magnesium 24hr Urine w/creatine,1282,CDM,300,RC,82570,HCPCS,outpatient,,,116,87,,104.4,90,,,percent of total billed charges,90% of total billed charges,107.88,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.42,81.4,,,percent of total billed charges,81.4% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87,75,,,percent of total billed charges,75% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,107.88,
(RES) Urine Creatinine (FENA),1283,CDM,300,RC,82570,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
"(RES) CREATININE, 24 HOUR URINE",1284,CDM,300,RC,82570,HCPCS,outpatient,,,63.48,47.61,,57.13,90,,,percent of total billed charges,90% of total billed charges,59.04,93,,,percent of total billed charges,93% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,53.96,85,,,percent of total billed charges,85% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,51.67,81.4,,,percent of total billed charges,81.4% of total billed charges,57.13,90,,,percent of total billed charges,90% of total billed charges,57.13,90,,,percent of total billed charges,90% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,24.12,38,,,percent of total billed charges,38% of total billed charges,47.61,75,,,percent of total billed charges,75% of total billed charges,53.96,85,,,percent of total billed charges,85% of total billed charges,24.12,59.04,
Creatinine Clearance,1285,CDM,300,RC,82575,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
Cryoglobulin AB QL Analysis,1286,CDM,300,RC,82595,HCPCS,outpatient,,,69.14,51.86,,62.23,90,,,percent of total billed charges,90% of total billed charges,64.3,93,,,percent of total billed charges,93% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,58.77,85,,,percent of total billed charges,85% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,56.28,81.4,,,percent of total billed charges,81.4% of total billed charges,62.23,90,,,percent of total billed charges,90% of total billed charges,62.23,90,,,percent of total billed charges,90% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,51.86,75,,,percent of total billed charges,75% of total billed charges,58.77,85,,,percent of total billed charges,85% of total billed charges,26.27,64.3,
cryoglobulin %Cryocrit-serum,1287,CDM,300,RC,82595,HCPCS,outpatient,,,107.1,80.33,,96.39,90,,,percent of total billed charges,90% of total billed charges,99.6,93,,,percent of total billed charges,93% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,87.18,81.4,,,percent of total billed charges,81.4% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,80.33,75,,,percent of total billed charges,75% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,40.7,99.6,
**DO NOT Vitamin B12 Serum,1288,CDM,300,RC,82607,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
(Result) Vitamin B12 Serum,1289,CDM,300,RC,82607,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Vitamin B12 (COBALAMIN) Serum,1290,CDM,300,RC,82607,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
cystatin C,1291,CDM,300,RC,82610,HCPCS,outpatient,,,170,127.5,,153,90,,,percent of total billed charges,90% of total billed charges,158.1,93,,,percent of total billed charges,93% of total billed charges,64.6,38,,,percent of total billed charges,38% of total billed charges,64.6,38,,,percent of total billed charges,38% of total billed charges,144.5,85,,,percent of total billed charges,85% of total billed charges,64.6,38,,,percent of total billed charges,38% of total billed charges,138.38,81.4,,,percent of total billed charges,81.4% of total billed charges,153,90,,,percent of total billed charges,90% of total billed charges,153,90,,,percent of total billed charges,90% of total billed charges,64.6,38,,,percent of total billed charges,38% of total billed charges,64.6,38,,,percent of total billed charges,38% of total billed charges,64.6,38,,,percent of total billed charges,38% of total billed charges,127.5,75,,,percent of total billed charges,75% of total billed charges,144.5,85,,,percent of total billed charges,85% of total billed charges,64.6,158.1,
"DHEA, Unconjugated",1292,CDM,300,RC,82626,HCPCS,outpatient,,,298.53,223.9,,268.68,90,,,percent of total billed charges,90% of total billed charges,277.63,93,,,percent of total billed charges,93% of total billed charges,113.44,38,,,percent of total billed charges,38% of total billed charges,113.44,38,,,percent of total billed charges,38% of total billed charges,253.75,85,,,percent of total billed charges,85% of total billed charges,113.44,38,,,percent of total billed charges,38% of total billed charges,243,81.4,,,percent of total billed charges,81.4% of total billed charges,268.68,90,,,percent of total billed charges,90% of total billed charges,268.68,90,,,percent of total billed charges,90% of total billed charges,113.44,38,,,percent of total billed charges,38% of total billed charges,113.44,38,,,percent of total billed charges,38% of total billed charges,113.44,38,,,percent of total billed charges,38% of total billed charges,223.9,75,,,percent of total billed charges,75% of total billed charges,253.75,85,,,percent of total billed charges,85% of total billed charges,113.44,277.63,
DHEA SULFATE,1293,CDM,300,RC,82627,HCPCS,outpatient,,,225,168.75,,202.5,90,,,percent of total billed charges,90% of total billed charges,209.25,93,,,percent of total billed charges,93% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,183.15,81.4,,,percent of total billed charges,81.4% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,168.75,75,,,percent of total billed charges,75% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,209.25,
Deoxycorticosterone,1294,CDM,300,RC,82633,HCPCS,outpatient,,,276,207,,248.4,90,,,percent of total billed charges,90% of total billed charges,256.68,93,,,percent of total billed charges,93% of total billed charges,104.88,38,,,percent of total billed charges,38% of total billed charges,104.88,38,,,percent of total billed charges,38% of total billed charges,234.6,85,,,percent of total billed charges,85% of total billed charges,104.88,38,,,percent of total billed charges,38% of total billed charges,224.66,81.4,,,percent of total billed charges,81.4% of total billed charges,248.4,90,,,percent of total billed charges,90% of total billed charges,248.4,90,,,percent of total billed charges,90% of total billed charges,104.88,38,,,percent of total billed charges,38% of total billed charges,104.88,38,,,percent of total billed charges,38% of total billed charges,104.88,38,,,percent of total billed charges,38% of total billed charges,207,75,,,percent of total billed charges,75% of total billed charges,234.6,85,,,percent of total billed charges,85% of total billed charges,104.88,256.68,
Dihydrotestosterone,1295,CDM,300,RC,82642,HCPCS,outpatient,,,239.06,179.3,,215.15,90,,,percent of total billed charges,90% of total billed charges,222.33,93,,,percent of total billed charges,93% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,203.2,85,,,percent of total billed charges,85% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,194.59,81.4,,,percent of total billed charges,81.4% of total billed charges,215.15,90,,,percent of total billed charges,90% of total billed charges,215.15,90,,,percent of total billed charges,90% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,179.3,75,,,percent of total billed charges,75% of total billed charges,203.2,85,,,percent of total billed charges,85% of total billed charges,90.84,222.33,
"Hydrocodone and Metabolites, Serum",1296,CDM,300,RC,82646,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
"(Result) Hydrocodone, Free",1297,CDM,300,RC,82646,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(Result) Hydromorphone, Free",1298,CDM,300,RC,82646,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"VITAMIN D, 1,25 DIHYDROXY",1299,CDM,300,RC,82652,HCPCS,outpatient,,,435.91,326.93,,392.32,90,,,percent of total billed charges,90% of total billed charges,405.4,93,,,percent of total billed charges,93% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,354.83,81.4,,,percent of total billed charges,81.4% of total billed charges,392.32,90,,,percent of total billed charges,90% of total billed charges,392.32,90,,,percent of total billed charges,90% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,326.93,75,,,percent of total billed charges,75% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,165.65,405.4,
Pancreatic Elastase-1,1300,CDM,300,RC,82653,HCPCS,outpatient,,,365.46,274.1,,328.91,90,,,percent of total billed charges,90% of total billed charges,339.88,93,,,percent of total billed charges,93% of total billed charges,138.87,38,,,percent of total billed charges,38% of total billed charges,138.87,38,,,percent of total billed charges,38% of total billed charges,310.64,85,,,percent of total billed charges,85% of total billed charges,138.87,38,,,percent of total billed charges,38% of total billed charges,297.48,81.4,,,percent of total billed charges,81.4% of total billed charges,328.91,90,,,percent of total billed charges,90% of total billed charges,328.91,90,,,percent of total billed charges,90% of total billed charges,138.87,38,,,percent of total billed charges,38% of total billed charges,138.87,38,,,percent of total billed charges,38% of total billed charges,138.87,38,,,percent of total billed charges,38% of total billed charges,274.1,75,,,percent of total billed charges,75% of total billed charges,310.64,85,,,percent of total billed charges,85% of total billed charges,138.87,339.88,
TPMT Activity,1301,CDM,300,RC,82657,HCPCS,outpatient,,,536.01,402.01,,482.41,90,,,percent of total billed charges,90% of total billed charges,498.49,93,,,percent of total billed charges,93% of total billed charges,203.68,38,,,percent of total billed charges,38% of total billed charges,203.68,38,,,percent of total billed charges,38% of total billed charges,455.61,85,,,percent of total billed charges,85% of total billed charges,203.68,38,,,percent of total billed charges,38% of total billed charges,436.31,81.4,,,percent of total billed charges,81.4% of total billed charges,482.41,90,,,percent of total billed charges,90% of total billed charges,482.41,90,,,percent of total billed charges,90% of total billed charges,203.68,38,,,percent of total billed charges,38% of total billed charges,203.68,38,,,percent of total billed charges,38% of total billed charges,203.68,38,,,percent of total billed charges,38% of total billed charges,402.01,75,,,percent of total billed charges,75% of total billed charges,455.61,85,,,percent of total billed charges,85% of total billed charges,203.68,498.49,
Erythropoietin level,1302,CDM,300,RC,82668,HCPCS,outpatient,,,208.83,156.62,,187.95,90,,,percent of total billed charges,90% of total billed charges,194.21,93,,,percent of total billed charges,93% of total billed charges,79.36,38,,,percent of total billed charges,38% of total billed charges,79.36,38,,,percent of total billed charges,38% of total billed charges,177.51,85,,,percent of total billed charges,85% of total billed charges,79.36,38,,,percent of total billed charges,38% of total billed charges,169.99,81.4,,,percent of total billed charges,81.4% of total billed charges,187.95,90,,,percent of total billed charges,90% of total billed charges,187.95,90,,,percent of total billed charges,90% of total billed charges,79.36,38,,,percent of total billed charges,38% of total billed charges,79.36,38,,,percent of total billed charges,38% of total billed charges,79.36,38,,,percent of total billed charges,38% of total billed charges,156.62,75,,,percent of total billed charges,75% of total billed charges,177.51,85,,,percent of total billed charges,85% of total billed charges,79.36,194.21,
Estradiol,1303,CDM,300,RC,82670,HCPCS,outpatient,,,131.24,98.43,,118.12,90,,,percent of total billed charges,90% of total billed charges,122.05,93,,,percent of total billed charges,93% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,111.55,85,,,percent of total billed charges,85% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,106.83,81.4,,,percent of total billed charges,81.4% of total billed charges,118.12,90,,,percent of total billed charges,90% of total billed charges,118.12,90,,,percent of total billed charges,90% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,98.43,75,,,percent of total billed charges,75% of total billed charges,111.55,85,,,percent of total billed charges,85% of total billed charges,49.87,122.05,
Estradiol Free,1304,CDM,300,RC,82670,HCPCS,outpatient,,,283.57,212.68,,255.21,90,,,percent of total billed charges,90% of total billed charges,263.72,93,,,percent of total billed charges,93% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,241.03,85,,,percent of total billed charges,85% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,230.83,81.4,,,percent of total billed charges,81.4% of total billed charges,255.21,90,,,percent of total billed charges,90% of total billed charges,255.21,90,,,percent of total billed charges,90% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,212.68,75,,,percent of total billed charges,75% of total billed charges,241.03,85,,,percent of total billed charges,85% of total billed charges,107.76,263.72,
Estradiol Ultrasensitive,1305,CDM,300,RC,82670,HCPCS,outpatient,,,251.13,188.35,,226.02,90,,,percent of total billed charges,90% of total billed charges,233.55,93,,,percent of total billed charges,93% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,213.46,85,,,percent of total billed charges,85% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,204.42,81.4,,,percent of total billed charges,81.4% of total billed charges,226.02,90,,,percent of total billed charges,90% of total billed charges,226.02,90,,,percent of total billed charges,90% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,95.43,38,,,percent of total billed charges,38% of total billed charges,188.35,75,,,percent of total billed charges,75% of total billed charges,213.46,85,,,percent of total billed charges,85% of total billed charges,95.43,233.55,
"Estrogens, Fractionated, LC/MS",1306,CDM,300,RC,82671,HCPCS,outpatient,,,636.81,477.61,,573.13,90,,,percent of total billed charges,90% of total billed charges,592.23,93,,,percent of total billed charges,93% of total billed charges,241.99,38,,,percent of total billed charges,38% of total billed charges,241.99,38,,,percent of total billed charges,38% of total billed charges,541.29,85,,,percent of total billed charges,85% of total billed charges,241.99,38,,,percent of total billed charges,38% of total billed charges,518.36,81.4,,,percent of total billed charges,81.4% of total billed charges,573.13,90,,,percent of total billed charges,90% of total billed charges,573.13,90,,,percent of total billed charges,90% of total billed charges,241.99,38,,,percent of total billed charges,38% of total billed charges,241.99,38,,,percent of total billed charges,38% of total billed charges,241.99,38,,,percent of total billed charges,38% of total billed charges,477.61,75,,,percent of total billed charges,75% of total billed charges,541.29,85,,,percent of total billed charges,85% of total billed charges,241.99,592.23,
"ESTROGEN, TOTAL, SERUM",1307,CDM,300,RC,82672,HCPCS,outpatient,,,180.45,135.34,,162.41,90,,,percent of total billed charges,90% of total billed charges,167.82,93,,,percent of total billed charges,93% of total billed charges,68.57,38,,,percent of total billed charges,38% of total billed charges,68.57,38,,,percent of total billed charges,38% of total billed charges,153.38,85,,,percent of total billed charges,85% of total billed charges,68.57,38,,,percent of total billed charges,38% of total billed charges,146.89,81.4,,,percent of total billed charges,81.4% of total billed charges,162.41,90,,,percent of total billed charges,90% of total billed charges,162.41,90,,,percent of total billed charges,90% of total billed charges,68.57,38,,,percent of total billed charges,38% of total billed charges,68.57,38,,,percent of total billed charges,38% of total billed charges,68.57,38,,,percent of total billed charges,38% of total billed charges,135.34,75,,,percent of total billed charges,75% of total billed charges,153.38,85,,,percent of total billed charges,85% of total billed charges,68.57,167.82,
"Estriol, Serum",1308,CDM,300,RC,82677,HCPCS,outpatient,,,164.53,123.4,,148.08,90,,,percent of total billed charges,90% of total billed charges,153.01,93,,,percent of total billed charges,93% of total billed charges,62.52,38,,,percent of total billed charges,38% of total billed charges,62.52,38,,,percent of total billed charges,38% of total billed charges,139.85,85,,,percent of total billed charges,85% of total billed charges,62.52,38,,,percent of total billed charges,38% of total billed charges,133.93,81.4,,,percent of total billed charges,81.4% of total billed charges,148.08,90,,,percent of total billed charges,90% of total billed charges,148.08,90,,,percent of total billed charges,90% of total billed charges,62.52,38,,,percent of total billed charges,38% of total billed charges,62.52,38,,,percent of total billed charges,38% of total billed charges,62.52,38,,,percent of total billed charges,38% of total billed charges,123.4,75,,,percent of total billed charges,75% of total billed charges,139.85,85,,,percent of total billed charges,85% of total billed charges,62.52,153.01,
Estrone,1309,CDM,300,RC,82679,HCPCS,outpatient,,,245.82,184.37,,221.24,90,,,percent of total billed charges,90% of total billed charges,228.61,93,,,percent of total billed charges,93% of total billed charges,93.41,38,,,percent of total billed charges,38% of total billed charges,93.41,38,,,percent of total billed charges,38% of total billed charges,208.95,85,,,percent of total billed charges,85% of total billed charges,93.41,38,,,percent of total billed charges,38% of total billed charges,200.1,81.4,,,percent of total billed charges,81.4% of total billed charges,221.24,90,,,percent of total billed charges,90% of total billed charges,221.24,90,,,percent of total billed charges,90% of total billed charges,93.41,38,,,percent of total billed charges,38% of total billed charges,93.41,38,,,percent of total billed charges,38% of total billed charges,93.41,38,,,percent of total billed charges,38% of total billed charges,184.37,75,,,percent of total billed charges,75% of total billed charges,208.95,85,,,percent of total billed charges,85% of total billed charges,93.41,228.61,
Vitamin B12 and Folate Panel,1310,CDM,300,RC,827,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"FECAL FAT, QUALITATIVE",1311,CDM,300,RC,82705,HCPCS,outpatient,,,71.47,53.6,,64.32,90,,,percent of total billed charges,90% of total billed charges,66.47,93,,,percent of total billed charges,93% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,58.18,81.4,,,percent of total billed charges,81.4% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,64.32,90,,,percent of total billed charges,90% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,27.16,38,,,percent of total billed charges,38% of total billed charges,53.6,75,,,percent of total billed charges,75% of total billed charges,60.75,85,,,percent of total billed charges,85% of total billed charges,27.16,66.47,
Ferritin,1313,CDM,300,RC,82728,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
"(Result) Ferritin, Serum",1314,CDM,300,RC,82728,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Ferritin (SLVRMC),1315,CDM,300,RC,82728,HCPCS,outpatient,,,127.35,95.51,,114.62,90,,,percent of total billed charges,90% of total billed charges,118.44,93,,,percent of total billed charges,93% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,108.25,85,,,percent of total billed charges,85% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,103.66,81.4,,,percent of total billed charges,81.4% of total billed charges,114.62,90,,,percent of total billed charges,90% of total billed charges,114.62,90,,,percent of total billed charges,90% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,48.39,38,,,percent of total billed charges,38% of total billed charges,95.51,75,,,percent of total billed charges,75% of total billed charges,108.25,85,,,percent of total billed charges,85% of total billed charges,48.39,118.44,
**DO NOT Folate,1316,CDM,300,RC,82746,HCPCS,outpatient,,,146.47,109.85,,131.82,90,,,percent of total billed charges,90% of total billed charges,136.22,93,,,percent of total billed charges,93% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,119.23,81.4,,,percent of total billed charges,81.4% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,109.85,75,,,percent of total billed charges,75% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,136.22,
(Result) Folate Serum,1317,CDM,300,RC,82746,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Folate (SLVRMC),1318,CDM,300,RC,82746,HCPCS,outpatient,,,132.65,99.49,,119.39,90,,,percent of total billed charges,90% of total billed charges,123.36,93,,,percent of total billed charges,93% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,112.75,85,,,percent of total billed charges,85% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,107.98,81.4,,,percent of total billed charges,81.4% of total billed charges,119.39,90,,,percent of total billed charges,90% of total billed charges,119.39,90,,,percent of total billed charges,90% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,99.49,75,,,percent of total billed charges,75% of total billed charges,112.75,85,,,percent of total billed charges,85% of total billed charges,50.41,123.36,
"Folate, Serum",1319,CDM,300,RC,82746,HCPCS,outpatient,,,146.47,109.85,,131.82,90,,,percent of total billed charges,90% of total billed charges,136.22,93,,,percent of total billed charges,93% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,119.23,81.4,,,percent of total billed charges,81.4% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,109.85,75,,,percent of total billed charges,75% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,136.22,
Folate RBC,1320,CDM,300,RC,82747,HCPCS,outpatient,,,205.36,154.02,,184.82,90,,,percent of total billed charges,90% of total billed charges,190.98,93,,,percent of total billed charges,93% of total billed charges,78.04,38,,,percent of total billed charges,38% of total billed charges,78.04,38,,,percent of total billed charges,38% of total billed charges,174.56,85,,,percent of total billed charges,85% of total billed charges,78.04,38,,,percent of total billed charges,38% of total billed charges,167.16,81.4,,,percent of total billed charges,81.4% of total billed charges,184.82,90,,,percent of total billed charges,90% of total billed charges,184.82,90,,,percent of total billed charges,90% of total billed charges,78.04,38,,,percent of total billed charges,38% of total billed charges,78.04,38,,,percent of total billed charges,38% of total billed charges,78.04,38,,,percent of total billed charges,38% of total billed charges,154.02,75,,,percent of total billed charges,75% of total billed charges,174.56,85,,,percent of total billed charges,85% of total billed charges,78.04,190.98,
Galectin-3,1321,CDM,300,RC,82777,HCPCS,outpatient,,,87.68,65.76,,78.91,90,,,percent of total billed charges,90% of total billed charges,81.54,93,,,percent of total billed charges,93% of total billed charges,33.32,38,,,percent of total billed charges,38% of total billed charges,33.32,38,,,percent of total billed charges,38% of total billed charges,74.53,85,,,percent of total billed charges,85% of total billed charges,33.32,38,,,percent of total billed charges,38% of total billed charges,71.37,81.4,,,percent of total billed charges,81.4% of total billed charges,78.91,90,,,percent of total billed charges,90% of total billed charges,78.91,90,,,percent of total billed charges,90% of total billed charges,33.32,38,,,percent of total billed charges,38% of total billed charges,33.32,38,,,percent of total billed charges,38% of total billed charges,33.32,38,,,percent of total billed charges,38% of total billed charges,65.76,75,,,percent of total billed charges,75% of total billed charges,74.53,85,,,percent of total billed charges,85% of total billed charges,33.32,81.54,
Immunoglobulin A (IgA),1322,CDM,300,RC,82784,HCPCS,outpatient,,,77.73,58.3,,69.96,90,,,percent of total billed charges,90% of total billed charges,72.29,93,,,percent of total billed charges,93% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,63.27,81.4,,,percent of total billed charges,81.4% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,58.3,75,,,percent of total billed charges,75% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,72.29,
IgD,1323,CDM,300,RC,82784,HCPCS,outpatient,,,131.75,98.81,,118.58,90,,,percent of total billed charges,90% of total billed charges,122.53,93,,,percent of total billed charges,93% of total billed charges,50.07,38,,,percent of total billed charges,38% of total billed charges,50.07,38,,,percent of total billed charges,38% of total billed charges,111.99,85,,,percent of total billed charges,85% of total billed charges,50.07,38,,,percent of total billed charges,38% of total billed charges,107.24,81.4,,,percent of total billed charges,81.4% of total billed charges,118.58,90,,,percent of total billed charges,90% of total billed charges,118.58,90,,,percent of total billed charges,90% of total billed charges,50.07,38,,,percent of total billed charges,38% of total billed charges,50.07,38,,,percent of total billed charges,38% of total billed charges,50.07,38,,,percent of total billed charges,38% of total billed charges,98.81,75,,,percent of total billed charges,75% of total billed charges,111.99,85,,,percent of total billed charges,85% of total billed charges,50.07,122.53,
Immunoglobulin M (IgM),1324,CDM,300,RC,82784,HCPCS,outpatient,,,77.73,58.3,,69.96,90,,,percent of total billed charges,90% of total billed charges,72.29,93,,,percent of total billed charges,93% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,63.27,81.4,,,percent of total billed charges,81.4% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,58.3,75,,,percent of total billed charges,75% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,72.29,
"(RES) IMMUNOGLOBULIN G, (Serum)",1325,CDM,300,RC,82784,HCPCS,outpatient,,,78.03,58.52,,70.23,90,,,percent of total billed charges,90% of total billed charges,72.57,93,,,percent of total billed charges,93% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,66.33,85,,,percent of total billed charges,85% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,63.52,81.4,,,percent of total billed charges,81.4% of total billed charges,70.23,90,,,percent of total billed charges,90% of total billed charges,70.23,90,,,percent of total billed charges,90% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,58.52,75,,,percent of total billed charges,75% of total billed charges,66.33,85,,,percent of total billed charges,85% of total billed charges,29.65,72.57,
(RES) IMMUNOGLOBULIN A,1326,CDM,300,RC,82784,HCPCS,outpatient,,,77.73,58.3,,69.96,90,,,percent of total billed charges,90% of total billed charges,72.29,93,,,percent of total billed charges,93% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,63.27,81.4,,,percent of total billed charges,81.4% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,58.3,75,,,percent of total billed charges,75% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,72.29,
Immunoglobulin G (IgG),1327,CDM,300,RC,82784,HCPCS,outpatient,,,77.73,58.3,,69.96,90,,,percent of total billed charges,90% of total billed charges,72.29,93,,,percent of total billed charges,93% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,63.27,81.4,,,percent of total billed charges,81.4% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,58.3,75,,,percent of total billed charges,75% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,72.29,
(RES) IMMUNOGLOBULIN M,1328,CDM,300,RC,82784,HCPCS,outpatient,,,77.73,58.3,,69.96,90,,,percent of total billed charges,90% of total billed charges,72.29,93,,,percent of total billed charges,93% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,63.27,81.4,,,percent of total billed charges,81.4% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,58.3,75,,,percent of total billed charges,75% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,72.29,
(RES) IMMUNOGLOBULIN G,1329,CDM,300,RC,82784,HCPCS,outpatient,,,77.73,58.3,,69.96,90,,,percent of total billed charges,90% of total billed charges,72.29,93,,,percent of total billed charges,93% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,63.27,81.4,,,percent of total billed charges,81.4% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,69.96,90,,,percent of total billed charges,90% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,29.54,38,,,percent of total billed charges,38% of total billed charges,58.3,75,,,percent of total billed charges,75% of total billed charges,66.07,85,,,percent of total billed charges,85% of total billed charges,29.54,72.29,
"IgE, Serum",1330,CDM,300,RC,82785,HCPCS,outpatient,,,103.12,77.34,,92.81,90,,,percent of total billed charges,90% of total billed charges,95.9,93,,,percent of total billed charges,93% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,83.94,81.4,,,percent of total billed charges,81.4% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,77.34,75,,,percent of total billed charges,75% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,95.9,
IgE,1331,CDM,300,RC,82785,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) IMMUNOGLOBULIN G SUBCLASS 1,1332,CDM,300,RC,82787,HCPCS,outpatient,,,90.84,68.13,,81.76,90,,,percent of total billed charges,90% of total billed charges,84.48,93,,,percent of total billed charges,93% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,77.21,85,,,percent of total billed charges,85% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,73.94,81.4,,,percent of total billed charges,81.4% of total billed charges,81.76,90,,,percent of total billed charges,90% of total billed charges,81.76,90,,,percent of total billed charges,90% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,68.13,75,,,percent of total billed charges,75% of total billed charges,77.21,85,,,percent of total billed charges,85% of total billed charges,34.52,84.48,
(RES) IMMUNOGLOBULIN G SUBCLASS 2,1333,CDM,300,RC,82787,HCPCS,outpatient,,,90.84,68.13,,81.76,90,,,percent of total billed charges,90% of total billed charges,84.48,93,,,percent of total billed charges,93% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,77.21,85,,,percent of total billed charges,85% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,73.94,81.4,,,percent of total billed charges,81.4% of total billed charges,81.76,90,,,percent of total billed charges,90% of total billed charges,81.76,90,,,percent of total billed charges,90% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,68.13,75,,,percent of total billed charges,75% of total billed charges,77.21,85,,,percent of total billed charges,85% of total billed charges,34.52,84.48,
(RES) IMMUNOGLOBULIN G SUBCLASS 3,1334,CDM,300,RC,82787,HCPCS,outpatient,,,90.84,68.13,,81.76,90,,,percent of total billed charges,90% of total billed charges,84.48,93,,,percent of total billed charges,93% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,77.21,85,,,percent of total billed charges,85% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,73.94,81.4,,,percent of total billed charges,81.4% of total billed charges,81.76,90,,,percent of total billed charges,90% of total billed charges,81.76,90,,,percent of total billed charges,90% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,68.13,75,,,percent of total billed charges,75% of total billed charges,77.21,85,,,percent of total billed charges,85% of total billed charges,34.52,84.48,
(RES) IMMUNOGLOBULIN G SUBCLASS 4,1335,CDM,300,RC,82787,HCPCS,outpatient,,,90.84,68.13,,81.76,90,,,percent of total billed charges,90% of total billed charges,84.48,93,,,percent of total billed charges,93% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,77.21,85,,,percent of total billed charges,85% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,73.94,81.4,,,percent of total billed charges,81.4% of total billed charges,81.76,90,,,percent of total billed charges,90% of total billed charges,81.76,90,,,percent of total billed charges,90% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,34.52,38,,,percent of total billed charges,38% of total billed charges,68.13,75,,,percent of total billed charges,75% of total billed charges,77.21,85,,,percent of total billed charges,85% of total billed charges,34.52,84.48,
VBG (venous blood gases),1336,CDM,300,RC,82803,HCPCS,outpatient,,,111.33,83.5,,100.2,90,,,percent of total billed charges,90% of total billed charges,103.54,93,,,percent of total billed charges,93% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,94.63,85,,,percent of total billed charges,85% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,90.62,81.4,,,percent of total billed charges,81.4% of total billed charges,100.2,90,,,percent of total billed charges,90% of total billed charges,100.2,90,,,percent of total billed charges,90% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,83.5,75,,,percent of total billed charges,75% of total billed charges,94.63,85,,,percent of total billed charges,85% of total billed charges,42.31,103.54,
TCO2,1337,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VBG-pH,1338,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VBG-pCO2,1339,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VBG-pO2,1340,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VBG-Base Excess,1341,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VBG-HCO3,1342,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VBG-TCO2,1343,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VBG-O2 Saturation,1344,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VBG - iSTAT,1345,CDM,300,RC,82803,HCPCS,outpatient,,,114.44,85.83,,103,90,,,percent of total billed charges,90% of total billed charges,106.43,93,,,percent of total billed charges,93% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,97.27,85,,,percent of total billed charges,85% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,93.15,81.4,,,percent of total billed charges,81.4% of total billed charges,103,90,,,percent of total billed charges,90% of total billed charges,103,90,,,percent of total billed charges,90% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,85.83,75,,,percent of total billed charges,75% of total billed charges,97.27,85,,,percent of total billed charges,85% of total billed charges,43.49,106.43,
V-BE,1346,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
V-HCO3,1347,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
V-pO2,1348,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
V-pH,1349,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
V-pCO2,1350,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
V-02SAT,1351,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
V-Total CO2,1352,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
V-base excess,1353,CDM,300,RC,82803,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG,1354,CDM,300,RC,82805,HCPCS,outpatient,,,335.13,251.35,,301.62,90,,,percent of total billed charges,90% of total billed charges,311.67,93,,,percent of total billed charges,93% of total billed charges,127.35,38,,,percent of total billed charges,38% of total billed charges,127.35,38,,,percent of total billed charges,38% of total billed charges,284.86,85,,,percent of total billed charges,85% of total billed charges,127.35,38,,,percent of total billed charges,38% of total billed charges,272.8,81.4,,,percent of total billed charges,81.4% of total billed charges,301.62,90,,,percent of total billed charges,90% of total billed charges,301.62,90,,,percent of total billed charges,90% of total billed charges,127.35,38,,,percent of total billed charges,38% of total billed charges,127.35,38,,,percent of total billed charges,38% of total billed charges,127.35,38,,,percent of total billed charges,38% of total billed charges,251.35,75,,,percent of total billed charges,75% of total billed charges,284.86,85,,,percent of total billed charges,85% of total billed charges,127.35,311.67,
BICARBONATE,1355,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Allens Test,1356,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG-Base Excess,1357,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG-HCO3,1358,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG-O2 Saturation,1359,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG-pCO2,1360,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG-pH,1361,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG-pO2,1362,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG-TCO2,1363,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG - iSTAT,1364,CDM,300,RC,82805,HCPCS,outpatient,,,114.44,85.83,,103,90,,,percent of total billed charges,90% of total billed charges,106.43,93,,,percent of total billed charges,93% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,97.27,85,,,percent of total billed charges,85% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,93.15,81.4,,,percent of total billed charges,81.4% of total billed charges,103,90,,,percent of total billed charges,90% of total billed charges,103,90,,,percent of total billed charges,90% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,85.83,75,,,percent of total billed charges,75% of total billed charges,97.27,85,,,percent of total billed charges,85% of total billed charges,43.49,106.43,
BASE EXCESS,1365,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
#NAME?,1366,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
pCO2,1367,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PH,1368,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
pO2,1369,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ABG Draw Site,1370,CDM,300,RC,82805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Gastrin,1371,CDM,300,RC,82941,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
Glucagon,1372,CDM,300,RC,82943,HCPCS,outpatient,,,189.87,142.4,,170.88,90,,,percent of total billed charges,90% of total billed charges,176.58,93,,,percent of total billed charges,93% of total billed charges,72.15,38,,,percent of total billed charges,38% of total billed charges,72.15,38,,,percent of total billed charges,38% of total billed charges,161.39,85,,,percent of total billed charges,85% of total billed charges,72.15,38,,,percent of total billed charges,38% of total billed charges,154.55,81.4,,,percent of total billed charges,81.4% of total billed charges,170.88,90,,,percent of total billed charges,90% of total billed charges,170.88,90,,,percent of total billed charges,90% of total billed charges,72.15,38,,,percent of total billed charges,38% of total billed charges,72.15,38,,,percent of total billed charges,38% of total billed charges,72.15,38,,,percent of total billed charges,38% of total billed charges,142.4,75,,,percent of total billed charges,75% of total billed charges,161.39,85,,,percent of total billed charges,85% of total billed charges,72.15,176.58,
"Glucose, random urine",1373,CDM,300,RC,82945,HCPCS,outpatient,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
Synovial Fluid Analysis(Quest),1374,CDM,300,RC,82945,HCPCS,outpatient,,,603.46,452.6,,543.11,90,,,percent of total billed charges,90% of total billed charges,561.22,93,,,percent of total billed charges,93% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,512.94,85,,,percent of total billed charges,85% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,491.22,81.4,,,percent of total billed charges,81.4% of total billed charges,543.11,90,,,percent of total billed charges,90% of total billed charges,543.11,90,,,percent of total billed charges,90% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,229.31,38,,,percent of total billed charges,38% of total billed charges,452.6,75,,,percent of total billed charges,75% of total billed charges,512.94,85,,,percent of total billed charges,85% of total billed charges,229.31,561.22,
"Glucose, CSF",1375,CDM,300,RC,82945,HCPCS,outpatient,,,45.95,34.46,,41.36,90,,,percent of total billed charges,90% of total billed charges,42.73,93,,,percent of total billed charges,93% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,39.06,85,,,percent of total billed charges,85% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,37.4,81.4,,,percent of total billed charges,81.4% of total billed charges,41.36,90,,,percent of total billed charges,90% of total billed charges,41.36,90,,,percent of total billed charges,90% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,34.46,75,,,percent of total billed charges,75% of total billed charges,39.06,85,,,percent of total billed charges,85% of total billed charges,17.46,42.73,
"Fluid Glucose, Alamosa",1376,CDM,300,RC,82945,HCPCS,outpatient,,,67.29,50.47,,60.56,90,,,percent of total billed charges,90% of total billed charges,62.58,93,,,percent of total billed charges,93% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,57.2,85,,,percent of total billed charges,85% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,54.77,81.4,,,percent of total billed charges,81.4% of total billed charges,60.56,90,,,percent of total billed charges,90% of total billed charges,60.56,90,,,percent of total billed charges,90% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,50.47,75,,,percent of total billed charges,75% of total billed charges,57.2,85,,,percent of total billed charges,85% of total billed charges,25.57,62.58,
Glucose,1377,CDM,300,RC,82947,HCPCS,outpatient,,,31.63,23.72,,28.47,90,,,percent of total billed charges,90% of total billed charges,29.42,93,,,percent of total billed charges,93% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,26.89,85,,,percent of total billed charges,85% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,25.75,81.4,,,percent of total billed charges,81.4% of total billed charges,28.47,90,,,percent of total billed charges,90% of total billed charges,28.47,90,,,percent of total billed charges,90% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,23.72,75,,,percent of total billed charges,75% of total billed charges,26.89,85,,,percent of total billed charges,85% of total billed charges,12.02,29.42,
Glucose 1 hr pp,1378,CDM,300,RC,82950,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
(result) GTT - 1 Hour pp,1379,CDM,300,RC,82951,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
GTT - 2 HR. (3 specs.)[Panel],1380,CDM,300,RC,82951,HCPCS,outpatient,,,110.4,82.8,,99.36,90,,,percent of total billed charges,90% of total billed charges,102.67,93,,,percent of total billed charges,93% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,89.87,81.4,,,percent of total billed charges,81.4% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,82.8,75,,,percent of total billed charges,75% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,102.67,
(result) GTT - 2 Hour pp,1381,CDM,300,RC,82951,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) Fasting Glucose (FBS),1382,CDM,300,RC,82951,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
GTT 3 Hr. - each addtl. (4 specs.),1383,CDM,300,RC,82952,HCPCS,outpatient,,,26.96,20.22,,24.26,90,,,percent of total billed charges,90% of total billed charges,25.07,93,,,percent of total billed charges,93% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,21.95,81.4,,,percent of total billed charges,81.4% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,20.22,75,,,percent of total billed charges,75% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,25.07,
G-6-PD,1384,CDM,300,RC,82955,HCPCS,outpatient,,,113.69,85.27,,102.32,90,,,percent of total billed charges,90% of total billed charges,105.73,93,,,percent of total billed charges,93% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,96.64,85,,,percent of total billed charges,85% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,92.54,81.4,,,percent of total billed charges,81.4% of total billed charges,102.32,90,,,percent of total billed charges,90% of total billed charges,102.32,90,,,percent of total billed charges,90% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,85.27,75,,,percent of total billed charges,75% of total billed charges,96.64,85,,,percent of total billed charges,85% of total billed charges,43.2,105.73,
"Glucose, Whole Blood",1385,CDM,300,RC,82962,HCPCS,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
Clinic FBS0 Fingerstick Blood Sugar,1386,CDM,300,RC,82962,HCPCS,outpatient,,,10.54,7.91,,9.49,90,,,percent of total billed charges,90% of total billed charges,9.8,93,,,percent of total billed charges,93% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.58,81.4,,,percent of total billed charges,81.4% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,7.91,75,,,percent of total billed charges,75% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,9.8,
GGTP (Gamma-glutamy transferase),1387,CDM,300,RC,82977,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Fructosamine,1388,CDM,300,RC,82985,HCPCS,outpatient,,,119.37,89.53,,107.43,90,,,percent of total billed charges,90% of total billed charges,111.01,93,,,percent of total billed charges,93% of total billed charges,45.36,38,,,percent of total billed charges,38% of total billed charges,45.36,38,,,percent of total billed charges,38% of total billed charges,101.46,85,,,percent of total billed charges,85% of total billed charges,45.36,38,,,percent of total billed charges,38% of total billed charges,97.17,81.4,,,percent of total billed charges,81.4% of total billed charges,107.43,90,,,percent of total billed charges,90% of total billed charges,107.43,90,,,percent of total billed charges,90% of total billed charges,45.36,38,,,percent of total billed charges,38% of total billed charges,45.36,38,,,percent of total billed charges,38% of total billed charges,45.36,38,,,percent of total billed charges,38% of total billed charges,89.53,75,,,percent of total billed charges,75% of total billed charges,101.46,85,,,percent of total billed charges,85% of total billed charges,45.36,111.01,
FSH,1389,CDM,300,RC,83001,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
FSH-PEDIATRICS,1390,CDM,300,RC,83001,HCPCS,outpatient,,,145.88,109.41,,131.29,90,,,percent of total billed charges,90% of total billed charges,135.67,93,,,percent of total billed charges,93% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,124,85,,,percent of total billed charges,85% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,118.75,81.4,,,percent of total billed charges,81.4% of total billed charges,131.29,90,,,percent of total billed charges,90% of total billed charges,131.29,90,,,percent of total billed charges,90% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,109.41,75,,,percent of total billed charges,75% of total billed charges,124,85,,,percent of total billed charges,85% of total billed charges,55.43,135.67,
LH,1391,CDM,300,RC,83002,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
LH Pediatric,1392,CDM,300,RC,83002,HCPCS,outpatient,,,145.88,109.41,,131.29,90,,,percent of total billed charges,90% of total billed charges,135.67,93,,,percent of total billed charges,93% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,124,85,,,percent of total billed charges,85% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,118.75,81.4,,,percent of total billed charges,81.4% of total billed charges,131.29,90,,,percent of total billed charges,90% of total billed charges,131.29,90,,,percent of total billed charges,90% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,55.43,38,,,percent of total billed charges,38% of total billed charges,109.41,75,,,percent of total billed charges,75% of total billed charges,124,85,,,percent of total billed charges,85% of total billed charges,55.43,135.67,
Growth Hormone,1393,CDM,300,RC,83003,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
Haptoglobin,1394,CDM,300,RC,83010,HCPCS,outpatient,,,113.69,85.27,,102.32,90,,,percent of total billed charges,90% of total billed charges,105.73,93,,,percent of total billed charges,93% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,96.64,85,,,percent of total billed charges,85% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,92.54,81.4,,,percent of total billed charges,81.4% of total billed charges,102.32,90,,,percent of total billed charges,90% of total billed charges,102.32,90,,,percent of total billed charges,90% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,43.2,38,,,percent of total billed charges,38% of total billed charges,85.27,75,,,percent of total billed charges,75% of total billed charges,96.64,85,,,percent of total billed charges,85% of total billed charges,43.2,105.73,
Urea breath test - H.pylori,1395,CDM,300,RC,83013,HCPCS,outpatient,,,255.45,191.59,,229.91,90,,,percent of total billed charges,90% of total billed charges,237.57,93,,,percent of total billed charges,93% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,217.13,85,,,percent of total billed charges,85% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,207.94,81.4,,,percent of total billed charges,81.4% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,191.59,75,,,percent of total billed charges,75% of total billed charges,217.13,85,,,percent of total billed charges,85% of total billed charges,97.07,237.57,
Urea Breath Test - H. Pylori - PEDIATRIC,1396,CDM,300,RC,83013,HCPCS,outpatient,,,255.45,191.59,,229.91,90,,,percent of total billed charges,90% of total billed charges,237.57,93,,,percent of total billed charges,93% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,217.13,85,,,percent of total billed charges,85% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,207.94,81.4,,,percent of total billed charges,81.4% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,191.59,75,,,percent of total billed charges,75% of total billed charges,217.13,85,,,percent of total billed charges,85% of total billed charges,97.07,237.57,
Cobalt,1397,CDM,300,RC,83018,HCPCS,outpatient,,,140.62,105.47,,126.56,90,,,percent of total billed charges,90% of total billed charges,130.78,93,,,percent of total billed charges,93% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,114.46,81.4,,,percent of total billed charges,81.4% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,105.47,75,,,percent of total billed charges,75% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,130.78,
(Result) Cobalt,1398,CDM,300,RC,83018,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Tin,1399,CDM,300,RC,83018,HCPCS,outpatient,,,165.21,123.91,,148.69,90,,,percent of total billed charges,90% of total billed charges,153.65,93,,,percent of total billed charges,93% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,134.48,81.4,,,percent of total billed charges,81.4% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,123.91,75,,,percent of total billed charges,75% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,153.65,
Platinum,1400,CDM,300,RC,83018,HCPCS,outpatient,,,202.73,152.05,,182.46,90,,,percent of total billed charges,90% of total billed charges,188.54,93,,,percent of total billed charges,93% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,172.32,85,,,percent of total billed charges,85% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,165.02,81.4,,,percent of total billed charges,81.4% of total billed charges,182.46,90,,,percent of total billed charges,90% of total billed charges,182.46,90,,,percent of total billed charges,90% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,152.05,75,,,percent of total billed charges,75% of total billed charges,172.32,85,,,percent of total billed charges,85% of total billed charges,77.04,188.54,
Thorium,1401,CDM,300,RC,83018,HCPCS,outpatient,,,260.13,195.1,,234.12,90,,,percent of total billed charges,90% of total billed charges,241.92,93,,,percent of total billed charges,93% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,211.75,81.4,,,percent of total billed charges,81.4% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,195.1,75,,,percent of total billed charges,75% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,241.92,
Uranium,1402,CDM,300,RC,83018,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,185.27,
Thal-hemoglobinopathy types,1403,CDM,300,RC,83021,HCPCS,outpatient,,,168.92,126.69,,152.03,90,,,percent of total billed charges,90% of total billed charges,157.1,93,,,percent of total billed charges,93% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,137.5,81.4,,,percent of total billed charges,81.4% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,126.69,75,,,percent of total billed charges,75% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,157.1,
Hemoglobin A1C,1404,CDM,300,RC,83036,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
Hemoglobin A1C,1405,CDM,300,RC,83036,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
Clinic Hemoglobin A1C whole blood,1406,CDM,300,RC,83037,HCPCS,outpatient,,,84.46,63.35,,76.01,90,,,percent of total billed charges,90% of total billed charges,78.55,93,,,percent of total billed charges,93% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,68.75,81.4,,,percent of total billed charges,81.4% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,63.35,75,,,percent of total billed charges,75% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,78.55,
Clinic Hemoglobin A1C whole blood,1407,CDM,300,RC,83037,HCPCS,outpatient,,,84.46,63.35,,76.01,90,,,percent of total billed charges,90% of total billed charges,78.55,93,,,percent of total billed charges,93% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,68.75,81.4,,,percent of total billed charges,81.4% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,63.35,75,,,percent of total billed charges,75% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,78.55,
Clinic Hemoglobin A1C whole blood,1408,CDM,300,RC,83037,HCPCS,outpatient,,,84.46,63.35,,76.01,90,,,percent of total billed charges,90% of total billed charges,78.55,93,,,percent of total billed charges,93% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,68.75,81.4,,,percent of total billed charges,81.4% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,63.35,75,,,percent of total billed charges,75% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,78.55,
(RES) Methemoglobin,1409,CDM,300,RC,83050,HCPCS,outpatient,,,109.32,81.99,,98.39,90,,,percent of total billed charges,90% of total billed charges,101.67,93,,,percent of total billed charges,93% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,92.92,85,,,percent of total billed charges,85% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,88.99,81.4,,,percent of total billed charges,81.4% of total billed charges,98.39,90,,,percent of total billed charges,90% of total billed charges,98.39,90,,,percent of total billed charges,90% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,81.99,75,,,percent of total billed charges,75% of total billed charges,92.92,85,,,percent of total billed charges,85% of total billed charges,41.54,101.67,
Histamine plasma,1410,CDM,300,RC,83088,HCPCS,outpatient,,,215.95,161.96,,194.36,90,,,percent of total billed charges,90% of total billed charges,200.83,93,,,percent of total billed charges,93% of total billed charges,82.06,38,,,percent of total billed charges,38% of total billed charges,82.06,38,,,percent of total billed charges,38% of total billed charges,183.56,85,,,percent of total billed charges,85% of total billed charges,82.06,38,,,percent of total billed charges,38% of total billed charges,175.78,81.4,,,percent of total billed charges,81.4% of total billed charges,194.36,90,,,percent of total billed charges,90% of total billed charges,194.36,90,,,percent of total billed charges,90% of total billed charges,82.06,38,,,percent of total billed charges,38% of total billed charges,82.06,38,,,percent of total billed charges,38% of total billed charges,82.06,38,,,percent of total billed charges,38% of total billed charges,161.96,75,,,percent of total billed charges,75% of total billed charges,183.56,85,,,percent of total billed charges,85% of total billed charges,82.06,200.83,
Homocysteine,1411,CDM,300,RC,83090,HCPCS,outpatient,,,255.45,191.59,,229.91,90,,,percent of total billed charges,90% of total billed charges,237.57,93,,,percent of total billed charges,93% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,217.13,85,,,percent of total billed charges,85% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,207.94,81.4,,,percent of total billed charges,81.4% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,191.59,75,,,percent of total billed charges,75% of total billed charges,217.13,85,,,percent of total billed charges,85% of total billed charges,97.07,237.57,
"(Result) Homocysteine, Cardio",1412,CDM,300,RC,83090,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Barium,1413,CDM,300,RC,83118,HCPCS,outpatient,,,214.42,160.82,,192.98,90,,,percent of total billed charges,90% of total billed charges,199.41,93,,,percent of total billed charges,93% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,182.26,85,,,percent of total billed charges,85% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,174.54,81.4,,,percent of total billed charges,81.4% of total billed charges,192.98,90,,,percent of total billed charges,90% of total billed charges,192.98,90,,,percent of total billed charges,90% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,81.48,38,,,percent of total billed charges,38% of total billed charges,160.82,75,,,percent of total billed charges,75% of total billed charges,182.26,85,,,percent of total billed charges,85% of total billed charges,81.48,199.41,
**Cardio IQ iLipid panel-HDL,1414,CDM,300,RC,83465,HCPCS,outpatient,,,43.66,32.75,,39.29,90,,,percent of total billed charges,90% of total billed charges,40.6,93,,,percent of total billed charges,93% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,37.11,85,,,percent of total billed charges,85% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,35.54,81.4,,,percent of total billed charges,81.4% of total billed charges,39.29,90,,,percent of total billed charges,90% of total billed charges,39.29,90,,,percent of total billed charges,90% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,32.75,75,,,percent of total billed charges,75% of total billed charges,37.11,85,,,percent of total billed charges,85% of total billed charges,16.59,40.6,
17 OH Cortocosteroid urine  24 results,1415,CDM,300,RC,83491,HCPCS,outpatient,,,139.21,104.41,,125.29,90,,,percent of total billed charges,90% of total billed charges,129.47,93,,,percent of total billed charges,93% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,118.33,85,,,percent of total billed charges,85% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,113.32,81.4,,,percent of total billed charges,81.4% of total billed charges,125.29,90,,,percent of total billed charges,90% of total billed charges,125.29,90,,,percent of total billed charges,90% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,104.41,75,,,percent of total billed charges,75% of total billed charges,118.33,85,,,percent of total billed charges,85% of total billed charges,52.9,129.47,
"(RES) 5-HIAA, URINE",1416,CDM,300,RC,83497,HCPCS,outpatient,,,123.39,92.54,,111.05,90,,,percent of total billed charges,90% of total billed charges,114.75,93,,,percent of total billed charges,93% of total billed charges,46.89,38,,,percent of total billed charges,38% of total billed charges,46.89,38,,,percent of total billed charges,38% of total billed charges,104.88,85,,,percent of total billed charges,85% of total billed charges,46.89,38,,,percent of total billed charges,38% of total billed charges,100.44,81.4,,,percent of total billed charges,81.4% of total billed charges,111.05,90,,,percent of total billed charges,90% of total billed charges,111.05,90,,,percent of total billed charges,90% of total billed charges,46.89,38,,,percent of total billed charges,38% of total billed charges,46.89,38,,,percent of total billed charges,38% of total billed charges,46.89,38,,,percent of total billed charges,38% of total billed charges,92.54,75,,,percent of total billed charges,75% of total billed charges,104.88,85,,,percent of total billed charges,85% of total billed charges,46.89,114.75,
(RES) PHOSPHATIDYLSERINE/ PROTHROMBIN AB (IGG),1417,CDM,300,RC,83516,HCPCS,outpatient,,,124.85,93.64,,112.37,90,,,percent of total billed charges,90% of total billed charges,116.11,93,,,percent of total billed charges,93% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,101.63,81.4,,,percent of total billed charges,81.4% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,93.64,75,,,percent of total billed charges,75% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,116.11,
(RES) PHOSPHATIDYLSERINE/ PROTHROMBIN AB (IGM),1418,CDM,300,RC,83516,HCPCS,outpatient,,,124.85,93.64,,112.37,90,,,percent of total billed charges,90% of total billed charges,116.11,93,,,percent of total billed charges,93% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,101.63,81.4,,,percent of total billed charges,81.4% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,112.37,90,,,percent of total billed charges,90% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,47.44,38,,,percent of total billed charges,38% of total billed charges,93.64,75,,,percent of total billed charges,75% of total billed charges,106.12,85,,,percent of total billed charges,85% of total billed charges,47.44,116.11,
Parietal Cell Ab,1419,CDM,300,RC,83516,HCPCS,outpatient,,,124.22,93.17,,111.8,90,,,percent of total billed charges,90% of total billed charges,115.52,93,,,percent of total billed charges,93% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,105.59,85,,,percent of total billed charges,85% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,101.12,81.4,,,percent of total billed charges,81.4% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,93.17,75,,,percent of total billed charges,75% of total billed charges,105.59,85,,,percent of total billed charges,85% of total billed charges,47.2,115.52,
ANA  Ribosomal P AB,1420,CDM,300,RC,83516,HCPCS,outpatient,,,142.95,107.21,,128.66,90,,,percent of total billed charges,90% of total billed charges,132.94,93,,,percent of total billed charges,93% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,116.36,81.4,,,percent of total billed charges,81.4% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,107.21,75,,,percent of total billed charges,75% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,132.94,
Myositis profile-PL 7 autoab,1421,CDM,300,RC,83516,HCPCS,outpatient,,,128.28,96.21,,115.45,90,,,percent of total billed charges,90% of total billed charges,119.3,93,,,percent of total billed charges,93% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,104.42,81.4,,,percent of total billed charges,81.4% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,96.21,75,,,percent of total billed charges,75% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,119.3,
Myositis profile Mi-2 autoab,1422,CDM,300,RC,83516,HCPCS,outpatient,,,196.46,147.35,,176.81,90,,,percent of total billed charges,90% of total billed charges,182.71,93,,,percent of total billed charges,93% of total billed charges,74.65,38,,,percent of total billed charges,38% of total billed charges,74.65,38,,,percent of total billed charges,38% of total billed charges,166.99,85,,,percent of total billed charges,85% of total billed charges,74.65,38,,,percent of total billed charges,38% of total billed charges,159.92,81.4,,,percent of total billed charges,81.4% of total billed charges,176.81,90,,,percent of total billed charges,90% of total billed charges,176.81,90,,,percent of total billed charges,90% of total billed charges,74.65,38,,,percent of total billed charges,38% of total billed charges,74.65,38,,,percent of total billed charges,38% of total billed charges,74.65,38,,,percent of total billed charges,38% of total billed charges,147.35,75,,,percent of total billed charges,75% of total billed charges,166.99,85,,,percent of total billed charges,85% of total billed charges,74.65,182.71,
Myositis profile Ku Autoab,1423,CDM,300,RC,83516,HCPCS,outpatient,,,128.28,96.21,,115.45,90,,,percent of total billed charges,90% of total billed charges,119.3,93,,,percent of total billed charges,93% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,104.42,81.4,,,percent of total billed charges,81.4% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,96.21,75,,,percent of total billed charges,75% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,119.3,
Myositis profile EJ autoab,1424,CDM,300,RC,83516,HCPCS,outpatient,,,128.28,96.21,,115.45,90,,,percent of total billed charges,90% of total billed charges,119.3,93,,,percent of total billed charges,93% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,104.42,81.4,,,percent of total billed charges,81.4% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,96.21,75,,,percent of total billed charges,75% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,119.3,
Histone Antibodies,1425,CDM,300,RC,83516,HCPCS,outpatient,,,136.71,102.53,,123.04,90,,,percent of total billed charges,90% of total billed charges,127.14,93,,,percent of total billed charges,93% of total billed charges,51.95,38,,,percent of total billed charges,38% of total billed charges,51.95,38,,,percent of total billed charges,38% of total billed charges,116.2,85,,,percent of total billed charges,85% of total billed charges,51.95,38,,,percent of total billed charges,38% of total billed charges,111.28,81.4,,,percent of total billed charges,81.4% of total billed charges,123.04,90,,,percent of total billed charges,90% of total billed charges,123.04,90,,,percent of total billed charges,90% of total billed charges,51.95,38,,,percent of total billed charges,38% of total billed charges,51.95,38,,,percent of total billed charges,38% of total billed charges,51.95,38,,,percent of total billed charges,38% of total billed charges,102.53,75,,,percent of total billed charges,75% of total billed charges,116.2,85,,,percent of total billed charges,85% of total billed charges,51.95,127.14,
(RES) VGKC Antibody Test,1426,CDM,300,RC,83519,HCPCS,outpatient,,,386.43,289.82,,347.79,90,,,percent of total billed charges,90% of total billed charges,359.38,93,,,percent of total billed charges,93% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,328.47,85,,,percent of total billed charges,85% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,314.55,81.4,,,percent of total billed charges,81.4% of total billed charges,347.79,90,,,percent of total billed charges,90% of total billed charges,347.79,90,,,percent of total billed charges,90% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,146.84,38,,,percent of total billed charges,38% of total billed charges,289.82,75,,,percent of total billed charges,75% of total billed charges,328.47,85,,,percent of total billed charges,85% of total billed charges,146.84,359.38,
Alpha Subunit,1427,CDM,300,RC,83519,HCPCS,outpatient,,,229.67,172.25,,206.7,90,,,percent of total billed charges,90% of total billed charges,213.59,93,,,percent of total billed charges,93% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,195.22,85,,,percent of total billed charges,85% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,186.95,81.4,,,percent of total billed charges,81.4% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,172.25,75,,,percent of total billed charges,75% of total billed charges,195.22,85,,,percent of total billed charges,85% of total billed charges,87.27,213.59,
MuSK AB test,1428,CDM,300,RC,83519,HCPCS,outpatient,,,1250.2,937.65,,1125.18,90,,,percent of total billed charges,90% of total billed charges,1162.69,93,,,percent of total billed charges,93% of total billed charges,475.08,38,,,percent of total billed charges,38% of total billed charges,475.08,38,,,percent of total billed charges,38% of total billed charges,1062.67,85,,,percent of total billed charges,85% of total billed charges,475.08,38,,,percent of total billed charges,38% of total billed charges,1017.66,81.4,,,percent of total billed charges,81.4% of total billed charges,1125.18,90,,,percent of total billed charges,90% of total billed charges,1125.18,90,,,percent of total billed charges,90% of total billed charges,475.08,38,,,percent of total billed charges,38% of total billed charges,475.08,38,,,percent of total billed charges,38% of total billed charges,475.08,38,,,percent of total billed charges,38% of total billed charges,937.65,75,,,percent of total billed charges,75% of total billed charges,1062.67,85,,,percent of total billed charges,85% of total billed charges,475.08,1162.69,
PTH-related Protein,1429,CDM,300,RC,83519,HCPCS,outpatient,,,333.35,250.01,,300.02,90,,,percent of total billed charges,90% of total billed charges,310.02,93,,,percent of total billed charges,93% of total billed charges,126.67,38,,,percent of total billed charges,38% of total billed charges,126.67,38,,,percent of total billed charges,38% of total billed charges,283.35,85,,,percent of total billed charges,85% of total billed charges,126.67,38,,,percent of total billed charges,38% of total billed charges,271.35,81.4,,,percent of total billed charges,81.4% of total billed charges,300.02,90,,,percent of total billed charges,90% of total billed charges,300.02,90,,,percent of total billed charges,90% of total billed charges,126.67,38,,,percent of total billed charges,38% of total billed charges,126.67,38,,,percent of total billed charges,38% of total billed charges,126.67,38,,,percent of total billed charges,38% of total billed charges,250.01,75,,,percent of total billed charges,75% of total billed charges,283.35,85,,,percent of total billed charges,85% of total billed charges,126.67,310.02,
Acetylcholine Receptor Binding Antibody,1430,CDM,300,RC,83519,HCPCS,outpatient,,,273.79,205.34,,246.41,90,,,percent of total billed charges,90% of total billed charges,254.62,93,,,percent of total billed charges,93% of total billed charges,104.04,38,,,percent of total billed charges,38% of total billed charges,104.04,38,,,percent of total billed charges,38% of total billed charges,232.72,85,,,percent of total billed charges,85% of total billed charges,104.04,38,,,percent of total billed charges,38% of total billed charges,222.87,81.4,,,percent of total billed charges,81.4% of total billed charges,246.41,90,,,percent of total billed charges,90% of total billed charges,246.41,90,,,percent of total billed charges,90% of total billed charges,104.04,38,,,percent of total billed charges,38% of total billed charges,104.04,38,,,percent of total billed charges,38% of total billed charges,104.04,38,,,percent of total billed charges,38% of total billed charges,205.34,75,,,percent of total billed charges,75% of total billed charges,232.72,85,,,percent of total billed charges,85% of total billed charges,104.04,254.62,
Acetylcholine Receptor Blocking Antibody,1431,CDM,300,RC,83519,HCPCS,outpatient,,,267.42,200.57,,240.68,90,,,percent of total billed charges,90% of total billed charges,248.7,93,,,percent of total billed charges,93% of total billed charges,101.62,38,,,percent of total billed charges,38% of total billed charges,101.62,38,,,percent of total billed charges,38% of total billed charges,227.31,85,,,percent of total billed charges,85% of total billed charges,101.62,38,,,percent of total billed charges,38% of total billed charges,217.68,81.4,,,percent of total billed charges,81.4% of total billed charges,240.68,90,,,percent of total billed charges,90% of total billed charges,240.68,90,,,percent of total billed charges,90% of total billed charges,101.62,38,,,percent of total billed charges,38% of total billed charges,101.62,38,,,percent of total billed charges,38% of total billed charges,101.62,38,,,percent of total billed charges,38% of total billed charges,200.57,75,,,percent of total billed charges,75% of total billed charges,227.31,85,,,percent of total billed charges,85% of total billed charges,101.62,248.7,
Thyrotropin Binding inhibitory Immuno(TBII),1432,CDM,300,RC,83519,HCPCS,outpatient,,,337.48,253.11,,303.73,90,,,percent of total billed charges,90% of total billed charges,313.86,93,,,percent of total billed charges,93% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,274.71,81.4,,,percent of total billed charges,81.4% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,253.11,75,,,percent of total billed charges,75% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,313.86,
TSH receptor binding Ab (TRab),1433,CDM,300,RC,83519,HCPCS,outpatient,,,251.57,188.68,,226.41,90,,,percent of total billed charges,90% of total billed charges,233.96,93,,,percent of total billed charges,93% of total billed charges,95.6,38,,,percent of total billed charges,38% of total billed charges,95.6,38,,,percent of total billed charges,38% of total billed charges,213.83,85,,,percent of total billed charges,85% of total billed charges,95.6,38,,,percent of total billed charges,38% of total billed charges,204.78,81.4,,,percent of total billed charges,81.4% of total billed charges,226.41,90,,,percent of total billed charges,90% of total billed charges,226.41,90,,,percent of total billed charges,90% of total billed charges,95.6,38,,,percent of total billed charges,38% of total billed charges,95.6,38,,,percent of total billed charges,38% of total billed charges,95.6,38,,,percent of total billed charges,38% of total billed charges,188.68,75,,,percent of total billed charges,75% of total billed charges,213.83,85,,,percent of total billed charges,85% of total billed charges,95.6,233.96,
IGF Binding Protein-1 (IGFBP-1),1434,CDM,300,RC,83519,HCPCS,outpatient,,,158.22,118.67,,142.4,90,,,percent of total billed charges,90% of total billed charges,147.14,93,,,percent of total billed charges,93% of total billed charges,60.12,38,,,percent of total billed charges,38% of total billed charges,60.12,38,,,percent of total billed charges,38% of total billed charges,134.49,85,,,percent of total billed charges,85% of total billed charges,60.12,38,,,percent of total billed charges,38% of total billed charges,128.79,81.4,,,percent of total billed charges,81.4% of total billed charges,142.4,90,,,percent of total billed charges,90% of total billed charges,142.4,90,,,percent of total billed charges,90% of total billed charges,60.12,38,,,percent of total billed charges,38% of total billed charges,60.12,38,,,percent of total billed charges,38% of total billed charges,60.12,38,,,percent of total billed charges,38% of total billed charges,118.67,75,,,percent of total billed charges,75% of total billed charges,134.49,85,,,percent of total billed charges,85% of total billed charges,60.12,147.14,
Acetylcholine Receptor Modulating Antibody,1435,CDM,300,RC,83519,HCPCS,outpatient,,,329.46,247.1,,296.51,90,,,percent of total billed charges,90% of total billed charges,306.4,93,,,percent of total billed charges,93% of total billed charges,125.19,38,,,percent of total billed charges,38% of total billed charges,125.19,38,,,percent of total billed charges,38% of total billed charges,280.04,85,,,percent of total billed charges,85% of total billed charges,125.19,38,,,percent of total billed charges,38% of total billed charges,268.18,81.4,,,percent of total billed charges,81.4% of total billed charges,296.51,90,,,percent of total billed charges,90% of total billed charges,296.51,90,,,percent of total billed charges,90% of total billed charges,125.19,38,,,percent of total billed charges,38% of total billed charges,125.19,38,,,percent of total billed charges,38% of total billed charges,125.19,38,,,percent of total billed charges,38% of total billed charges,247.1,75,,,percent of total billed charges,75% of total billed charges,280.04,85,,,percent of total billed charges,85% of total billed charges,125.19,306.4,
Acetylcholine Receptor Ganglionic (Alpha 3) AB,1436,CDM,300,RC,83519,HCPCS,outpatient,,,327.59,245.69,,294.83,90,,,percent of total billed charges,90% of total billed charges,304.66,93,,,percent of total billed charges,93% of total billed charges,124.48,38,,,percent of total billed charges,38% of total billed charges,124.48,38,,,percent of total billed charges,38% of total billed charges,278.45,85,,,percent of total billed charges,85% of total billed charges,124.48,38,,,percent of total billed charges,38% of total billed charges,266.66,81.4,,,percent of total billed charges,81.4% of total billed charges,294.83,90,,,percent of total billed charges,90% of total billed charges,294.83,90,,,percent of total billed charges,90% of total billed charges,124.48,38,,,percent of total billed charges,38% of total billed charges,124.48,38,,,percent of total billed charges,38% of total billed charges,124.48,38,,,percent of total billed charges,38% of total billed charges,245.69,75,,,percent of total billed charges,75% of total billed charges,278.45,85,,,percent of total billed charges,85% of total billed charges,124.48,304.66,
(RES) ACETYLCHOLINE RECEPTOR GANGLIONIC (ALPHA 3) AB,1437,CDM,300,RC,83519,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
(RES) VOLTAGE GATED POTASSIUM CHANNEL (VGKC) AB,1438,CDM,300,RC,83519,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
(RES) ACETYLCHOLINE RECEPTOR BINDING AB,1439,CDM,300,RC,83519,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
T3 (Triiodothyronine) AB,1440,CDM,300,RC,83519,HCPCS,outpatient,,,203.7,152.78,,183.33,90,,,percent of total billed charges,90% of total billed charges,189.44,93,,,percent of total billed charges,93% of total billed charges,77.41,38,,,percent of total billed charges,38% of total billed charges,77.41,38,,,percent of total billed charges,38% of total billed charges,173.15,85,,,percent of total billed charges,85% of total billed charges,77.41,38,,,percent of total billed charges,38% of total billed charges,165.81,81.4,,,percent of total billed charges,81.4% of total billed charges,183.33,90,,,percent of total billed charges,90% of total billed charges,183.33,90,,,percent of total billed charges,90% of total billed charges,77.41,38,,,percent of total billed charges,38% of total billed charges,77.41,38,,,percent of total billed charges,38% of total billed charges,77.41,38,,,percent of total billed charges,38% of total billed charges,152.78,75,,,percent of total billed charges,75% of total billed charges,173.15,85,,,percent of total billed charges,85% of total billed charges,77.41,189.44,
(RES) Acetylcholine Receptor Binding Antibody,1441,CDM,300,RC,83519,HCPCS,outpatient,,,290.24,217.68,,261.22,90,,,percent of total billed charges,90% of total billed charges,269.92,93,,,percent of total billed charges,93% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,246.7,85,,,percent of total billed charges,85% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,236.26,81.4,,,percent of total billed charges,81.4% of total billed charges,261.22,90,,,percent of total billed charges,90% of total billed charges,261.22,90,,,percent of total billed charges,90% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,217.68,75,,,percent of total billed charges,75% of total billed charges,246.7,85,,,percent of total billed charges,85% of total billed charges,110.29,269.92,
(RES) Acetylcholine Receptor Blocking Antibody,1442,CDM,300,RC,83519,HCPCS,outpatient,,,290.24,217.68,,261.22,90,,,percent of total billed charges,90% of total billed charges,269.92,93,,,percent of total billed charges,93% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,246.7,85,,,percent of total billed charges,85% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,236.26,81.4,,,percent of total billed charges,81.4% of total billed charges,261.22,90,,,percent of total billed charges,90% of total billed charges,261.22,90,,,percent of total billed charges,90% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,217.68,75,,,percent of total billed charges,75% of total billed charges,246.7,85,,,percent of total billed charges,85% of total billed charges,110.29,269.92,
(RES) Acetylcholine Receptor Modulating Antibody,1443,CDM,300,RC,83519,HCPCS,outpatient,,,290.24,217.68,,261.22,90,,,percent of total billed charges,90% of total billed charges,269.92,93,,,percent of total billed charges,93% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,246.7,85,,,percent of total billed charges,85% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,236.26,81.4,,,percent of total billed charges,81.4% of total billed charges,261.22,90,,,percent of total billed charges,90% of total billed charges,261.22,90,,,percent of total billed charges,90% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,110.29,38,,,percent of total billed charges,38% of total billed charges,217.68,75,,,percent of total billed charges,75% of total billed charges,246.7,85,,,percent of total billed charges,85% of total billed charges,110.29,269.92,
procollagen Type 1 intact,1444,CDM,300,RC,83519,HCPCS,outpatient,,,321.63,241.22,,289.47,90,,,percent of total billed charges,90% of total billed charges,299.12,93,,,percent of total billed charges,93% of total billed charges,122.22,38,,,percent of total billed charges,38% of total billed charges,122.22,38,,,percent of total billed charges,38% of total billed charges,273.39,85,,,percent of total billed charges,85% of total billed charges,122.22,38,,,percent of total billed charges,38% of total billed charges,261.81,81.4,,,percent of total billed charges,81.4% of total billed charges,289.47,90,,,percent of total billed charges,90% of total billed charges,289.47,90,,,percent of total billed charges,90% of total billed charges,122.22,38,,,percent of total billed charges,38% of total billed charges,122.22,38,,,percent of total billed charges,38% of total billed charges,122.22,38,,,percent of total billed charges,38% of total billed charges,241.22,75,,,percent of total billed charges,75% of total billed charges,273.39,85,,,percent of total billed charges,85% of total billed charges,122.22,299.12,
(RES) CV2 AB,1445,CDM,300,RC,83520,HCPCS,outpatient,,,384.26,288.2,,345.83,90,,,percent of total billed charges,90% of total billed charges,357.36,93,,,percent of total billed charges,93% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,326.62,85,,,percent of total billed charges,85% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,312.79,81.4,,,percent of total billed charges,81.4% of total billed charges,345.83,90,,,percent of total billed charges,90% of total billed charges,345.83,90,,,percent of total billed charges,90% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,288.2,75,,,percent of total billed charges,75% of total billed charges,326.62,85,,,percent of total billed charges,85% of total billed charges,146.02,357.36,
aspergillus niger IgA,1446,CDM,300,RC,83520,HCPCS,outpatient,,,95.72,71.79,,86.15,90,,,percent of total billed charges,90% of total billed charges,89.02,93,,,percent of total billed charges,93% of total billed charges,36.37,38,,,percent of total billed charges,38% of total billed charges,36.37,38,,,percent of total billed charges,38% of total billed charges,81.36,85,,,percent of total billed charges,85% of total billed charges,36.37,38,,,percent of total billed charges,38% of total billed charges,77.92,81.4,,,percent of total billed charges,81.4% of total billed charges,86.15,90,,,percent of total billed charges,90% of total billed charges,86.15,90,,,percent of total billed charges,90% of total billed charges,36.37,38,,,percent of total billed charges,38% of total billed charges,36.37,38,,,percent of total billed charges,38% of total billed charges,36.37,38,,,percent of total billed charges,38% of total billed charges,71.79,75,,,percent of total billed charges,75% of total billed charges,81.36,85,,,percent of total billed charges,85% of total billed charges,36.37,89.02,
(RES) Hu AutoAB,1447,CDM,300,RC,83520,HCPCS,outpatient,,,384.26,288.2,,345.83,90,,,percent of total billed charges,90% of total billed charges,357.36,93,,,percent of total billed charges,93% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,326.62,85,,,percent of total billed charges,85% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,312.79,81.4,,,percent of total billed charges,81.4% of total billed charges,345.83,90,,,percent of total billed charges,90% of total billed charges,345.83,90,,,percent of total billed charges,90% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,288.2,75,,,percent of total billed charges,75% of total billed charges,326.62,85,,,percent of total billed charges,85% of total billed charges,146.02,357.36,
Profile - IBSDetex-Vinculin,1448,CDM,300,RC,83520,HCPCS,outpatient,,,103.39,77.54,,93.05,90,,,percent of total billed charges,90% of total billed charges,96.15,93,,,percent of total billed charges,93% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,87.88,85,,,percent of total billed charges,85% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,84.16,81.4,,,percent of total billed charges,81.4% of total billed charges,93.05,90,,,percent of total billed charges,90% of total billed charges,93.05,90,,,percent of total billed charges,90% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,77.54,75,,,percent of total billed charges,75% of total billed charges,87.88,85,,,percent of total billed charges,85% of total billed charges,39.29,96.15,
(RES) IGE ANTIBODY (ANTI IGE IGG),1449,CDM,300,RC,83520,HCPCS,outpatient,,,69.86,52.4,,62.87,90,,,percent of total billed charges,90% of total billed charges,64.97,93,,,percent of total billed charges,93% of total billed charges,26.55,38,,,percent of total billed charges,38% of total billed charges,26.55,38,,,percent of total billed charges,38% of total billed charges,59.38,85,,,percent of total billed charges,85% of total billed charges,26.55,38,,,percent of total billed charges,38% of total billed charges,56.87,81.4,,,percent of total billed charges,81.4% of total billed charges,62.87,90,,,percent of total billed charges,90% of total billed charges,62.87,90,,,percent of total billed charges,90% of total billed charges,26.55,38,,,percent of total billed charges,38% of total billed charges,26.55,38,,,percent of total billed charges,38% of total billed charges,26.55,38,,,percent of total billed charges,38% of total billed charges,52.4,75,,,percent of total billed charges,75% of total billed charges,59.38,85,,,percent of total billed charges,85% of total billed charges,26.55,64.97,
"(RES) ADALIMUMAB AB, IBD",1450,CDM,300,RC,83520,HCPCS,outpatient,,,208.08,156.06,,187.27,90,,,percent of total billed charges,90% of total billed charges,193.51,93,,,percent of total billed charges,93% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,176.87,85,,,percent of total billed charges,85% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,169.38,81.4,,,percent of total billed charges,81.4% of total billed charges,187.27,90,,,percent of total billed charges,90% of total billed charges,187.27,90,,,percent of total billed charges,90% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,156.06,75,,,percent of total billed charges,75% of total billed charges,176.87,85,,,percent of total billed charges,85% of total billed charges,79.07,193.51,
"(RES) PLA2R AB, ELISA",1451,CDM,300,RC,83520,HCPCS,outpatient,,,318.36,238.77,,286.52,90,,,percent of total billed charges,90% of total billed charges,296.07,93,,,percent of total billed charges,93% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,270.61,85,,,percent of total billed charges,85% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,259.15,81.4,,,percent of total billed charges,81.4% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,286.52,90,,,percent of total billed charges,90% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,120.98,38,,,percent of total billed charges,38% of total billed charges,238.77,75,,,percent of total billed charges,75% of total billed charges,270.61,85,,,percent of total billed charges,85% of total billed charges,120.98,296.07,
(RES) DESMOGLEIN 1 ANTIBODY,1453,CDM,300,RC,83520,HCPCS,outpatient,,,103.39,77.54,,93.05,90,,,percent of total billed charges,90% of total billed charges,96.15,93,,,percent of total billed charges,93% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,87.88,85,,,percent of total billed charges,85% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,84.16,81.4,,,percent of total billed charges,81.4% of total billed charges,93.05,90,,,percent of total billed charges,90% of total billed charges,93.05,90,,,percent of total billed charges,90% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,39.29,38,,,percent of total billed charges,38% of total billed charges,77.54,75,,,percent of total billed charges,75% of total billed charges,87.88,85,,,percent of total billed charges,85% of total billed charges,39.29,96.15,
(RES) MaTa AutoAB,1454,CDM,300,RC,83520,HCPCS,outpatient,,,384.26,288.2,,345.83,90,,,percent of total billed charges,90% of total billed charges,357.36,93,,,percent of total billed charges,93% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,326.62,85,,,percent of total billed charges,85% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,312.79,81.4,,,percent of total billed charges,81.4% of total billed charges,345.83,90,,,percent of total billed charges,90% of total billed charges,345.83,90,,,percent of total billed charges,90% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,288.2,75,,,percent of total billed charges,75% of total billed charges,326.62,85,,,percent of total billed charges,85% of total billed charges,146.02,357.36,
(RES) Amphiphysin AB,1455,CDM,300,RC,83520,HCPCS,outpatient,,,384.26,288.2,,345.83,90,,,percent of total billed charges,90% of total billed charges,357.36,93,,,percent of total billed charges,93% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,326.62,85,,,percent of total billed charges,85% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,312.79,81.4,,,percent of total billed charges,81.4% of total billed charges,345.83,90,,,percent of total billed charges,90% of total billed charges,345.83,90,,,percent of total billed charges,90% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,146.02,38,,,percent of total billed charges,38% of total billed charges,288.2,75,,,percent of total billed charges,75% of total billed charges,326.62,85,,,percent of total billed charges,85% of total billed charges,146.02,357.36,
Soluble Liver Antigen (SLA) Autoantibody,1456,CDM,300,RC,83520,HCPCS,outpatient,,,126.64,94.98,,113.98,90,,,percent of total billed charges,90% of total billed charges,117.78,93,,,percent of total billed charges,93% of total billed charges,48.12,38,,,percent of total billed charges,38% of total billed charges,48.12,38,,,percent of total billed charges,38% of total billed charges,107.64,85,,,percent of total billed charges,85% of total billed charges,48.12,38,,,percent of total billed charges,38% of total billed charges,103.08,81.4,,,percent of total billed charges,81.4% of total billed charges,113.98,90,,,percent of total billed charges,90% of total billed charges,113.98,90,,,percent of total billed charges,90% of total billed charges,48.12,38,,,percent of total billed charges,38% of total billed charges,48.12,38,,,percent of total billed charges,38% of total billed charges,48.12,38,,,percent of total billed charges,38% of total billed charges,94.98,75,,,percent of total billed charges,75% of total billed charges,107.64,85,,,percent of total billed charges,85% of total billed charges,48.12,117.78,
Leptin,1457,CDM,300,RC,83520,HCPCS,outpatient,,,106.12,79.59,,95.51,90,,,percent of total billed charges,90% of total billed charges,98.69,93,,,percent of total billed charges,93% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,86.38,81.4,,,percent of total billed charges,81.4% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,79.59,75,,,percent of total billed charges,75% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,98.69,
Human Transforming Growth Factor beta 1,1458,CDM,300,RC,83520,HCPCS,outpatient,,,119.65,89.74,,107.69,90,,,percent of total billed charges,90% of total billed charges,111.27,93,,,percent of total billed charges,93% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,101.7,85,,,percent of total billed charges,85% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,97.4,81.4,,,percent of total billed charges,81.4% of total billed charges,107.69,90,,,percent of total billed charges,90% of total billed charges,107.69,90,,,percent of total billed charges,90% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,89.74,75,,,percent of total billed charges,75% of total billed charges,101.7,85,,,percent of total billed charges,85% of total billed charges,45.47,111.27,
Vascular Endothelial Growth Factor,1459,CDM,300,RC,83520,HCPCS,outpatient,,,338.13,253.6,,304.32,90,,,percent of total billed charges,90% of total billed charges,314.46,93,,,percent of total billed charges,93% of total billed charges,128.49,38,,,percent of total billed charges,38% of total billed charges,128.49,38,,,percent of total billed charges,38% of total billed charges,287.41,85,,,percent of total billed charges,85% of total billed charges,128.49,38,,,percent of total billed charges,38% of total billed charges,275.24,81.4,,,percent of total billed charges,81.4% of total billed charges,304.32,90,,,percent of total billed charges,90% of total billed charges,304.32,90,,,percent of total billed charges,90% of total billed charges,128.49,38,,,percent of total billed charges,38% of total billed charges,128.49,38,,,percent of total billed charges,38% of total billed charges,128.49,38,,,percent of total billed charges,38% of total billed charges,253.6,75,,,percent of total billed charges,75% of total billed charges,287.41,85,,,percent of total billed charges,85% of total billed charges,128.49,314.46,
Gonadotropin Releasing Hormone,1460,CDM,300,RC,83520,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
MMP-9 (SLVRMC),1461,CDM,300,RC,83520,HCPCS,outpatient,,,286.11,214.58,,257.5,90,,,percent of total billed charges,90% of total billed charges,266.08,93,,,percent of total billed charges,93% of total billed charges,108.72,38,,,percent of total billed charges,38% of total billed charges,108.72,38,,,percent of total billed charges,38% of total billed charges,243.19,85,,,percent of total billed charges,85% of total billed charges,108.72,38,,,percent of total billed charges,38% of total billed charges,232.89,81.4,,,percent of total billed charges,81.4% of total billed charges,257.5,90,,,percent of total billed charges,90% of total billed charges,257.5,90,,,percent of total billed charges,90% of total billed charges,108.72,38,,,percent of total billed charges,38% of total billed charges,108.72,38,,,percent of total billed charges,38% of total billed charges,108.72,38,,,percent of total billed charges,38% of total billed charges,214.58,75,,,percent of total billed charges,75% of total billed charges,243.19,85,,,percent of total billed charges,85% of total billed charges,108.72,266.08,
Inhibin B,1463,CDM,300,RC,83520,HCPCS,outpatient,,,239.26,179.45,,215.33,90,,,percent of total billed charges,90% of total billed charges,222.51,93,,,percent of total billed charges,93% of total billed charges,90.92,38,,,percent of total billed charges,38% of total billed charges,90.92,38,,,percent of total billed charges,38% of total billed charges,203.37,85,,,percent of total billed charges,85% of total billed charges,90.92,38,,,percent of total billed charges,38% of total billed charges,194.76,81.4,,,percent of total billed charges,81.4% of total billed charges,215.33,90,,,percent of total billed charges,90% of total billed charges,215.33,90,,,percent of total billed charges,90% of total billed charges,90.92,38,,,percent of total billed charges,38% of total billed charges,90.92,38,,,percent of total billed charges,38% of total billed charges,90.92,38,,,percent of total billed charges,38% of total billed charges,179.45,75,,,percent of total billed charges,75% of total billed charges,203.37,85,,,percent of total billed charges,85% of total billed charges,90.92,222.51,
(RES) KAPPA LIGHT CHAINS,1464,CDM,300,RC,83520,HCPCS,outpatient,,,31.23,23.42,,28.11,90,,,percent of total billed charges,90% of total billed charges,29.04,93,,,percent of total billed charges,93% of total billed charges,11.87,38,,,percent of total billed charges,38% of total billed charges,11.87,38,,,percent of total billed charges,38% of total billed charges,26.55,85,,,percent of total billed charges,85% of total billed charges,11.87,38,,,percent of total billed charges,38% of total billed charges,25.42,81.4,,,percent of total billed charges,81.4% of total billed charges,28.11,90,,,percent of total billed charges,90% of total billed charges,28.11,90,,,percent of total billed charges,90% of total billed charges,11.87,38,,,percent of total billed charges,38% of total billed charges,11.87,38,,,percent of total billed charges,38% of total billed charges,11.87,38,,,percent of total billed charges,38% of total billed charges,23.42,75,,,percent of total billed charges,75% of total billed charges,26.55,85,,,percent of total billed charges,85% of total billed charges,11.87,29.04,
(RES) LAMBDA LIGHT CHAIN,1465,CDM,300,RC,83520,HCPCS,outpatient,,,31.26,23.45,,28.13,90,,,percent of total billed charges,90% of total billed charges,29.07,93,,,percent of total billed charges,93% of total billed charges,11.88,38,,,percent of total billed charges,38% of total billed charges,11.88,38,,,percent of total billed charges,38% of total billed charges,26.57,85,,,percent of total billed charges,85% of total billed charges,11.88,38,,,percent of total billed charges,38% of total billed charges,25.45,81.4,,,percent of total billed charges,81.4% of total billed charges,28.13,90,,,percent of total billed charges,90% of total billed charges,28.13,90,,,percent of total billed charges,90% of total billed charges,11.88,38,,,percent of total billed charges,38% of total billed charges,11.88,38,,,percent of total billed charges,38% of total billed charges,11.88,38,,,percent of total billed charges,38% of total billed charges,23.45,75,,,percent of total billed charges,75% of total billed charges,26.57,85,,,percent of total billed charges,85% of total billed charges,11.88,29.07,
"(RES) T-TAU PROTEIN, CSF",1466,CDM,300,RC,83520,HCPCS,outpatient,,,227.15,170.36,,204.44,90,,,percent of total billed charges,90% of total billed charges,211.25,93,,,percent of total billed charges,93% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,193.08,85,,,percent of total billed charges,85% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,184.9,81.4,,,percent of total billed charges,81.4% of total billed charges,204.44,90,,,percent of total billed charges,90% of total billed charges,204.44,90,,,percent of total billed charges,90% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,170.36,75,,,percent of total billed charges,75% of total billed charges,193.08,85,,,percent of total billed charges,85% of total billed charges,86.32,211.25,
Adiponectin,1467,CDM,300,RC,83520,HCPCS,outpatient,,,272.92,204.69,,245.63,90,,,percent of total billed charges,90% of total billed charges,253.82,93,,,percent of total billed charges,93% of total billed charges,103.71,38,,,percent of total billed charges,38% of total billed charges,103.71,38,,,percent of total billed charges,38% of total billed charges,231.98,85,,,percent of total billed charges,85% of total billed charges,103.71,38,,,percent of total billed charges,38% of total billed charges,222.16,81.4,,,percent of total billed charges,81.4% of total billed charges,245.63,90,,,percent of total billed charges,90% of total billed charges,245.63,90,,,percent of total billed charges,90% of total billed charges,103.71,38,,,percent of total billed charges,38% of total billed charges,103.71,38,,,percent of total billed charges,38% of total billed charges,103.71,38,,,percent of total billed charges,38% of total billed charges,204.69,75,,,percent of total billed charges,75% of total billed charges,231.98,85,,,percent of total billed charges,85% of total billed charges,103.71,253.82,
(RES) 14-3-3 GAMMA,1468,CDM,300,RC,83520,HCPCS,outpatient,,,227.16,170.37,,204.44,90,,,percent of total billed charges,90% of total billed charges,211.26,93,,,percent of total billed charges,93% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,193.09,85,,,percent of total billed charges,85% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,184.91,81.4,,,percent of total billed charges,81.4% of total billed charges,204.44,90,,,percent of total billed charges,90% of total billed charges,204.44,90,,,percent of total billed charges,90% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,86.32,38,,,percent of total billed charges,38% of total billed charges,170.37,75,,,percent of total billed charges,75% of total billed charges,193.09,85,,,percent of total billed charges,85% of total billed charges,86.32,211.26,
(RES) DESMOGLEIN 3 ANTIBODY,1469,CDM,300,RC,83520,HCPCS,outpatient,,,68.91,51.68,,62.02,90,,,percent of total billed charges,90% of total billed charges,64.09,93,,,percent of total billed charges,93% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,56.09,81.4,,,percent of total billed charges,81.4% of total billed charges,62.02,90,,,percent of total billed charges,90% of total billed charges,62.02,90,,,percent of total billed charges,90% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,51.68,75,,,percent of total billed charges,75% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,26.19,64.09,
"Adalimumab Anti-Drug AB, IBD",1470,CDM,300,RC,83520,HCPCS,outpatient,,,208.08,156.06,,187.27,90,,,percent of total billed charges,90% of total billed charges,193.51,93,,,percent of total billed charges,93% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,176.87,85,,,percent of total billed charges,85% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,169.38,81.4,,,percent of total billed charges,81.4% of total billed charges,187.27,90,,,percent of total billed charges,90% of total billed charges,187.27,90,,,percent of total billed charges,90% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,79.07,38,,,percent of total billed charges,38% of total billed charges,156.06,75,,,percent of total billed charges,75% of total billed charges,176.87,85,,,percent of total billed charges,85% of total billed charges,79.07,193.51,
Anti-Mullerian Hormone(AMH),1471,CDM,300,RC,83520,HCPCS,outpatient,,,172.25,129.19,,155.03,90,,,percent of total billed charges,90% of total billed charges,160.19,93,,,percent of total billed charges,93% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,146.41,85,,,percent of total billed charges,85% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,140.21,81.4,,,percent of total billed charges,81.4% of total billed charges,155.03,90,,,percent of total billed charges,90% of total billed charges,155.03,90,,,percent of total billed charges,90% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,129.19,75,,,percent of total billed charges,75% of total billed charges,146.41,85,,,percent of total billed charges,85% of total billed charges,65.46,160.19,
Fibroblast Growth Factor 23 (FGF 23),1472,CDM,300,RC,83520,HCPCS,outpatient,,,291.83,218.87,,262.65,90,,,percent of total billed charges,90% of total billed charges,271.4,93,,,percent of total billed charges,93% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,248.06,85,,,percent of total billed charges,85% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,237.55,81.4,,,percent of total billed charges,81.4% of total billed charges,262.65,90,,,percent of total billed charges,90% of total billed charges,262.65,90,,,percent of total billed charges,90% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,218.87,75,,,percent of total billed charges,75% of total billed charges,248.06,85,,,percent of total billed charges,85% of total billed charges,110.9,271.4,
OxLDL,1473,CDM,300,RC,83520,HCPCS,outpatient,,,58.26,43.7,,52.43,90,,,percent of total billed charges,90% of total billed charges,54.18,93,,,percent of total billed charges,93% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,49.52,85,,,percent of total billed charges,85% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,47.42,81.4,,,percent of total billed charges,81.4% of total billed charges,52.43,90,,,percent of total billed charges,90% of total billed charges,52.43,90,,,percent of total billed charges,90% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,22.14,38,,,percent of total billed charges,38% of total billed charges,43.7,75,,,percent of total billed charges,75% of total billed charges,49.52,85,,,percent of total billed charges,85% of total billed charges,22.14,54.18,
Bullous Pemphigoid 180 ab,1474,CDM,300,RC,83520,HCPCS,outpatient,,,284.17,213.13,,255.75,90,,,percent of total billed charges,90% of total billed charges,264.28,93,,,percent of total billed charges,93% of total billed charges,107.98,38,,,percent of total billed charges,38% of total billed charges,107.98,38,,,percent of total billed charges,38% of total billed charges,241.54,85,,,percent of total billed charges,85% of total billed charges,107.98,38,,,percent of total billed charges,38% of total billed charges,231.31,81.4,,,percent of total billed charges,81.4% of total billed charges,255.75,90,,,percent of total billed charges,90% of total billed charges,255.75,90,,,percent of total billed charges,90% of total billed charges,107.98,38,,,percent of total billed charges,38% of total billed charges,107.98,38,,,percent of total billed charges,38% of total billed charges,107.98,38,,,percent of total billed charges,38% of total billed charges,213.13,75,,,percent of total billed charges,75% of total billed charges,241.54,85,,,percent of total billed charges,85% of total billed charges,107.98,264.28,
Anti GBM (Glomerular basement membrane),1475,CDM,300,RC,83520,HCPCS,outpatient,,,254.29,190.72,,228.86,90,,,percent of total billed charges,90% of total billed charges,236.49,93,,,percent of total billed charges,93% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,216.15,85,,,percent of total billed charges,85% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,206.99,81.4,,,percent of total billed charges,81.4% of total billed charges,228.86,90,,,percent of total billed charges,90% of total billed charges,228.86,90,,,percent of total billed charges,90% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,190.72,75,,,percent of total billed charges,75% of total billed charges,216.15,85,,,percent of total billed charges,85% of total billed charges,96.63,236.49,
Bullous Pemphigoid 230 IgG ab,1476,CDM,300,RC,83520,HCPCS,outpatient,,,119.46,89.6,,107.51,90,,,percent of total billed charges,90% of total billed charges,111.1,93,,,percent of total billed charges,93% of total billed charges,45.39,38,,,percent of total billed charges,38% of total billed charges,45.39,38,,,percent of total billed charges,38% of total billed charges,101.54,85,,,percent of total billed charges,85% of total billed charges,45.39,38,,,percent of total billed charges,38% of total billed charges,97.24,81.4,,,percent of total billed charges,81.4% of total billed charges,107.51,90,,,percent of total billed charges,90% of total billed charges,107.51,90,,,percent of total billed charges,90% of total billed charges,45.39,38,,,percent of total billed charges,38% of total billed charges,45.39,38,,,percent of total billed charges,38% of total billed charges,45.39,38,,,percent of total billed charges,38% of total billed charges,89.6,75,,,percent of total billed charges,75% of total billed charges,101.54,85,,,percent of total billed charges,85% of total billed charges,45.39,111.1,
Profile - IBSDeTex-Cytolethal Distend Toxin B Ab,1477,CDM,300,RC,83520,HCPCS,outpatient,,,112.57,84.43,,101.31,90,,,percent of total billed charges,90% of total billed charges,104.69,93,,,percent of total billed charges,93% of total billed charges,42.78,38,,,percent of total billed charges,38% of total billed charges,42.78,38,,,percent of total billed charges,38% of total billed charges,95.68,85,,,percent of total billed charges,85% of total billed charges,42.78,38,,,percent of total billed charges,38% of total billed charges,91.63,81.4,,,percent of total billed charges,81.4% of total billed charges,101.31,90,,,percent of total billed charges,90% of total billed charges,101.31,90,,,percent of total billed charges,90% of total billed charges,42.78,38,,,percent of total billed charges,38% of total billed charges,42.78,38,,,percent of total billed charges,38% of total billed charges,42.78,38,,,percent of total billed charges,38% of total billed charges,84.43,75,,,percent of total billed charges,75% of total billed charges,95.68,85,,,percent of total billed charges,85% of total billed charges,42.78,104.69,
"(RES) KAPPA LIGHT CHAIN, FREE, SERUM",1478,CDM,300,RC,83521,HCPCS,outpatient,,,191.43,143.57,,172.29,90,,,percent of total billed charges,90% of total billed charges,178.03,93,,,percent of total billed charges,93% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,162.72,85,,,percent of total billed charges,85% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,155.82,81.4,,,percent of total billed charges,81.4% of total billed charges,172.29,90,,,percent of total billed charges,90% of total billed charges,172.29,90,,,percent of total billed charges,90% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,143.57,75,,,percent of total billed charges,75% of total billed charges,162.72,85,,,percent of total billed charges,85% of total billed charges,72.74,178.03,
"(RES) LAMBDA LIGHT CHAIN, FREE, SERUM",1479,CDM,300,RC,83521,HCPCS,outpatient,,,191.43,143.57,,172.29,90,,,percent of total billed charges,90% of total billed charges,178.03,93,,,percent of total billed charges,93% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,162.72,85,,,percent of total billed charges,85% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,155.82,81.4,,,percent of total billed charges,81.4% of total billed charges,172.29,90,,,percent of total billed charges,90% of total billed charges,172.29,90,,,percent of total billed charges,90% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,72.74,38,,,percent of total billed charges,38% of total billed charges,143.57,75,,,percent of total billed charges,75% of total billed charges,162.72,85,,,percent of total billed charges,85% of total billed charges,72.74,178.03,
"(RE) KAPPA LIGHT CHAIN, FREE",1480,CDM,300,RC,83521,HCPCS,outpatient,,,166.46,124.85,,149.81,90,,,percent of total billed charges,90% of total billed charges,154.81,93,,,percent of total billed charges,93% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,141.49,85,,,percent of total billed charges,85% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,135.5,81.4,,,percent of total billed charges,81.4% of total billed charges,149.81,90,,,percent of total billed charges,90% of total billed charges,149.81,90,,,percent of total billed charges,90% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,124.85,75,,,percent of total billed charges,75% of total billed charges,141.49,85,,,percent of total billed charges,85% of total billed charges,63.25,154.81,
"(RE) LAMBDA LIGHT CHAIN, FREE",1481,CDM,300,RC,83521,HCPCS,outpatient,,,166.46,124.85,,149.81,90,,,percent of total billed charges,90% of total billed charges,154.81,93,,,percent of total billed charges,93% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,141.49,85,,,percent of total billed charges,85% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,135.5,81.4,,,percent of total billed charges,81.4% of total billed charges,149.81,90,,,percent of total billed charges,90% of total billed charges,149.81,90,,,percent of total billed charges,90% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,63.25,38,,,percent of total billed charges,38% of total billed charges,124.85,75,,,percent of total billed charges,75% of total billed charges,141.49,85,,,percent of total billed charges,85% of total billed charges,63.25,154.81,
INSULIN,1482,CDM,300,RC,83525,HCPCS,outpatient,,,66.79,50.09,,60.11,90,,,percent of total billed charges,90% of total billed charges,62.11,93,,,percent of total billed charges,93% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,54.37,81.4,,,percent of total billed charges,81.4% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,50.09,75,,,percent of total billed charges,75% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,62.11,
"Insulin, Intact, LC/MS/MS",1483,CDM,300,RC,83525,HCPCS,outpatient,,,54.1,40.58,,48.69,90,,,percent of total billed charges,90% of total billed charges,50.31,93,,,percent of total billed charges,93% of total billed charges,20.56,38,,,percent of total billed charges,38% of total billed charges,20.56,38,,,percent of total billed charges,38% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,20.56,38,,,percent of total billed charges,38% of total billed charges,44.04,81.4,,,percent of total billed charges,81.4% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,20.56,38,,,percent of total billed charges,38% of total billed charges,20.56,38,,,percent of total billed charges,38% of total billed charges,20.56,38,,,percent of total billed charges,38% of total billed charges,40.58,75,,,percent of total billed charges,75% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,20.56,50.31,
"(RES) INSULIN, INTACT, LC/MS/MS",1484,CDM,300,RC,83525,HCPCS,outpatient,,,35.7,26.78,,32.13,90,,,percent of total billed charges,90% of total billed charges,33.2,93,,,percent of total billed charges,93% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,29.06,81.4,,,percent of total billed charges,81.4% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,26.78,75,,,percent of total billed charges,75% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,33.2,
Interleukin-6,1485,CDM,300,RC,83529,HCPCS,outpatient,,,317.97,238.48,,286.17,90,,,percent of total billed charges,90% of total billed charges,295.71,93,,,percent of total billed charges,93% of total billed charges,120.83,38,,,percent of total billed charges,38% of total billed charges,120.83,38,,,percent of total billed charges,38% of total billed charges,270.27,85,,,percent of total billed charges,85% of total billed charges,120.83,38,,,percent of total billed charges,38% of total billed charges,258.83,81.4,,,percent of total billed charges,81.4% of total billed charges,286.17,90,,,percent of total billed charges,90% of total billed charges,286.17,90,,,percent of total billed charges,90% of total billed charges,120.83,38,,,percent of total billed charges,38% of total billed charges,120.83,38,,,percent of total billed charges,38% of total billed charges,120.83,38,,,percent of total billed charges,38% of total billed charges,238.48,75,,,percent of total billed charges,75% of total billed charges,270.27,85,,,percent of total billed charges,85% of total billed charges,120.83,295.71,
"Iron, Total (Serum)",1486,CDM,300,RC,83540,HCPCS,outpatient,,,91.41,68.56,,82.27,90,,,percent of total billed charges,90% of total billed charges,85.01,93,,,percent of total billed charges,93% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,77.7,85,,,percent of total billed charges,85% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,74.41,81.4,,,percent of total billed charges,81.4% of total billed charges,82.27,90,,,percent of total billed charges,90% of total billed charges,82.27,90,,,percent of total billed charges,90% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,68.56,75,,,percent of total billed charges,75% of total billed charges,77.7,85,,,percent of total billed charges,85% of total billed charges,34.74,85.01,
Iron (SLVRMC),1487,CDM,300,RC,83540,HCPCS,outpatient,,,106.12,79.59,,95.51,90,,,percent of total billed charges,90% of total billed charges,98.69,93,,,percent of total billed charges,93% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,86.38,81.4,,,percent of total billed charges,81.4% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,79.59,75,,,percent of total billed charges,75% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,98.69,
TIBC (SLVRMC),1488,CDM,300,RC,83550,HCPCS,outpatient,,,185.71,139.28,,167.14,90,,,percent of total billed charges,90% of total billed charges,172.71,93,,,percent of total billed charges,93% of total billed charges,70.57,38,,,percent of total billed charges,38% of total billed charges,70.57,38,,,percent of total billed charges,38% of total billed charges,157.85,85,,,percent of total billed charges,85% of total billed charges,70.57,38,,,percent of total billed charges,38% of total billed charges,151.17,81.4,,,percent of total billed charges,81.4% of total billed charges,167.14,90,,,percent of total billed charges,90% of total billed charges,167.14,90,,,percent of total billed charges,90% of total billed charges,70.57,38,,,percent of total billed charges,38% of total billed charges,70.57,38,,,percent of total billed charges,38% of total billed charges,70.57,38,,,percent of total billed charges,38% of total billed charges,139.28,75,,,percent of total billed charges,75% of total billed charges,157.85,85,,,percent of total billed charges,85% of total billed charges,70.57,172.71,
TIBC-IRON BINDING CAPACITY,1489,CDM,300,RC,83550,HCPCS,outpatient,,,91.41,68.56,,82.27,90,,,percent of total billed charges,90% of total billed charges,85.01,93,,,percent of total billed charges,93% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,77.7,85,,,percent of total billed charges,85% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,74.41,81.4,,,percent of total billed charges,81.4% of total billed charges,82.27,90,,,percent of total billed charges,90% of total billed charges,82.27,90,,,percent of total billed charges,90% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,34.74,38,,,percent of total billed charges,38% of total billed charges,68.56,75,,,percent of total billed charges,75% of total billed charges,77.7,85,,,percent of total billed charges,85% of total billed charges,34.74,85.01,
"17 Ketosteroids, 24 Urine  RESULTS",1490,CDM,300,RC,83586,HCPCS,outpatient,,,139.21,104.41,,125.29,90,,,percent of total billed charges,90% of total billed charges,129.47,93,,,percent of total billed charges,93% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,118.33,85,,,percent of total billed charges,85% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,113.32,81.4,,,percent of total billed charges,81.4% of total billed charges,125.29,90,,,percent of total billed charges,90% of total billed charges,125.29,90,,,percent of total billed charges,90% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,52.9,38,,,percent of total billed charges,38% of total billed charges,104.41,75,,,percent of total billed charges,75% of total billed charges,118.33,85,,,percent of total billed charges,85% of total billed charges,52.9,129.47,
Lactic Acid,1491,CDM,300,RC,83605,HCPCS,outpatient,,,50.38,37.79,,45.34,90,,,percent of total billed charges,90% of total billed charges,46.85,93,,,percent of total billed charges,93% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,41.01,81.4,,,percent of total billed charges,81.4% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,37.79,75,,,percent of total billed charges,75% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,46.85,
Lactic Acid,1492,CDM,300,RC,83605,HCPCS,outpatient,,,50.38,37.79,,45.34,90,,,percent of total billed charges,90% of total billed charges,46.85,93,,,percent of total billed charges,93% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,41.01,81.4,,,percent of total billed charges,81.4% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,37.79,75,,,percent of total billed charges,75% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,46.85,
"Quest - Lactic Acid, Plasma",1493,CDM,300,RC,83605,HCPCS,outpatient,,,120.15,90.11,,108.14,90,,,percent of total billed charges,90% of total billed charges,111.74,93,,,percent of total billed charges,93% of total billed charges,45.66,38,,,percent of total billed charges,38% of total billed charges,45.66,38,,,percent of total billed charges,38% of total billed charges,102.13,85,,,percent of total billed charges,85% of total billed charges,45.66,38,,,percent of total billed charges,38% of total billed charges,97.8,81.4,,,percent of total billed charges,81.4% of total billed charges,108.14,90,,,percent of total billed charges,90% of total billed charges,108.14,90,,,percent of total billed charges,90% of total billed charges,45.66,38,,,percent of total billed charges,38% of total billed charges,45.66,38,,,percent of total billed charges,38% of total billed charges,45.66,38,,,percent of total billed charges,38% of total billed charges,90.11,75,,,percent of total billed charges,75% of total billed charges,102.13,85,,,percent of total billed charges,85% of total billed charges,45.66,111.74,
Lactic Acid  I-STAT,1494,CDM,300,RC,83605,HCPCS,outpatient,,,68.91,51.68,,62.02,90,,,percent of total billed charges,90% of total billed charges,64.09,93,,,percent of total billed charges,93% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,56.09,81.4,,,percent of total billed charges,81.4% of total billed charges,62.02,90,,,percent of total billed charges,90% of total billed charges,62.02,90,,,percent of total billed charges,90% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,51.68,75,,,percent of total billed charges,75% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,26.19,64.09,
LDH (QUEST ONLY),1495,CDM,300,RC,83615,HCPCS,outpatient,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
"LD, Pleural Fluid",1496,CDM,300,RC,83615,HCPCS,outpatient,,,65.25,48.94,,58.73,90,,,percent of total billed charges,90% of total billed charges,60.68,93,,,percent of total billed charges,93% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,55.46,85,,,percent of total billed charges,85% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,53.11,81.4,,,percent of total billed charges,81.4% of total billed charges,58.73,90,,,percent of total billed charges,90% of total billed charges,58.73,90,,,percent of total billed charges,90% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,48.94,75,,,percent of total billed charges,75% of total billed charges,55.46,85,,,percent of total billed charges,85% of total billed charges,24.8,60.68,
LDH-Body Fluid (SLVH),1497,CDM,300,RC,83615,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
"LD, Peritoneal Fluid",1498,CDM,300,RC,83615,HCPCS,outpatient,,,65.25,48.94,,58.73,90,,,percent of total billed charges,90% of total billed charges,60.68,93,,,percent of total billed charges,93% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,55.46,85,,,percent of total billed charges,85% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,53.11,81.4,,,percent of total billed charges,81.4% of total billed charges,58.73,90,,,percent of total billed charges,90% of total billed charges,58.73,90,,,percent of total billed charges,90% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,24.8,38,,,percent of total billed charges,38% of total billed charges,48.94,75,,,percent of total billed charges,75% of total billed charges,55.46,85,,,percent of total billed charges,85% of total billed charges,24.8,60.68,
LDH,1499,CDM,300,RC,83615,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
Lactate Dehydrogenase (LD) Serum,1500,CDM,300,RC,83615,HCPCS,outpatient,,,66.02,49.52,,59.42,90,,,percent of total billed charges,90% of total billed charges,61.4,93,,,percent of total billed charges,93% of total billed charges,25.09,38,,,percent of total billed charges,38% of total billed charges,25.09,38,,,percent of total billed charges,38% of total billed charges,56.12,85,,,percent of total billed charges,85% of total billed charges,25.09,38,,,percent of total billed charges,38% of total billed charges,53.74,81.4,,,percent of total billed charges,81.4% of total billed charges,59.42,90,,,percent of total billed charges,90% of total billed charges,59.42,90,,,percent of total billed charges,90% of total billed charges,25.09,38,,,percent of total billed charges,38% of total billed charges,25.09,38,,,percent of total billed charges,38% of total billed charges,25.09,38,,,percent of total billed charges,38% of total billed charges,49.52,75,,,percent of total billed charges,75% of total billed charges,56.12,85,,,percent of total billed charges,85% of total billed charges,25.09,61.4,
(RES) Lactate Dehydrog. Iso. (LDI),1501,CDM,300,RC,83625,HCPCS,outpatient,,,109.32,81.99,,98.39,90,,,percent of total billed charges,90% of total billed charges,101.67,93,,,percent of total billed charges,93% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,92.92,85,,,percent of total billed charges,85% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,88.99,81.4,,,percent of total billed charges,81.4% of total billed charges,98.39,90,,,percent of total billed charges,90% of total billed charges,98.39,90,,,percent of total billed charges,90% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,41.54,38,,,percent of total billed charges,38% of total billed charges,81.99,75,,,percent of total billed charges,75% of total billed charges,92.92,85,,,percent of total billed charges,85% of total billed charges,41.54,101.67,
Fecal Leuk (Lactoferrin),1502,CDM,300,RC,83630,HCPCS,outpatient,,,93.74,70.31,,84.37,90,,,percent of total billed charges,90% of total billed charges,87.18,93,,,percent of total billed charges,93% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,79.68,85,,,percent of total billed charges,85% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,76.3,81.4,,,percent of total billed charges,81.4% of total billed charges,84.37,90,,,percent of total billed charges,90% of total billed charges,84.37,90,,,percent of total billed charges,90% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,70.31,75,,,percent of total billed charges,75% of total billed charges,79.68,85,,,percent of total billed charges,85% of total billed charges,35.62,87.18,
"Lactoferrin, quanitative stool",1503,CDM,300,RC,83631,HCPCS,outpatient,,,286.05,214.54,,257.45,90,,,percent of total billed charges,90% of total billed charges,266.03,93,,,percent of total billed charges,93% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,243.14,85,,,percent of total billed charges,85% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,232.84,81.4,,,percent of total billed charges,81.4% of total billed charges,257.45,90,,,percent of total billed charges,90% of total billed charges,257.45,90,,,percent of total billed charges,90% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,214.54,75,,,percent of total billed charges,75% of total billed charges,243.14,85,,,percent of total billed charges,85% of total billed charges,108.7,266.03,
"Lead, Blood",1504,CDM,300,RC,83655,HCPCS,outpatient,,,156.96,117.72,,141.26,90,,,percent of total billed charges,90% of total billed charges,145.97,93,,,percent of total billed charges,93% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,127.77,81.4,,,percent of total billed charges,81.4% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,117.72,75,,,percent of total billed charges,75% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,145.97,
"(RES) LEAD, URINE",1505,CDM,300,RC,83655,HCPCS,outpatient,,,169.95,127.46,,152.96,90,,,percent of total billed charges,90% of total billed charges,158.05,93,,,percent of total billed charges,93% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,144.46,85,,,percent of total billed charges,85% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,138.34,81.4,,,percent of total billed charges,81.4% of total billed charges,152.96,90,,,percent of total billed charges,90% of total billed charges,152.96,90,,,percent of total billed charges,90% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,127.46,75,,,percent of total billed charges,75% of total billed charges,144.46,85,,,percent of total billed charges,85% of total billed charges,64.58,158.05,
(RES) Lead (HMP - Blood),1506,CDM,300,RC,83655,HCPCS,outpatient,,,162.36,121.77,,146.12,90,,,percent of total billed charges,90% of total billed charges,150.99,93,,,percent of total billed charges,93% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,132.16,81.4,,,percent of total billed charges,81.4% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,121.77,75,,,percent of total billed charges,75% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,150.99,
Lipase,1507,CDM,300,RC,83690,HCPCS,outpatient,,,99.59,74.69,,89.63,90,,,percent of total billed charges,90% of total billed charges,92.62,93,,,percent of total billed charges,93% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,84.65,85,,,percent of total billed charges,85% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,81.07,81.4,,,percent of total billed charges,81.4% of total billed charges,89.63,90,,,percent of total billed charges,90% of total billed charges,89.63,90,,,percent of total billed charges,90% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,74.69,75,,,percent of total billed charges,75% of total billed charges,84.65,85,,,percent of total billed charges,85% of total billed charges,37.84,92.62,
Lipoprotein (a),1508,CDM,300,RC,83695,HCPCS,outpatient,,,29.03,21.77,,26.13,90,,,percent of total billed charges,90% of total billed charges,27,93,,,percent of total billed charges,93% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,23.63,81.4,,,percent of total billed charges,81.4% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,21.77,75,,,percent of total billed charges,75% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,27,
"(RES) Cardio IQ, Lipoprotein (a)",1509,CDM,300,RC,83695,HCPCS,outpatient,,,39.06,29.3,,35.15,90,,,percent of total billed charges,90% of total billed charges,36.33,93,,,percent of total billed charges,93% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,33.2,85,,,percent of total billed charges,85% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,31.79,81.4,,,percent of total billed charges,81.4% of total billed charges,35.15,90,,,percent of total billed charges,90% of total billed charges,35.15,90,,,percent of total billed charges,90% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,14.84,38,,,percent of total billed charges,38% of total billed charges,29.3,75,,,percent of total billed charges,75% of total billed charges,33.2,85,,,percent of total billed charges,85% of total billed charges,14.84,36.33,
Lp-PLA2 Activity,1510,CDM,300,RC,83698,HCPCS,outpatient,,,54.12,40.59,,48.71,90,,,percent of total billed charges,90% of total billed charges,50.33,93,,,percent of total billed charges,93% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,44.05,81.4,,,percent of total billed charges,81.4% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,40.59,75,,,percent of total billed charges,75% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,50.33,
(RES) Lp-PLA2 Activity,1511,CDM,300,RC,83698,HCPCS,outpatient,,,46.56,34.92,,41.9,90,,,percent of total billed charges,90% of total billed charges,43.3,93,,,percent of total billed charges,93% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,39.58,85,,,percent of total billed charges,85% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,37.9,81.4,,,percent of total billed charges,81.4% of total billed charges,41.9,90,,,percent of total billed charges,90% of total billed charges,41.9,90,,,percent of total billed charges,90% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,34.92,75,,,percent of total billed charges,75% of total billed charges,39.58,85,,,percent of total billed charges,85% of total billed charges,17.69,43.3,
VAP CHOLESTEROL TEST,1512,CDM,300,RC,83701,HCPCS,outpatient,,,284.74,213.56,,256.27,90,,,percent of total billed charges,90% of total billed charges,264.81,93,,,percent of total billed charges,93% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,242.03,85,,,percent of total billed charges,85% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,231.78,81.4,,,percent of total billed charges,81.4% of total billed charges,256.27,90,,,percent of total billed charges,90% of total billed charges,256.27,90,,,percent of total billed charges,90% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,213.56,75,,,percent of total billed charges,75% of total billed charges,242.03,85,,,percent of total billed charges,85% of total billed charges,108.2,264.81,
(RES) HDL CHOLESTEROL,1513,CDM,300,RC,83701,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
"(RES) Cardio IQ, Lipoprotein Frac. Ion Mot.",1514,CDM,300,RC,83704,HCPCS,outpatient,,,68.87,51.65,,61.98,90,,,percent of total billed charges,90% of total billed charges,64.05,93,,,percent of total billed charges,93% of total billed charges,26.17,38,,,percent of total billed charges,38% of total billed charges,26.17,38,,,percent of total billed charges,38% of total billed charges,58.54,85,,,percent of total billed charges,85% of total billed charges,26.17,38,,,percent of total billed charges,38% of total billed charges,56.06,81.4,,,percent of total billed charges,81.4% of total billed charges,61.98,90,,,percent of total billed charges,90% of total billed charges,61.98,90,,,percent of total billed charges,90% of total billed charges,26.17,38,,,percent of total billed charges,38% of total billed charges,26.17,38,,,percent of total billed charges,38% of total billed charges,26.17,38,,,percent of total billed charges,38% of total billed charges,51.65,75,,,percent of total billed charges,75% of total billed charges,58.54,85,,,percent of total billed charges,85% of total billed charges,26.17,64.05,
"(RES) Lipoprotein Fractionation, NMR",1515,CDM,300,RC,83704,HCPCS,outpatient,,,245.53,184.15,,220.98,90,,,percent of total billed charges,90% of total billed charges,228.34,93,,,percent of total billed charges,93% of total billed charges,93.3,38,,,percent of total billed charges,38% of total billed charges,93.3,38,,,percent of total billed charges,38% of total billed charges,208.7,85,,,percent of total billed charges,85% of total billed charges,93.3,38,,,percent of total billed charges,38% of total billed charges,199.86,81.4,,,percent of total billed charges,81.4% of total billed charges,220.98,90,,,percent of total billed charges,90% of total billed charges,220.98,90,,,percent of total billed charges,90% of total billed charges,93.3,38,,,percent of total billed charges,38% of total billed charges,93.3,38,,,percent of total billed charges,38% of total billed charges,93.3,38,,,percent of total billed charges,38% of total billed charges,184.15,75,,,percent of total billed charges,75% of total billed charges,208.7,85,,,percent of total billed charges,85% of total billed charges,93.3,228.34,
Cardio IQ Lipoprotein Fract. Ion Mobility,1516,CDM,300,RC,83704,HCPCS,outpatient,,,58.36,43.77,,52.52,90,,,percent of total billed charges,90% of total billed charges,54.27,93,,,percent of total billed charges,93% of total billed charges,22.18,38,,,percent of total billed charges,38% of total billed charges,22.18,38,,,percent of total billed charges,38% of total billed charges,49.61,85,,,percent of total billed charges,85% of total billed charges,22.18,38,,,percent of total billed charges,38% of total billed charges,47.51,81.4,,,percent of total billed charges,81.4% of total billed charges,52.52,90,,,percent of total billed charges,90% of total billed charges,52.52,90,,,percent of total billed charges,90% of total billed charges,22.18,38,,,percent of total billed charges,38% of total billed charges,22.18,38,,,percent of total billed charges,38% of total billed charges,22.18,38,,,percent of total billed charges,38% of total billed charges,43.77,75,,,percent of total billed charges,75% of total billed charges,49.61,85,,,percent of total billed charges,85% of total billed charges,22.18,54.27,
HDL,1517,CDM,300,RC,83718,HCPCS,outpatient,,,66.79,50.09,,60.11,90,,,percent of total billed charges,90% of total billed charges,62.11,93,,,percent of total billed charges,93% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,54.37,81.4,,,percent of total billed charges,81.4% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,50.09,75,,,percent of total billed charges,75% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,62.11,
****Cardio IQ Lipid panel-Trigs,1518,CDM,300,RC,83719,HCPCS,outpatient,,,43.66,32.75,,39.29,90,,,percent of total billed charges,90% of total billed charges,40.6,93,,,percent of total billed charges,93% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,37.11,85,,,percent of total billed charges,85% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,35.54,81.4,,,percent of total billed charges,81.4% of total billed charges,39.29,90,,,percent of total billed charges,90% of total billed charges,39.29,90,,,percent of total billed charges,90% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,16.59,38,,,percent of total billed charges,38% of total billed charges,32.75,75,,,percent of total billed charges,75% of total billed charges,37.11,85,,,percent of total billed charges,85% of total billed charges,16.59,40.6,
LDL-Direct,1519,CDM,300,RC,83721,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
Magnesium,1520,CDM,300,RC,83735,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
"Magnesium, RBC",1521,CDM,300,RC,83735,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
"Magnesium, Urine w Creatinine",1522,CDM,300,RC,83735,HCPCS,outpatient,,,132.52,99.39,,119.27,90,,,percent of total billed charges,90% of total billed charges,123.24,93,,,percent of total billed charges,93% of total billed charges,50.36,38,,,percent of total billed charges,38% of total billed charges,50.36,38,,,percent of total billed charges,38% of total billed charges,112.64,85,,,percent of total billed charges,85% of total billed charges,50.36,38,,,percent of total billed charges,38% of total billed charges,107.87,81.4,,,percent of total billed charges,81.4% of total billed charges,119.27,90,,,percent of total billed charges,90% of total billed charges,119.27,90,,,percent of total billed charges,90% of total billed charges,50.36,38,,,percent of total billed charges,38% of total billed charges,50.36,38,,,percent of total billed charges,38% of total billed charges,50.36,38,,,percent of total billed charges,38% of total billed charges,99.39,75,,,percent of total billed charges,75% of total billed charges,112.64,85,,,percent of total billed charges,85% of total billed charges,50.36,123.24,
"Magnesium, 24-hour urine w/o creatinine",1523,CDM,300,RC,83735,HCPCS,outpatient,,,73.61,55.21,,66.25,90,,,percent of total billed charges,90% of total billed charges,68.46,93,,,percent of total billed charges,93% of total billed charges,27.97,38,,,percent of total billed charges,38% of total billed charges,27.97,38,,,percent of total billed charges,38% of total billed charges,62.57,85,,,percent of total billed charges,85% of total billed charges,27.97,38,,,percent of total billed charges,38% of total billed charges,59.92,81.4,,,percent of total billed charges,81.4% of total billed charges,66.25,90,,,percent of total billed charges,90% of total billed charges,66.25,90,,,percent of total billed charges,90% of total billed charges,27.97,38,,,percent of total billed charges,38% of total billed charges,27.97,38,,,percent of total billed charges,38% of total billed charges,27.97,38,,,percent of total billed charges,38% of total billed charges,55.21,75,,,percent of total billed charges,75% of total billed charges,62.57,85,,,percent of total billed charges,85% of total billed charges,27.97,68.46,
(RES) Magnesium 24 Hr Urine,1524,CDM,300,RC,83735,HCPCS,outpatient,,,38.76,29.07,,34.88,90,,,percent of total billed charges,90% of total billed charges,36.05,93,,,percent of total billed charges,93% of total billed charges,14.73,38,,,percent of total billed charges,38% of total billed charges,14.73,38,,,percent of total billed charges,38% of total billed charges,32.95,85,,,percent of total billed charges,85% of total billed charges,14.73,38,,,percent of total billed charges,38% of total billed charges,31.55,81.4,,,percent of total billed charges,81.4% of total billed charges,34.88,90,,,percent of total billed charges,90% of total billed charges,34.88,90,,,percent of total billed charges,90% of total billed charges,14.73,38,,,percent of total billed charges,38% of total billed charges,14.73,38,,,percent of total billed charges,38% of total billed charges,14.73,38,,,percent of total billed charges,38% of total billed charges,29.07,75,,,percent of total billed charges,75% of total billed charges,32.95,85,,,percent of total billed charges,85% of total billed charges,14.73,36.05,
"Manganese, Blood",1525,CDM,300,RC,83785,HCPCS,outpatient,,,233.8,175.35,,210.42,90,,,percent of total billed charges,90% of total billed charges,217.43,93,,,percent of total billed charges,93% of total billed charges,88.84,38,,,percent of total billed charges,38% of total billed charges,88.84,38,,,percent of total billed charges,38% of total billed charges,198.73,85,,,percent of total billed charges,85% of total billed charges,88.84,38,,,percent of total billed charges,38% of total billed charges,190.31,81.4,,,percent of total billed charges,81.4% of total billed charges,210.42,90,,,percent of total billed charges,90% of total billed charges,210.42,90,,,percent of total billed charges,90% of total billed charges,88.84,38,,,percent of total billed charges,38% of total billed charges,88.84,38,,,percent of total billed charges,38% of total billed charges,88.84,38,,,percent of total billed charges,38% of total billed charges,175.35,75,,,percent of total billed charges,75% of total billed charges,198.73,85,,,percent of total billed charges,85% of total billed charges,88.84,217.43,
Oxcarbazepine-Trileptal,1526,CDM,300,RC,83789,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,162.37,
"Iodine, Serum/Plasma(Blue Top)",1528,CDM,300,RC,83789,HCPCS,outpatient,,,179.29,134.47,,161.36,90,,,percent of total billed charges,90% of total billed charges,166.74,93,,,percent of total billed charges,93% of total billed charges,68.13,38,,,percent of total billed charges,38% of total billed charges,68.13,38,,,percent of total billed charges,38% of total billed charges,152.4,85,,,percent of total billed charges,85% of total billed charges,68.13,38,,,percent of total billed charges,38% of total billed charges,145.94,81.4,,,percent of total billed charges,81.4% of total billed charges,161.36,90,,,percent of total billed charges,90% of total billed charges,161.36,90,,,percent of total billed charges,90% of total billed charges,68.13,38,,,percent of total billed charges,38% of total billed charges,68.13,38,,,percent of total billed charges,38% of total billed charges,68.13,38,,,percent of total billed charges,38% of total billed charges,134.47,75,,,percent of total billed charges,75% of total billed charges,152.4,85,,,percent of total billed charges,85% of total billed charges,68.13,166.74,
Pro-predict Metabolites,1529,CDM,300,RC,83789,HCPCS,outpatient,,,251.22,188.42,,226.1,90,,,percent of total billed charges,90% of total billed charges,233.63,93,,,percent of total billed charges,93% of total billed charges,95.46,38,,,percent of total billed charges,38% of total billed charges,95.46,38,,,percent of total billed charges,38% of total billed charges,213.54,85,,,percent of total billed charges,85% of total billed charges,95.46,38,,,percent of total billed charges,38% of total billed charges,204.49,81.4,,,percent of total billed charges,81.4% of total billed charges,226.1,90,,,percent of total billed charges,90% of total billed charges,226.1,90,,,percent of total billed charges,90% of total billed charges,95.46,38,,,percent of total billed charges,38% of total billed charges,95.46,38,,,percent of total billed charges,38% of total billed charges,95.46,38,,,percent of total billed charges,38% of total billed charges,188.42,75,,,percent of total billed charges,75% of total billed charges,213.54,85,,,percent of total billed charges,85% of total billed charges,95.46,233.63,
Mercury - 24 hr. urine,1530,CDM,300,RC,83825,HCPCS,outpatient,,,171.14,128.36,,154.03,90,,,percent of total billed charges,90% of total billed charges,159.16,93,,,percent of total billed charges,93% of total billed charges,65.03,38,,,percent of total billed charges,38% of total billed charges,65.03,38,,,percent of total billed charges,38% of total billed charges,145.47,85,,,percent of total billed charges,85% of total billed charges,65.03,38,,,percent of total billed charges,38% of total billed charges,139.31,81.4,,,percent of total billed charges,81.4% of total billed charges,154.03,90,,,percent of total billed charges,90% of total billed charges,154.03,90,,,percent of total billed charges,90% of total billed charges,65.03,38,,,percent of total billed charges,38% of total billed charges,65.03,38,,,percent of total billed charges,38% of total billed charges,65.03,38,,,percent of total billed charges,38% of total billed charges,128.36,75,,,percent of total billed charges,75% of total billed charges,145.47,85,,,percent of total billed charges,85% of total billed charges,65.03,159.16,
(RES) Mercury (HMP - Blood),1531,CDM,300,RC,83825,HCPCS,outpatient,,,162.36,121.77,,146.12,90,,,percent of total billed charges,90% of total billed charges,150.99,93,,,percent of total billed charges,93% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,132.16,81.4,,,percent of total billed charges,81.4% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,121.77,75,,,percent of total billed charges,75% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,150.99,
"(RES) MERCURY, RANDOM URINE",1532,CDM,300,RC,83825,HCPCS,outpatient,,,169.95,127.46,,152.96,90,,,percent of total billed charges,90% of total billed charges,158.05,93,,,percent of total billed charges,93% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,144.46,85,,,percent of total billed charges,85% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,138.34,81.4,,,percent of total billed charges,81.4% of total billed charges,152.96,90,,,percent of total billed charges,90% of total billed charges,152.96,90,,,percent of total billed charges,90% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,64.58,38,,,percent of total billed charges,38% of total billed charges,127.46,75,,,percent of total billed charges,75% of total billed charges,144.46,85,,,percent of total billed charges,85% of total billed charges,64.58,158.05,
"Mercury, Blood",1533,CDM,300,RC,83825,HCPCS,outpatient,,,166.67,125,,150,90,,,percent of total billed charges,90% of total billed charges,155,93,,,percent of total billed charges,93% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,135.67,81.4,,,percent of total billed charges,81.4% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,125,75,,,percent of total billed charges,75% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,155,
"(RES)MERCURY, BLOOD",1534,CDM,300,RC,83825,HCPCS,outpatient,,,156.96,117.72,,141.26,90,,,percent of total billed charges,90% of total billed charges,145.97,93,,,percent of total billed charges,93% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,127.77,81.4,,,percent of total billed charges,81.4% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,117.72,75,,,percent of total billed charges,75% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,145.97,
Metanephrines Free Plasma[Panel],1535,CDM,300,RC,83835,HCPCS,outpatient,,,424.18,318.14,,381.76,90,,,percent of total billed charges,90% of total billed charges,394.49,93,,,percent of total billed charges,93% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,360.55,85,,,percent of total billed charges,85% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,345.28,81.4,,,percent of total billed charges,81.4% of total billed charges,381.76,90,,,percent of total billed charges,90% of total billed charges,381.76,90,,,percent of total billed charges,90% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,318.14,75,,,percent of total billed charges,75% of total billed charges,360.55,85,,,percent of total billed charges,85% of total billed charges,161.19,394.49,
(Results)Metanephrine Free,1536,CDM,300,RC,83835,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Results)Normetanephrine Free,1537,CDM,300,RC,83835,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(results)Total Free Metanephrines,1538,CDM,300,RC,83835,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Metanephrines 24hr Urine Fractionated,1539,CDM,300,RC,83835,HCPCS,outpatient,,,393.71,295.28,,354.34,90,,,percent of total billed charges,90% of total billed charges,366.15,93,,,percent of total billed charges,93% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,334.65,85,,,percent of total billed charges,85% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,320.48,81.4,,,percent of total billed charges,81.4% of total billed charges,354.34,90,,,percent of total billed charges,90% of total billed charges,354.34,90,,,percent of total billed charges,90% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,295.28,75,,,percent of total billed charges,75% of total billed charges,334.65,85,,,percent of total billed charges,85% of total billed charges,149.61,366.15,
"Metanephrine, Fractionated Random Urine",1540,CDM,300,RC,83835,HCPCS,outpatient,,,227.08,170.31,,204.37,90,,,percent of total billed charges,90% of total billed charges,211.18,93,,,percent of total billed charges,93% of total billed charges,86.29,38,,,percent of total billed charges,38% of total billed charges,86.29,38,,,percent of total billed charges,38% of total billed charges,193.02,85,,,percent of total billed charges,85% of total billed charges,86.29,38,,,percent of total billed charges,38% of total billed charges,184.84,81.4,,,percent of total billed charges,81.4% of total billed charges,204.37,90,,,percent of total billed charges,90% of total billed charges,204.37,90,,,percent of total billed charges,90% of total billed charges,86.29,38,,,percent of total billed charges,38% of total billed charges,86.29,38,,,percent of total billed charges,38% of total billed charges,86.29,38,,,percent of total billed charges,38% of total billed charges,170.31,75,,,percent of total billed charges,75% of total billed charges,193.02,85,,,percent of total billed charges,85% of total billed charges,86.29,211.18,
"Myoglobin, Urine",1541,CDM,300,RC,83874,HCPCS,outpatient,,,162.36,121.77,,146.12,90,,,percent of total billed charges,90% of total billed charges,150.99,93,,,percent of total billed charges,93% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,132.16,81.4,,,percent of total billed charges,81.4% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,121.77,75,,,percent of total billed charges,75% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,150.99,
Myoglobin Serum,1542,CDM,300,RC,83874,HCPCS,outpatient,,,167.58,125.69,,150.82,90,,,percent of total billed charges,90% of total billed charges,155.85,93,,,percent of total billed charges,93% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,142.44,85,,,percent of total billed charges,85% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,136.41,81.4,,,percent of total billed charges,81.4% of total billed charges,150.82,90,,,percent of total billed charges,90% of total billed charges,150.82,90,,,percent of total billed charges,90% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,125.69,75,,,percent of total billed charges,75% of total billed charges,142.44,85,,,percent of total billed charges,85% of total billed charges,63.68,155.85,
BNP,1543,CDM,300,RC,83880,HCPCS,outpatient,,,205.05,153.79,,184.55,90,,,percent of total billed charges,90% of total billed charges,190.7,93,,,percent of total billed charges,93% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,166.91,81.4,,,percent of total billed charges,81.4% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,153.79,75,,,percent of total billed charges,75% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,190.7,
BNP,1544,CDM,300,RC,83880,HCPCS,outpatient,,,205.05,153.79,,184.55,90,,,percent of total billed charges,90% of total billed charges,190.7,93,,,percent of total billed charges,93% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,166.91,81.4,,,percent of total billed charges,81.4% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,153.79,75,,,percent of total billed charges,75% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,190.7,
Quest - BNP,1545,CDM,300,RC,83880,HCPCS,outpatient,,,208.92,156.69,,188.03,90,,,percent of total billed charges,90% of total billed charges,194.3,93,,,percent of total billed charges,93% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,177.58,85,,,percent of total billed charges,85% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,170.06,81.4,,,percent of total billed charges,81.4% of total billed charges,188.03,90,,,percent of total billed charges,90% of total billed charges,188.03,90,,,percent of total billed charges,90% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,156.69,75,,,percent of total billed charges,75% of total billed charges,177.58,85,,,percent of total billed charges,85% of total billed charges,79.39,194.3,
Quest - NT-proBNP,1546,CDM,300,RC,83880,HCPCS,outpatient,,,203.5,152.63,,183.15,90,,,percent of total billed charges,90% of total billed charges,189.26,93,,,percent of total billed charges,93% of total billed charges,77.33,38,,,percent of total billed charges,38% of total billed charges,77.33,38,,,percent of total billed charges,38% of total billed charges,172.98,85,,,percent of total billed charges,85% of total billed charges,77.33,38,,,percent of total billed charges,38% of total billed charges,165.65,81.4,,,percent of total billed charges,81.4% of total billed charges,183.15,90,,,percent of total billed charges,90% of total billed charges,183.15,90,,,percent of total billed charges,90% of total billed charges,77.33,38,,,percent of total billed charges,38% of total billed charges,77.33,38,,,percent of total billed charges,38% of total billed charges,77.33,38,,,percent of total billed charges,38% of total billed charges,152.63,75,,,percent of total billed charges,75% of total billed charges,172.98,85,,,percent of total billed charges,85% of total billed charges,77.33,189.26,
Retinol Binding Protein,1547,CDM,300,RC,83883,HCPCS,outpatient,,,145.66,109.25,,131.09,90,,,percent of total billed charges,90% of total billed charges,135.46,93,,,percent of total billed charges,93% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,123.81,85,,,percent of total billed charges,85% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,118.57,81.4,,,percent of total billed charges,81.4% of total billed charges,131.09,90,,,percent of total billed charges,90% of total billed charges,131.09,90,,,percent of total billed charges,90% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,109.25,75,,,percent of total billed charges,75% of total billed charges,123.81,85,,,percent of total billed charges,85% of total billed charges,55.35,135.46,
"(RES) KAPPA LIGHT CHAIN, TOTAL, RANDOM URINE",1548,CDM,300,RC,83883,HCPCS,outpatient,,,204.73,153.55,,184.26,90,,,percent of total billed charges,90% of total billed charges,190.4,93,,,percent of total billed charges,93% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,174.02,85,,,percent of total billed charges,85% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,166.65,81.4,,,percent of total billed charges,81.4% of total billed charges,184.26,90,,,percent of total billed charges,90% of total billed charges,184.26,90,,,percent of total billed charges,90% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,153.55,75,,,percent of total billed charges,75% of total billed charges,174.02,85,,,percent of total billed charges,85% of total billed charges,77.8,190.4,
Alpha-2-Macroglobulin,1549,CDM,300,RC,83883,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
"(RES) LAMBDA LIGHT CHAIN, TOTAL, RANDOM URINE",1550,CDM,300,RC,83883,HCPCS,outpatient,,,204.73,153.55,,184.26,90,,,percent of total billed charges,90% of total billed charges,190.4,93,,,percent of total billed charges,93% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,174.02,85,,,percent of total billed charges,85% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,166.65,81.4,,,percent of total billed charges,81.4% of total billed charges,184.26,90,,,percent of total billed charges,90% of total billed charges,184.26,90,,,percent of total billed charges,90% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,77.8,38,,,percent of total billed charges,38% of total billed charges,153.55,75,,,percent of total billed charges,75% of total billed charges,174.02,85,,,percent of total billed charges,85% of total billed charges,77.8,190.4,
"Nickel, Blood",1551,CDM,300,RC,83885,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,101.34,
"Nickel, Serum/Plasma",1552,CDM,300,RC,83885,HCPCS,outpatient,,,105.06,78.8,,94.55,90,,,percent of total billed charges,90% of total billed charges,97.71,93,,,percent of total billed charges,93% of total billed charges,39.92,38,,,percent of total billed charges,38% of total billed charges,39.92,38,,,percent of total billed charges,38% of total billed charges,89.3,85,,,percent of total billed charges,85% of total billed charges,39.92,38,,,percent of total billed charges,38% of total billed charges,85.52,81.4,,,percent of total billed charges,81.4% of total billed charges,94.55,90,,,percent of total billed charges,90% of total billed charges,94.55,90,,,percent of total billed charges,90% of total billed charges,39.92,38,,,percent of total billed charges,38% of total billed charges,39.92,38,,,percent of total billed charges,38% of total billed charges,39.92,38,,,percent of total billed charges,38% of total billed charges,78.8,75,,,percent of total billed charges,75% of total billed charges,89.3,85,,,percent of total billed charges,85% of total billed charges,39.92,97.71,
5' Nucleotidase,1553,CDM,300,RC,83915,HCPCS,outpatient,,,87.15,65.36,,78.44,90,,,percent of total billed charges,90% of total billed charges,81.05,93,,,percent of total billed charges,93% of total billed charges,33.12,38,,,percent of total billed charges,38% of total billed charges,33.12,38,,,percent of total billed charges,38% of total billed charges,74.08,85,,,percent of total billed charges,85% of total billed charges,33.12,38,,,percent of total billed charges,38% of total billed charges,70.94,81.4,,,percent of total billed charges,81.4% of total billed charges,78.44,90,,,percent of total billed charges,90% of total billed charges,78.44,90,,,percent of total billed charges,90% of total billed charges,33.12,38,,,percent of total billed charges,38% of total billed charges,33.12,38,,,percent of total billed charges,38% of total billed charges,33.12,38,,,percent of total billed charges,38% of total billed charges,65.36,75,,,percent of total billed charges,75% of total billed charges,74.08,85,,,percent of total billed charges,85% of total billed charges,33.12,81.05,
"Oligoclonal Bands, CSF",1554,CDM,300,RC,83916,HCPCS,outpatient,,,167.71,125.78,,150.94,90,,,percent of total billed charges,90% of total billed charges,155.97,93,,,percent of total billed charges,93% of total billed charges,63.73,38,,,percent of total billed charges,38% of total billed charges,63.73,38,,,percent of total billed charges,38% of total billed charges,142.55,85,,,percent of total billed charges,85% of total billed charges,63.73,38,,,percent of total billed charges,38% of total billed charges,136.52,81.4,,,percent of total billed charges,81.4% of total billed charges,150.94,90,,,percent of total billed charges,90% of total billed charges,150.94,90,,,percent of total billed charges,90% of total billed charges,63.73,38,,,percent of total billed charges,38% of total billed charges,63.73,38,,,percent of total billed charges,38% of total billed charges,63.73,38,,,percent of total billed charges,38% of total billed charges,125.78,75,,,percent of total billed charges,75% of total billed charges,142.55,85,,,percent of total billed charges,85% of total billed charges,63.73,155.97,
(RES) METHYLMALONIC ACID,1555,CDM,300,RC,83921,HCPCS,outpatient,,,292.26,219.2,,263.03,90,,,percent of total billed charges,90% of total billed charges,271.8,93,,,percent of total billed charges,93% of total billed charges,111.06,38,,,percent of total billed charges,38% of total billed charges,111.06,38,,,percent of total billed charges,38% of total billed charges,248.42,85,,,percent of total billed charges,85% of total billed charges,111.06,38,,,percent of total billed charges,38% of total billed charges,237.9,81.4,,,percent of total billed charges,81.4% of total billed charges,263.03,90,,,percent of total billed charges,90% of total billed charges,263.03,90,,,percent of total billed charges,90% of total billed charges,111.06,38,,,percent of total billed charges,38% of total billed charges,111.06,38,,,percent of total billed charges,38% of total billed charges,111.06,38,,,percent of total billed charges,38% of total billed charges,219.2,75,,,percent of total billed charges,75% of total billed charges,248.42,85,,,percent of total billed charges,85% of total billed charges,111.06,271.8,
Methylmalonic Acid,1556,CDM,300,RC,83921,HCPCS,outpatient,,,268.01,201.01,,241.21,90,,,percent of total billed charges,90% of total billed charges,249.25,93,,,percent of total billed charges,93% of total billed charges,101.84,38,,,percent of total billed charges,38% of total billed charges,101.84,38,,,percent of total billed charges,38% of total billed charges,227.81,85,,,percent of total billed charges,85% of total billed charges,101.84,38,,,percent of total billed charges,38% of total billed charges,218.16,81.4,,,percent of total billed charges,81.4% of total billed charges,241.21,90,,,percent of total billed charges,90% of total billed charges,241.21,90,,,percent of total billed charges,90% of total billed charges,101.84,38,,,percent of total billed charges,38% of total billed charges,101.84,38,,,percent of total billed charges,38% of total billed charges,101.84,38,,,percent of total billed charges,38% of total billed charges,201.01,75,,,percent of total billed charges,75% of total billed charges,227.81,85,,,percent of total billed charges,85% of total billed charges,101.84,249.25,
Morphine QT Urine,1557,CDM,300,RC,83925,HCPCS,outpatient,,,185.81,139.36,,167.23,90,,,percent of total billed charges,90% of total billed charges,172.8,93,,,percent of total billed charges,93% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,157.94,85,,,percent of total billed charges,85% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,151.25,81.4,,,percent of total billed charges,81.4% of total billed charges,167.23,90,,,percent of total billed charges,90% of total billed charges,167.23,90,,,percent of total billed charges,90% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,139.36,75,,,percent of total billed charges,75% of total billed charges,157.94,85,,,percent of total billed charges,85% of total billed charges,70.61,172.8,
"Osmolality, Urine",1558,CDM,300,RC,83935,HCPCS,outpatient,,,116.01,87.01,,104.41,90,,,percent of total billed charges,90% of total billed charges,107.89,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.43,81.4,,,percent of total billed charges,81.4% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87.01,75,,,percent of total billed charges,75% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,107.89,
Oxalate Urine 24hrs,1560,CDM,300,RC,83945,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
PTH intact wo calcium,1561,CDM,300,RC,83970,HCPCS,outpatient,,,244.91,183.68,,220.42,90,,,percent of total billed charges,90% of total billed charges,227.77,93,,,percent of total billed charges,93% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,208.17,85,,,percent of total billed charges,85% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,199.36,81.4,,,percent of total billed charges,81.4% of total billed charges,220.42,90,,,percent of total billed charges,90% of total billed charges,220.42,90,,,percent of total billed charges,90% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,183.68,75,,,percent of total billed charges,75% of total billed charges,208.17,85,,,percent of total billed charges,85% of total billed charges,93.07,227.77,
"(RES) PARATHYROID HORMONE, INTACT",1562,CDM,300,RC,83970,HCPCS,outpatient,,,243.51,182.63,,219.16,90,,,percent of total billed charges,90% of total billed charges,226.46,93,,,percent of total billed charges,93% of total billed charges,92.53,38,,,percent of total billed charges,38% of total billed charges,92.53,38,,,percent of total billed charges,38% of total billed charges,206.98,85,,,percent of total billed charges,85% of total billed charges,92.53,38,,,percent of total billed charges,38% of total billed charges,198.22,81.4,,,percent of total billed charges,81.4% of total billed charges,219.16,90,,,percent of total billed charges,90% of total billed charges,219.16,90,,,percent of total billed charges,90% of total billed charges,92.53,38,,,percent of total billed charges,38% of total billed charges,92.53,38,,,percent of total billed charges,38% of total billed charges,92.53,38,,,percent of total billed charges,38% of total billed charges,182.63,75,,,percent of total billed charges,75% of total billed charges,206.98,85,,,percent of total billed charges,85% of total billed charges,92.53,226.46,
PTH - Intact and Calcium,1563,CDM,300,RC,83970,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"pH, Feces",1564,CDM,300,RC,83986,HCPCS,outpatient,,,94.88,71.16,,85.39,90,,,percent of total billed charges,90% of total billed charges,88.24,93,,,percent of total billed charges,93% of total billed charges,36.05,38,,,percent of total billed charges,38% of total billed charges,36.05,38,,,percent of total billed charges,38% of total billed charges,80.65,85,,,percent of total billed charges,85% of total billed charges,36.05,38,,,percent of total billed charges,38% of total billed charges,77.23,81.4,,,percent of total billed charges,81.4% of total billed charges,85.39,90,,,percent of total billed charges,90% of total billed charges,85.39,90,,,percent of total billed charges,90% of total billed charges,36.05,38,,,percent of total billed charges,38% of total billed charges,36.05,38,,,percent of total billed charges,38% of total billed charges,36.05,38,,,percent of total billed charges,38% of total billed charges,71.16,75,,,percent of total billed charges,75% of total billed charges,80.65,85,,,percent of total billed charges,85% of total billed charges,36.05,88.24,
pH - body fluid SLVH,1566,CDM,300,RC,83986,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
Calprotectin (Stool),1567,CDM,300,RC,83993,HCPCS,outpatient,,,277.71,208.28,,249.94,90,,,percent of total billed charges,90% of total billed charges,258.27,93,,,percent of total billed charges,93% of total billed charges,105.53,38,,,percent of total billed charges,38% of total billed charges,105.53,38,,,percent of total billed charges,38% of total billed charges,236.05,85,,,percent of total billed charges,85% of total billed charges,105.53,38,,,percent of total billed charges,38% of total billed charges,226.06,81.4,,,percent of total billed charges,81.4% of total billed charges,249.94,90,,,percent of total billed charges,90% of total billed charges,249.94,90,,,percent of total billed charges,90% of total billed charges,105.53,38,,,percent of total billed charges,38% of total billed charges,105.53,38,,,percent of total billed charges,38% of total billed charges,105.53,38,,,percent of total billed charges,38% of total billed charges,208.28,75,,,percent of total billed charges,75% of total billed charges,236.05,85,,,percent of total billed charges,85% of total billed charges,105.53,258.27,
Alk Phos,1568,CDM,300,RC,84075,HCPCS,outpatient,,,116,87,,104.4,90,,,percent of total billed charges,90% of total billed charges,107.88,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.42,81.4,,,percent of total billed charges,81.4% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87,75,,,percent of total billed charges,75% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,107.88,
Alk Phos-Bone specific,1569,CDM,300,RC,84075,HCPCS,outpatient,,,144.73,108.55,,130.26,90,,,percent of total billed charges,90% of total billed charges,134.6,93,,,percent of total billed charges,93% of total billed charges,55,38,,,percent of total billed charges,38% of total billed charges,55,38,,,percent of total billed charges,38% of total billed charges,123.02,85,,,percent of total billed charges,85% of total billed charges,55,38,,,percent of total billed charges,38% of total billed charges,117.81,81.4,,,percent of total billed charges,81.4% of total billed charges,130.26,90,,,percent of total billed charges,90% of total billed charges,130.26,90,,,percent of total billed charges,90% of total billed charges,55,38,,,percent of total billed charges,38% of total billed charges,55,38,,,percent of total billed charges,38% of total billed charges,55,38,,,percent of total billed charges,38% of total billed charges,108.55,75,,,percent of total billed charges,75% of total billed charges,123.02,85,,,percent of total billed charges,85% of total billed charges,55,134.6,
(RES) ALKALINE PHOSPHATASE,1570,CDM,300,RC,84075,HCPCS,outpatient,,,89.06,66.8,,80.15,90,,,percent of total billed charges,90% of total billed charges,82.83,93,,,percent of total billed charges,93% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,75.7,85,,,percent of total billed charges,85% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,72.49,81.4,,,percent of total billed charges,81.4% of total billed charges,80.15,90,,,percent of total billed charges,90% of total billed charges,80.15,90,,,percent of total billed charges,90% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,66.8,75,,,percent of total billed charges,75% of total billed charges,75.7,85,,,percent of total billed charges,85% of total billed charges,33.84,82.83,
(RES) ALK PHOS ISOENZYMES,1571,CDM,300,RC,84080,HCPCS,outpatient,,,89.06,66.8,,80.15,90,,,percent of total billed charges,90% of total billed charges,82.83,93,,,percent of total billed charges,93% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,75.7,85,,,percent of total billed charges,85% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,72.49,81.4,,,percent of total billed charges,81.4% of total billed charges,80.15,90,,,percent of total billed charges,90% of total billed charges,80.15,90,,,percent of total billed charges,90% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,66.8,75,,,percent of total billed charges,75% of total billed charges,75.7,85,,,percent of total billed charges,85% of total billed charges,33.84,82.83,
Phosphorus,1572,CDM,300,RC,84100,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Phosporus 24hr Urine,1573,CDM,300,RC,84105,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
"Phosphate, Random Urine w/o Creatinine",1574,CDM,300,RC,84105,HCPCS,outpatient,,,67.11,50.33,,60.4,90,,,percent of total billed charges,90% of total billed charges,62.41,93,,,percent of total billed charges,93% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,54.63,81.4,,,percent of total billed charges,81.4% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,50.33,75,,,percent of total billed charges,75% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,62.41,
"Porphobilinogen quant, urine",1575,CDM,300,RC,84110,HCPCS,outpatient,,,94.2,70.65,,84.78,90,,,percent of total billed charges,90% of total billed charges,87.61,93,,,percent of total billed charges,93% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,76.68,81.4,,,percent of total billed charges,81.4% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,70.65,75,,,percent of total billed charges,75% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,35.8,87.61,
"Porphobilinogen, Qnt, 24 Hr Urine",1576,CDM,300,RC,84110,HCPCS,outpatient,,,96.34,72.26,,86.71,90,,,percent of total billed charges,90% of total billed charges,89.6,93,,,percent of total billed charges,93% of total billed charges,36.61,38,,,percent of total billed charges,38% of total billed charges,36.61,38,,,percent of total billed charges,38% of total billed charges,81.89,85,,,percent of total billed charges,85% of total billed charges,36.61,38,,,percent of total billed charges,38% of total billed charges,78.42,81.4,,,percent of total billed charges,81.4% of total billed charges,86.71,90,,,percent of total billed charges,90% of total billed charges,86.71,90,,,percent of total billed charges,90% of total billed charges,36.61,38,,,percent of total billed charges,38% of total billed charges,36.61,38,,,percent of total billed charges,38% of total billed charges,36.61,38,,,percent of total billed charges,38% of total billed charges,72.26,75,,,percent of total billed charges,75% of total billed charges,81.89,85,,,percent of total billed charges,85% of total billed charges,36.61,89.6,
Porphyrins Fractionated QT random Urine,1577,CDM,300,RC,84120,HCPCS,outpatient,,,144.49,108.37,,130.04,90,,,percent of total billed charges,90% of total billed charges,134.38,93,,,percent of total billed charges,93% of total billed charges,54.91,38,,,percent of total billed charges,38% of total billed charges,54.91,38,,,percent of total billed charges,38% of total billed charges,122.82,85,,,percent of total billed charges,85% of total billed charges,54.91,38,,,percent of total billed charges,38% of total billed charges,117.61,81.4,,,percent of total billed charges,81.4% of total billed charges,130.04,90,,,percent of total billed charges,90% of total billed charges,130.04,90,,,percent of total billed charges,90% of total billed charges,54.91,38,,,percent of total billed charges,38% of total billed charges,54.91,38,,,percent of total billed charges,38% of total billed charges,54.91,38,,,percent of total billed charges,38% of total billed charges,108.37,75,,,percent of total billed charges,75% of total billed charges,122.82,85,,,percent of total billed charges,85% of total billed charges,54.91,134.38,
Potassium,1578,CDM,300,RC,84132,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
potassium-RBC,1579,CDM,300,RC,84132,HCPCS,outpatient,,,136.27,102.2,,122.64,90,,,percent of total billed charges,90% of total billed charges,126.73,93,,,percent of total billed charges,93% of total billed charges,51.78,38,,,percent of total billed charges,38% of total billed charges,51.78,38,,,percent of total billed charges,38% of total billed charges,115.83,85,,,percent of total billed charges,85% of total billed charges,51.78,38,,,percent of total billed charges,38% of total billed charges,110.92,81.4,,,percent of total billed charges,81.4% of total billed charges,122.64,90,,,percent of total billed charges,90% of total billed charges,122.64,90,,,percent of total billed charges,90% of total billed charges,51.78,38,,,percent of total billed charges,38% of total billed charges,51.78,38,,,percent of total billed charges,38% of total billed charges,51.78,38,,,percent of total billed charges,38% of total billed charges,102.2,75,,,percent of total billed charges,75% of total billed charges,115.83,85,,,percent of total billed charges,85% of total billed charges,51.78,126.73,
"Potassium, Urine - 24 hr w/o Creat",1580,CDM,300,RC,84133,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
"(RES) POTASSIUM, 24 HOUR URINE",1581,CDM,300,RC,84133,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
"Potassium, Random Urine w/o Creatinine",1582,CDM,300,RC,84133,HCPCS,outpatient,,,65.79,49.34,,59.21,90,,,percent of total billed charges,90% of total billed charges,61.18,93,,,percent of total billed charges,93% of total billed charges,25,38,,,percent of total billed charges,38% of total billed charges,25,38,,,percent of total billed charges,38% of total billed charges,55.92,85,,,percent of total billed charges,85% of total billed charges,25,38,,,percent of total billed charges,38% of total billed charges,53.55,81.4,,,percent of total billed charges,81.4% of total billed charges,59.21,90,,,percent of total billed charges,90% of total billed charges,59.21,90,,,percent of total billed charges,90% of total billed charges,25,38,,,percent of total billed charges,38% of total billed charges,25,38,,,percent of total billed charges,38% of total billed charges,25,38,,,percent of total billed charges,38% of total billed charges,49.34,75,,,percent of total billed charges,75% of total billed charges,55.92,85,,,percent of total billed charges,85% of total billed charges,25,61.18,
Prealbumin,1583,CDM,300,RC,84134,HCPCS,outpatient,,,104.31,78.23,,93.88,90,,,percent of total billed charges,90% of total billed charges,97.01,93,,,percent of total billed charges,93% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,88.66,85,,,percent of total billed charges,85% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,84.91,81.4,,,percent of total billed charges,81.4% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,78.23,75,,,percent of total billed charges,75% of total billed charges,88.66,85,,,percent of total billed charges,85% of total billed charges,39.64,97.01,
"Pregnenolone, LC/MS",1584,CDM,300,RC,84140,HCPCS,outpatient,,,154.8,116.1,,139.32,90,,,percent of total billed charges,90% of total billed charges,143.96,93,,,percent of total billed charges,93% of total billed charges,58.82,38,,,percent of total billed charges,38% of total billed charges,58.82,38,,,percent of total billed charges,38% of total billed charges,131.58,85,,,percent of total billed charges,85% of total billed charges,58.82,38,,,percent of total billed charges,38% of total billed charges,126.01,81.4,,,percent of total billed charges,81.4% of total billed charges,139.32,90,,,percent of total billed charges,90% of total billed charges,139.32,90,,,percent of total billed charges,90% of total billed charges,58.82,38,,,percent of total billed charges,38% of total billed charges,58.82,38,,,percent of total billed charges,38% of total billed charges,58.82,38,,,percent of total billed charges,38% of total billed charges,116.1,75,,,percent of total billed charges,75% of total billed charges,131.58,85,,,percent of total billed charges,85% of total billed charges,58.82,143.96,
PROGESTERONE,1585,CDM,300,RC,84144,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
17 OH Progesterone,1586,CDM,300,RC,84144,HCPCS,outpatient,,,141.79,106.34,,127.61,90,,,percent of total billed charges,90% of total billed charges,131.86,93,,,percent of total billed charges,93% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,115.42,81.4,,,percent of total billed charges,81.4% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,106.34,75,,,percent of total billed charges,75% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,131.86,
Procalcitonin,1587,CDM,300,RC,84145,HCPCS,outpatient,,,382.87,287.15,,344.58,90,,,percent of total billed charges,90% of total billed charges,356.07,93,,,percent of total billed charges,93% of total billed charges,145.49,38,,,percent of total billed charges,38% of total billed charges,145.49,38,,,percent of total billed charges,38% of total billed charges,325.44,85,,,percent of total billed charges,85% of total billed charges,145.49,38,,,percent of total billed charges,38% of total billed charges,311.66,81.4,,,percent of total billed charges,81.4% of total billed charges,344.58,90,,,percent of total billed charges,90% of total billed charges,344.58,90,,,percent of total billed charges,90% of total billed charges,145.49,38,,,percent of total billed charges,38% of total billed charges,145.49,38,,,percent of total billed charges,38% of total billed charges,145.49,38,,,percent of total billed charges,38% of total billed charges,287.15,75,,,percent of total billed charges,75% of total billed charges,325.44,85,,,percent of total billed charges,85% of total billed charges,145.49,356.07,
Procalcitonin (SLVRMC),1588,CDM,300,RC,84145,HCPCS,outpatient,,,291.83,218.87,,262.65,90,,,percent of total billed charges,90% of total billed charges,271.4,93,,,percent of total billed charges,93% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,248.06,85,,,percent of total billed charges,85% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,237.55,81.4,,,percent of total billed charges,81.4% of total billed charges,262.65,90,,,percent of total billed charges,90% of total billed charges,262.65,90,,,percent of total billed charges,90% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,110.9,38,,,percent of total billed charges,38% of total billed charges,218.87,75,,,percent of total billed charges,75% of total billed charges,248.06,85,,,percent of total billed charges,85% of total billed charges,110.9,271.4,
Prolactin,1589,CDM,300,RC,84146,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
"Prolactin, Dilution Study",1590,CDM,300,RC,84146,HCPCS,outpatient,,,363.74,272.81,,327.37,90,,,percent of total billed charges,90% of total billed charges,338.28,93,,,percent of total billed charges,93% of total billed charges,138.22,38,,,percent of total billed charges,38% of total billed charges,138.22,38,,,percent of total billed charges,38% of total billed charges,309.18,85,,,percent of total billed charges,85% of total billed charges,138.22,38,,,percent of total billed charges,38% of total billed charges,296.08,81.4,,,percent of total billed charges,81.4% of total billed charges,327.37,90,,,percent of total billed charges,90% of total billed charges,327.37,90,,,percent of total billed charges,90% of total billed charges,138.22,38,,,percent of total billed charges,38% of total billed charges,138.22,38,,,percent of total billed charges,38% of total billed charges,138.22,38,,,percent of total billed charges,38% of total billed charges,272.81,75,,,percent of total billed charges,75% of total billed charges,309.18,85,,,percent of total billed charges,85% of total billed charges,138.22,338.28,
"Prolactin, Total and Monometric",1591,CDM,300,RC,84146,HCPCS,outpatient,,,324.7,243.53,,292.23,90,,,percent of total billed charges,90% of total billed charges,301.97,93,,,percent of total billed charges,93% of total billed charges,123.39,38,,,percent of total billed charges,38% of total billed charges,123.39,38,,,percent of total billed charges,38% of total billed charges,276,85,,,percent of total billed charges,85% of total billed charges,123.39,38,,,percent of total billed charges,38% of total billed charges,264.31,81.4,,,percent of total billed charges,81.4% of total billed charges,292.23,90,,,percent of total billed charges,90% of total billed charges,292.23,90,,,percent of total billed charges,90% of total billed charges,123.39,38,,,percent of total billed charges,38% of total billed charges,123.39,38,,,percent of total billed charges,38% of total billed charges,123.39,38,,,percent of total billed charges,38% of total billed charges,243.53,75,,,percent of total billed charges,75% of total billed charges,276,85,,,percent of total billed charges,85% of total billed charges,123.39,301.97,
PSA Total,1592,CDM,300,RC,84153,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,101.34,
"(RES) PSA, TOTAL",1593,CDM,300,RC,84153,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,101.34,
"PSA, w HAMA Treatment",1594,CDM,300,RC,84153,HCPCS,outpatient,,,140.86,105.65,,126.77,90,,,percent of total billed charges,90% of total billed charges,131,93,,,percent of total billed charges,93% of total billed charges,53.53,38,,,percent of total billed charges,38% of total billed charges,53.53,38,,,percent of total billed charges,38% of total billed charges,119.73,85,,,percent of total billed charges,85% of total billed charges,53.53,38,,,percent of total billed charges,38% of total billed charges,114.66,81.4,,,percent of total billed charges,81.4% of total billed charges,126.77,90,,,percent of total billed charges,90% of total billed charges,126.77,90,,,percent of total billed charges,90% of total billed charges,53.53,38,,,percent of total billed charges,38% of total billed charges,53.53,38,,,percent of total billed charges,38% of total billed charges,53.53,38,,,percent of total billed charges,38% of total billed charges,105.65,75,,,percent of total billed charges,75% of total billed charges,119.73,85,,,percent of total billed charges,85% of total billed charges,53.53,131,
PSA Free,1595,CDM,301,RC,84154,HCPCS,outpatient,,,232.01,174.01,,208.81,90,,,percent of total billed charges,90% of total billed charges,215.77,93,,,percent of total billed charges,93% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,188.86,81.4,,,percent of total billed charges,81.4% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,174.01,75,,,percent of total billed charges,75% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,215.77,
"(RES) PSA, FREE",1596,CDM,300,RC,84154,HCPCS,outpatient,,,232.01,174.01,,208.81,90,,,percent of total billed charges,90% of total billed charges,215.77,93,,,percent of total billed charges,93% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,188.86,81.4,,,percent of total billed charges,81.4% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,174.01,75,,,percent of total billed charges,75% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,215.77,
Total Protein,1597,CDM,300,RC,84155,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
"Profile - Protein, Total Serum",1598,CDM,300,RC,84155,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
"(RES) PROTEIN, TOTAL",1599,CDM,300,RC,84155,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
"(RE) PROTEIN, TOTAL",1600,CDM,300,RC,84155,HCPCS,outpatient,,,58.15,43.61,,52.34,90,,,percent of total billed charges,90% of total billed charges,54.08,93,,,percent of total billed charges,93% of total billed charges,22.1,38,,,percent of total billed charges,38% of total billed charges,22.1,38,,,percent of total billed charges,38% of total billed charges,49.43,85,,,percent of total billed charges,85% of total billed charges,22.1,38,,,percent of total billed charges,38% of total billed charges,47.33,81.4,,,percent of total billed charges,81.4% of total billed charges,52.34,90,,,percent of total billed charges,90% of total billed charges,52.34,90,,,percent of total billed charges,90% of total billed charges,22.1,38,,,percent of total billed charges,38% of total billed charges,22.1,38,,,percent of total billed charges,38% of total billed charges,22.1,38,,,percent of total billed charges,38% of total billed charges,43.61,75,,,percent of total billed charges,75% of total billed charges,49.43,85,,,percent of total billed charges,85% of total billed charges,22.1,54.08,
(Result) Hours of Collection,1601,CDM,300,RC,84156,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Profile - Urine Protein Random,1602,CDM,300,RC,84156,HCPCS,outpatient,,,45.95,34.46,,41.36,90,,,percent of total billed charges,90% of total billed charges,42.73,93,,,percent of total billed charges,93% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,39.06,85,,,percent of total billed charges,85% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,37.4,81.4,,,percent of total billed charges,81.4% of total billed charges,41.36,90,,,percent of total billed charges,90% of total billed charges,41.36,90,,,percent of total billed charges,90% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,34.46,75,,,percent of total billed charges,75% of total billed charges,39.06,85,,,percent of total billed charges,85% of total billed charges,17.46,42.73,
"Protein, 24 Hr Urine",1603,CDM,300,RC,84156,HCPCS,outpatient,,,52.72,39.54,,47.45,90,,,percent of total billed charges,90% of total billed charges,49.03,93,,,percent of total billed charges,93% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,42.91,81.4,,,percent of total billed charges,81.4% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,39.54,75,,,percent of total billed charges,75% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,49.03,
"(RES) PROTEIN, TOTAL, RANDOM UR",1604,CDM,300,RC,84156,HCPCS,outpatient,,,45.95,34.46,,41.36,90,,,percent of total billed charges,90% of total billed charges,42.73,93,,,percent of total billed charges,93% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,39.06,85,,,percent of total billed charges,85% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,37.4,81.4,,,percent of total billed charges,81.4% of total billed charges,41.36,90,,,percent of total billed charges,90% of total billed charges,41.36,90,,,percent of total billed charges,90% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,17.46,38,,,percent of total billed charges,38% of total billed charges,34.46,75,,,percent of total billed charges,75% of total billed charges,39.06,85,,,percent of total billed charges,85% of total billed charges,17.46,42.73,
"(RES) PROTEIN, TOTAL, 24 HR UR",1605,CDM,300,RC,84156,HCPCS,outpatient,,,52.72,39.54,,47.45,90,,,percent of total billed charges,90% of total billed charges,49.03,93,,,percent of total billed charges,93% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,42.91,81.4,,,percent of total billed charges,81.4% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,39.54,75,,,percent of total billed charges,75% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,49.03,
"Urine Protein, Total, Random w/o Creatinine",1606,CDM,300,RC,84156,HCPCS,outpatient,,,67.11,50.33,,60.4,90,,,percent of total billed charges,90% of total billed charges,62.41,93,,,percent of total billed charges,93% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,54.63,81.4,,,percent of total billed charges,81.4% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,50.33,75,,,percent of total billed charges,75% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,62.41,
"Protein, CSF",1607,CDM,300,RC,84157,HCPCS,outpatient,,,69.14,51.86,,62.23,90,,,percent of total billed charges,90% of total billed charges,64.3,93,,,percent of total billed charges,93% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,58.77,85,,,percent of total billed charges,85% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,56.28,81.4,,,percent of total billed charges,81.4% of total billed charges,62.23,90,,,percent of total billed charges,90% of total billed charges,62.23,90,,,percent of total billed charges,90% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,51.86,75,,,percent of total billed charges,75% of total billed charges,58.77,85,,,percent of total billed charges,85% of total billed charges,26.27,64.3,
"Protein, Total Peritoneal Fluid",1608,CDM,300,RC,84157,HCPCS,outpatient,,,72.78,54.59,,65.5,90,,,percent of total billed charges,90% of total billed charges,67.69,93,,,percent of total billed charges,93% of total billed charges,27.66,38,,,percent of total billed charges,38% of total billed charges,27.66,38,,,percent of total billed charges,38% of total billed charges,61.86,85,,,percent of total billed charges,85% of total billed charges,27.66,38,,,percent of total billed charges,38% of total billed charges,59.24,81.4,,,percent of total billed charges,81.4% of total billed charges,65.5,90,,,percent of total billed charges,90% of total billed charges,65.5,90,,,percent of total billed charges,90% of total billed charges,27.66,38,,,percent of total billed charges,38% of total billed charges,27.66,38,,,percent of total billed charges,38% of total billed charges,27.66,38,,,percent of total billed charges,38% of total billed charges,54.59,75,,,percent of total billed charges,75% of total billed charges,61.86,85,,,percent of total billed charges,85% of total billed charges,27.66,67.69,
Fluid Protein Alamosa,1609,CDM,300,RC,84157,HCPCS,outpatient,,,70.77,53.08,,63.69,90,,,percent of total billed charges,90% of total billed charges,65.82,93,,,percent of total billed charges,93% of total billed charges,26.89,38,,,percent of total billed charges,38% of total billed charges,26.89,38,,,percent of total billed charges,38% of total billed charges,60.15,85,,,percent of total billed charges,85% of total billed charges,26.89,38,,,percent of total billed charges,38% of total billed charges,57.61,81.4,,,percent of total billed charges,81.4% of total billed charges,63.69,90,,,percent of total billed charges,90% of total billed charges,63.69,90,,,percent of total billed charges,90% of total billed charges,26.89,38,,,percent of total billed charges,38% of total billed charges,26.89,38,,,percent of total billed charges,38% of total billed charges,26.89,38,,,percent of total billed charges,38% of total billed charges,53.08,75,,,percent of total billed charges,75% of total billed charges,60.15,85,,,percent of total billed charges,85% of total billed charges,26.89,65.82,
"Protein, Body Fluid ref lab",1610,CDM,300,RC,84157,HCPCS,outpatient,,,68.91,51.68,,62.02,90,,,percent of total billed charges,90% of total billed charges,64.09,93,,,percent of total billed charges,93% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,56.09,81.4,,,percent of total billed charges,81.4% of total billed charges,62.02,90,,,percent of total billed charges,90% of total billed charges,62.02,90,,,percent of total billed charges,90% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,51.68,75,,,percent of total billed charges,75% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,26.19,64.09,
PROTEIN ELECTROPHORESIS SERUM,1611,CDM,300,RC,84165,HCPCS,outpatient,,,86.15,64.61,,77.54,90,,,percent of total billed charges,90% of total billed charges,80.12,93,,,percent of total billed charges,93% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,73.23,85,,,percent of total billed charges,85% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,70.13,81.4,,,percent of total billed charges,81.4% of total billed charges,77.54,90,,,percent of total billed charges,90% of total billed charges,77.54,90,,,percent of total billed charges,90% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,64.61,75,,,percent of total billed charges,75% of total billed charges,73.23,85,,,percent of total billed charges,85% of total billed charges,32.74,80.12,
(RES) PROTEIN ELECTROPHORESIS,1612,CDM,300,RC,84165,HCPCS,outpatient,,,75.75,56.81,,68.18,90,,,percent of total billed charges,90% of total billed charges,70.45,93,,,percent of total billed charges,93% of total billed charges,28.79,38,,,percent of total billed charges,38% of total billed charges,28.79,38,,,percent of total billed charges,38% of total billed charges,64.39,85,,,percent of total billed charges,85% of total billed charges,28.79,38,,,percent of total billed charges,38% of total billed charges,61.66,81.4,,,percent of total billed charges,81.4% of total billed charges,68.18,90,,,percent of total billed charges,90% of total billed charges,68.18,90,,,percent of total billed charges,90% of total billed charges,28.79,38,,,percent of total billed charges,38% of total billed charges,28.79,38,,,percent of total billed charges,38% of total billed charges,28.79,38,,,percent of total billed charges,38% of total billed charges,56.81,75,,,percent of total billed charges,75% of total billed charges,64.39,85,,,percent of total billed charges,85% of total billed charges,28.79,70.45,
(Result) Albumin (PE),1613,CDM,300,RC,84165,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Globulin (PE),1614,CDM,300,RC,84165,HCPCS,outpatient,,,9.37,7.03,,8.43,90,,,percent of total billed charges,90% of total billed charges,8.71,93,,,percent of total billed charges,93% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,7.96,85,,,percent of total billed charges,85% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,7.63,81.4,,,percent of total billed charges,81.4% of total billed charges,8.43,90,,,percent of total billed charges,90% of total billed charges,8.43,90,,,percent of total billed charges,90% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,7.03,75,,,percent of total billed charges,75% of total billed charges,7.96,85,,,percent of total billed charges,85% of total billed charges,3.56,8.71,
(Result) A/G Ratio (PE),1615,CDM,300,RC,84165,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Alpha-1,1616,CDM,300,RC,84165,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Alpha-2,1617,CDM,300,RC,84165,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Beta,1618,CDM,300,RC,84165,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Gamma,1619,CDM,300,RC,84165,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RE) PROTEIN ELECTROPHORESIS,1620,CDM,300,RC,84165,HCPCS,outpatient,,,173.21,129.91,,155.89,90,,,percent of total billed charges,90% of total billed charges,161.09,93,,,percent of total billed charges,93% of total billed charges,65.82,38,,,percent of total billed charges,38% of total billed charges,65.82,38,,,percent of total billed charges,38% of total billed charges,147.23,85,,,percent of total billed charges,85% of total billed charges,65.82,38,,,percent of total billed charges,38% of total billed charges,140.99,81.4,,,percent of total billed charges,81.4% of total billed charges,155.89,90,,,percent of total billed charges,90% of total billed charges,155.89,90,,,percent of total billed charges,90% of total billed charges,65.82,38,,,percent of total billed charges,38% of total billed charges,65.82,38,,,percent of total billed charges,38% of total billed charges,65.82,38,,,percent of total billed charges,38% of total billed charges,129.91,75,,,percent of total billed charges,75% of total billed charges,147.23,85,,,percent of total billed charges,85% of total billed charges,65.82,161.09,
(RES) PROTEIN ELECTRO URINE,1621,CDM,300,RC,84166,HCPCS,outpatient,,,121.23,90.92,,109.11,90,,,percent of total billed charges,90% of total billed charges,112.74,93,,,percent of total billed charges,93% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,103.05,85,,,percent of total billed charges,85% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,98.68,81.4,,,percent of total billed charges,81.4% of total billed charges,109.11,90,,,percent of total billed charges,90% of total billed charges,109.11,90,,,percent of total billed charges,90% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,90.92,75,,,percent of total billed charges,75% of total billed charges,103.05,85,,,percent of total billed charges,85% of total billed charges,46.07,112.74,
(RES) PL-7 AB,1622,CDM,300,RC,84182,HCPCS,outpatient,,,125.87,94.4,,113.28,90,,,percent of total billed charges,90% of total billed charges,117.06,93,,,percent of total billed charges,93% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,102.46,81.4,,,percent of total billed charges,81.4% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,94.4,75,,,percent of total billed charges,75% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,117.06,
(RES) JO-1 AB,1623,CDM,300,RC,84182,HCPCS,outpatient,,,176.87,132.65,,159.18,90,,,percent of total billed charges,90% of total billed charges,164.49,93,,,percent of total billed charges,93% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,143.97,81.4,,,percent of total billed charges,81.4% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,132.65,75,,,percent of total billed charges,75% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,164.49,
(RES) PL-7 Antibody,1624,CDM,300,RC,84182,HCPCS,outpatient,,,176.87,132.65,,159.18,90,,,percent of total billed charges,90% of total billed charges,164.49,93,,,percent of total billed charges,93% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,143.97,81.4,,,percent of total billed charges,81.4% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,132.65,75,,,percent of total billed charges,75% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,164.49,
(RES) PL-12 Antibody,1625,CDM,300,RC,84182,HCPCS,outpatient,,,176.87,132.65,,159.18,90,,,percent of total billed charges,90% of total billed charges,164.49,93,,,percent of total billed charges,93% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,143.97,81.4,,,percent of total billed charges,81.4% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,132.65,75,,,percent of total billed charges,75% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,164.49,
(RES) EJ Antibody,1626,CDM,300,RC,84182,HCPCS,outpatient,,,176.87,132.65,,159.18,90,,,percent of total billed charges,90% of total billed charges,164.49,93,,,percent of total billed charges,93% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,143.97,81.4,,,percent of total billed charges,81.4% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,132.65,75,,,percent of total billed charges,75% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,164.49,
(RES) OJ Antibody,1627,CDM,300,RC,84182,HCPCS,outpatient,,,176.87,132.65,,159.18,90,,,percent of total billed charges,90% of total billed charges,164.49,93,,,percent of total billed charges,93% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,143.97,81.4,,,percent of total billed charges,81.4% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,132.65,75,,,percent of total billed charges,75% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,164.49,
(RES) SRP Antibody,1628,CDM,300,RC,84182,HCPCS,outpatient,,,176.87,132.65,,159.18,90,,,percent of total billed charges,90% of total billed charges,164.49,93,,,percent of total billed charges,93% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,143.97,81.4,,,percent of total billed charges,81.4% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,132.65,75,,,percent of total billed charges,75% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,164.49,
"(RES) ANNA1 (HU) AB, LB",1629,CDM,300,RC,84182,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,328.98,
"(RES) ANNA2 (RI) AB, LB",1630,CDM,300,RC,84182,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,328.98,
(RES)  PL-12 AB,1631,CDM,300,RC,84182,HCPCS,outpatient,,,125.87,94.4,,113.28,90,,,percent of total billed charges,90% of total billed charges,117.06,93,,,percent of total billed charges,93% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,102.46,81.4,,,percent of total billed charges,81.4% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,94.4,75,,,percent of total billed charges,75% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,117.06,
"(RES) PCA TR (DNER) AB, LB",1632,CDM,300,RC,84182,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,328.98,
"(RES) AGNA/SOX1 AB, LB",1633,CDM,300,RC,84182,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,328.98,
"(RES) MA2/TA AB, LB",1634,CDM,300,RC,84182,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,328.98,
"(RES) ZIC4 AB, LB",1635,CDM,300,RC,84182,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,328.98,
"(RES) CRMP5/CV2 AB, LB",1636,CDM,300,RC,84182,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,328.98,
"(RES) AMPHIPHYSIN AB, LB",1637,CDM,300,RC,84182,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,328.98,
(RES) EJ AB,1638,CDM,300,RC,84182,HCPCS,outpatient,,,125.87,94.4,,113.28,90,,,percent of total billed charges,90% of total billed charges,117.06,93,,,percent of total billed charges,93% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,102.46,81.4,,,percent of total billed charges,81.4% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,94.4,75,,,percent of total billed charges,75% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,117.06,
Proinsulin,1640,CDM,300,RC,84206,HCPCS,outpatient,,,258.12,193.59,,232.31,90,,,percent of total billed charges,90% of total billed charges,240.05,93,,,percent of total billed charges,93% of total billed charges,98.09,38,,,percent of total billed charges,38% of total billed charges,98.09,38,,,percent of total billed charges,38% of total billed charges,219.4,85,,,percent of total billed charges,85% of total billed charges,98.09,38,,,percent of total billed charges,38% of total billed charges,210.11,81.4,,,percent of total billed charges,81.4% of total billed charges,232.31,90,,,percent of total billed charges,90% of total billed charges,232.31,90,,,percent of total billed charges,90% of total billed charges,98.09,38,,,percent of total billed charges,38% of total billed charges,98.09,38,,,percent of total billed charges,38% of total billed charges,98.09,38,,,percent of total billed charges,38% of total billed charges,193.59,75,,,percent of total billed charges,75% of total billed charges,219.4,85,,,percent of total billed charges,85% of total billed charges,98.09,240.05,
"Vit B6, Plasma",1641,CDM,300,RC,84207,HCPCS,outpatient,,,279.14,209.36,,251.23,90,,,percent of total billed charges,90% of total billed charges,259.6,93,,,percent of total billed charges,93% of total billed charges,106.07,38,,,percent of total billed charges,38% of total billed charges,106.07,38,,,percent of total billed charges,38% of total billed charges,237.27,85,,,percent of total billed charges,85% of total billed charges,106.07,38,,,percent of total billed charges,38% of total billed charges,227.22,81.4,,,percent of total billed charges,81.4% of total billed charges,251.23,90,,,percent of total billed charges,90% of total billed charges,251.23,90,,,percent of total billed charges,90% of total billed charges,106.07,38,,,percent of total billed charges,38% of total billed charges,106.07,38,,,percent of total billed charges,38% of total billed charges,106.07,38,,,percent of total billed charges,38% of total billed charges,209.36,75,,,percent of total billed charges,75% of total billed charges,237.27,85,,,percent of total billed charges,85% of total billed charges,106.07,259.6,
"Vitamin B6, Plasma",1642,CDM,300,RC,84207,HCPCS,outpatient,,,272.77,204.58,,245.49,90,,,percent of total billed charges,90% of total billed charges,253.68,93,,,percent of total billed charges,93% of total billed charges,103.65,38,,,percent of total billed charges,38% of total billed charges,103.65,38,,,percent of total billed charges,38% of total billed charges,231.85,85,,,percent of total billed charges,85% of total billed charges,103.65,38,,,percent of total billed charges,38% of total billed charges,222.03,81.4,,,percent of total billed charges,81.4% of total billed charges,245.49,90,,,percent of total billed charges,90% of total billed charges,245.49,90,,,percent of total billed charges,90% of total billed charges,103.65,38,,,percent of total billed charges,38% of total billed charges,103.65,38,,,percent of total billed charges,38% of total billed charges,103.65,38,,,percent of total billed charges,38% of total billed charges,204.58,75,,,percent of total billed charges,75% of total billed charges,231.85,85,,,percent of total billed charges,85% of total billed charges,103.65,253.68,
"Pyruvic Acid (Pyruvate), Blood",1643,CDM,300,RC,84210,HCPCS,outpatient,,,146.55,109.91,,131.9,90,,,percent of total billed charges,90% of total billed charges,136.29,93,,,percent of total billed charges,93% of total billed charges,55.69,38,,,percent of total billed charges,38% of total billed charges,55.69,38,,,percent of total billed charges,38% of total billed charges,124.57,85,,,percent of total billed charges,85% of total billed charges,55.69,38,,,percent of total billed charges,38% of total billed charges,119.29,81.4,,,percent of total billed charges,81.4% of total billed charges,131.9,90,,,percent of total billed charges,90% of total billed charges,131.9,90,,,percent of total billed charges,90% of total billed charges,55.69,38,,,percent of total billed charges,38% of total billed charges,55.69,38,,,percent of total billed charges,38% of total billed charges,55.69,38,,,percent of total billed charges,38% of total billed charges,109.91,75,,,percent of total billed charges,75% of total billed charges,124.57,85,,,percent of total billed charges,85% of total billed charges,55.69,136.29,
Anti-IgE Receptor AB,1644,CDM,300,RC,84238,HCPCS,outpatient,,,243.73,182.8,,219.36,90,,,percent of total billed charges,90% of total billed charges,226.67,93,,,percent of total billed charges,93% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,207.17,85,,,percent of total billed charges,85% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,198.4,81.4,,,percent of total billed charges,81.4% of total billed charges,219.36,90,,,percent of total billed charges,90% of total billed charges,219.36,90,,,percent of total billed charges,90% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,182.8,75,,,percent of total billed charges,75% of total billed charges,207.17,85,,,percent of total billed charges,85% of total billed charges,92.62,226.67,
Soluble Transferrin Receptor,1645,CDM,300,RC,84238,HCPCS,outpatient,,,276.02,207.02,,248.42,90,,,percent of total billed charges,90% of total billed charges,256.7,93,,,percent of total billed charges,93% of total billed charges,104.89,38,,,percent of total billed charges,38% of total billed charges,104.89,38,,,percent of total billed charges,38% of total billed charges,234.62,85,,,percent of total billed charges,85% of total billed charges,104.89,38,,,percent of total billed charges,38% of total billed charges,224.68,81.4,,,percent of total billed charges,81.4% of total billed charges,248.42,90,,,percent of total billed charges,90% of total billed charges,248.42,90,,,percent of total billed charges,90% of total billed charges,104.89,38,,,percent of total billed charges,38% of total billed charges,104.89,38,,,percent of total billed charges,38% of total billed charges,104.89,38,,,percent of total billed charges,38% of total billed charges,207.02,75,,,percent of total billed charges,75% of total billed charges,234.62,85,,,percent of total billed charges,85% of total billed charges,104.89,256.7,
Plasma Renin Activity,1646,CDM,300,RC,84244,HCPCS,outpatient,,,146.2,109.65,,131.58,90,,,percent of total billed charges,90% of total billed charges,135.97,93,,,percent of total billed charges,93% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,124.27,85,,,percent of total billed charges,85% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,119.01,81.4,,,percent of total billed charges,81.4% of total billed charges,131.58,90,,,percent of total billed charges,90% of total billed charges,131.58,90,,,percent of total billed charges,90% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,109.65,75,,,percent of total billed charges,75% of total billed charges,124.27,85,,,percent of total billed charges,85% of total billed charges,55.56,135.97,
"(RES) PLASMA RENIN ACTIVITY, LC/MS/MS",1647,CDM,300,RC,84244,HCPCS,outpatient,,,146.2,109.65,,131.58,90,,,percent of total billed charges,90% of total billed charges,135.97,93,,,percent of total billed charges,93% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,124.27,85,,,percent of total billed charges,85% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,119.01,81.4,,,percent of total billed charges,81.4% of total billed charges,131.58,90,,,percent of total billed charges,90% of total billed charges,131.58,90,,,percent of total billed charges,90% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,55.56,38,,,percent of total billed charges,38% of total billed charges,109.65,75,,,percent of total billed charges,75% of total billed charges,124.27,85,,,percent of total billed charges,85% of total billed charges,55.56,135.97,
(RES) PLASMA RENIN ACTIVITY,1648,CDM,300,RC,84244,HCPCS,outpatient,,,130.84,98.13,,117.76,90,,,percent of total billed charges,90% of total billed charges,121.68,93,,,percent of total billed charges,93% of total billed charges,49.72,38,,,percent of total billed charges,38% of total billed charges,49.72,38,,,percent of total billed charges,38% of total billed charges,111.21,85,,,percent of total billed charges,85% of total billed charges,49.72,38,,,percent of total billed charges,38% of total billed charges,106.5,81.4,,,percent of total billed charges,81.4% of total billed charges,117.76,90,,,percent of total billed charges,90% of total billed charges,117.76,90,,,percent of total billed charges,90% of total billed charges,49.72,38,,,percent of total billed charges,38% of total billed charges,49.72,38,,,percent of total billed charges,38% of total billed charges,49.72,38,,,percent of total billed charges,38% of total billed charges,98.13,75,,,percent of total billed charges,75% of total billed charges,111.21,85,,,percent of total billed charges,85% of total billed charges,49.72,121.68,
Vitamin B2 Riboflavin,1649,CDM,300,RC,84252,HCPCS,outpatient,,,226.34,169.76,,203.71,90,,,percent of total billed charges,90% of total billed charges,210.5,93,,,percent of total billed charges,93% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,192.39,85,,,percent of total billed charges,85% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,184.24,81.4,,,percent of total billed charges,81.4% of total billed charges,203.71,90,,,percent of total billed charges,90% of total billed charges,203.71,90,,,percent of total billed charges,90% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,169.76,75,,,percent of total billed charges,75% of total billed charges,192.39,85,,,percent of total billed charges,85% of total billed charges,86.01,210.5,
Selenium,1650,CDM,300,RC,84255,HCPCS,outpatient,,,177.93,133.45,,160.14,90,,,percent of total billed charges,90% of total billed charges,165.47,93,,,percent of total billed charges,93% of total billed charges,67.61,38,,,percent of total billed charges,38% of total billed charges,67.61,38,,,percent of total billed charges,38% of total billed charges,151.24,85,,,percent of total billed charges,85% of total billed charges,67.61,38,,,percent of total billed charges,38% of total billed charges,144.84,81.4,,,percent of total billed charges,81.4% of total billed charges,160.14,90,,,percent of total billed charges,90% of total billed charges,160.14,90,,,percent of total billed charges,90% of total billed charges,67.61,38,,,percent of total billed charges,38% of total billed charges,67.61,38,,,percent of total billed charges,38% of total billed charges,67.61,38,,,percent of total billed charges,38% of total billed charges,133.45,75,,,percent of total billed charges,75% of total billed charges,151.24,85,,,percent of total billed charges,85% of total billed charges,67.61,165.47,
"Serotonin, Serum",1651,CDM,300,RC,84260,HCPCS,outpatient,,,307.01,230.26,,276.31,90,,,percent of total billed charges,90% of total billed charges,285.52,93,,,percent of total billed charges,93% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,260.96,85,,,percent of total billed charges,85% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,249.91,81.4,,,percent of total billed charges,81.4% of total billed charges,276.31,90,,,percent of total billed charges,90% of total billed charges,276.31,90,,,percent of total billed charges,90% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,230.26,75,,,percent of total billed charges,75% of total billed charges,260.96,85,,,percent of total billed charges,85% of total billed charges,116.66,285.52,
SEX HORMONE BINDING GLOBULIN,1652,CDM,300,RC,84270,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
Sodium,1653,CDM,300,RC,84295,HCPCS,outpatient,,,30.46,22.85,,27.41,90,,,percent of total billed charges,90% of total billed charges,28.33,93,,,percent of total billed charges,93% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,24.79,81.4,,,percent of total billed charges,81.4% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,22.85,75,,,percent of total billed charges,75% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,28.33,
(FENA) Sodium,1654,CDM,300,RC,84295,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Sodium, Urine - Random",1655,CDM,300,RC,84300,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
Profile-URINE SODIUM-RANDOM-1,1656,CDM,300,RC,84300,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
(RESULT) URINE SODIUM-RANDOM-2,1657,CDM,300,RC,84300,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Sodium 24hr Urine,1658,CDM,300,RC,84300,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
"(RES) SODIUM, RANDOM URINE",1659,CDM,300,RC,84300,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
(RES) Urine Sodium (FENA),1660,CDM,300,RC,84300,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
IGF-1,1661,CDM,300,RC,84305,HCPCS,outpatient,,,242.55,181.91,,218.3,90,,,percent of total billed charges,90% of total billed charges,225.57,93,,,percent of total billed charges,93% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,206.17,85,,,percent of total billed charges,85% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,197.44,81.4,,,percent of total billed charges,81.4% of total billed charges,218.3,90,,,percent of total billed charges,90% of total billed charges,218.3,90,,,percent of total billed charges,90% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,181.91,75,,,percent of total billed charges,75% of total billed charges,206.17,85,,,percent of total billed charges,85% of total billed charges,92.17,225.57,
Adenosine Deaminase -pleural fluid,1662,CDM,300,RC,84311,HCPCS,outpatient,,,237.82,178.37,,214.04,90,,,percent of total billed charges,90% of total billed charges,221.17,93,,,percent of total billed charges,93% of total billed charges,90.37,38,,,percent of total billed charges,38% of total billed charges,90.37,38,,,percent of total billed charges,38% of total billed charges,202.15,85,,,percent of total billed charges,85% of total billed charges,90.37,38,,,percent of total billed charges,38% of total billed charges,193.59,81.4,,,percent of total billed charges,81.4% of total billed charges,214.04,90,,,percent of total billed charges,90% of total billed charges,214.04,90,,,percent of total billed charges,90% of total billed charges,90.37,38,,,percent of total billed charges,38% of total billed charges,90.37,38,,,percent of total billed charges,38% of total billed charges,90.37,38,,,percent of total billed charges,38% of total billed charges,178.37,75,,,percent of total billed charges,75% of total billed charges,202.15,85,,,percent of total billed charges,85% of total billed charges,90.37,221.17,
Arylsulfatase A,1663,CDM,300,RC,84311,HCPCS,outpatient,,,430.2,322.65,,387.18,90,,,percent of total billed charges,90% of total billed charges,400.09,93,,,percent of total billed charges,93% of total billed charges,163.48,38,,,percent of total billed charges,38% of total billed charges,163.48,38,,,percent of total billed charges,38% of total billed charges,365.67,85,,,percent of total billed charges,85% of total billed charges,163.48,38,,,percent of total billed charges,38% of total billed charges,350.18,81.4,,,percent of total billed charges,81.4% of total billed charges,387.18,90,,,percent of total billed charges,90% of total billed charges,387.18,90,,,percent of total billed charges,90% of total billed charges,163.48,38,,,percent of total billed charges,38% of total billed charges,163.48,38,,,percent of total billed charges,38% of total billed charges,163.48,38,,,percent of total billed charges,38% of total billed charges,322.65,75,,,percent of total billed charges,75% of total billed charges,365.67,85,,,percent of total billed charges,85% of total billed charges,163.48,400.09,
Phospholipids,1664,CDM,300,RC,84311,HCPCS,outpatient,,,107.1,80.33,,96.39,90,,,percent of total billed charges,90% of total billed charges,99.6,93,,,percent of total billed charges,93% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,87.18,81.4,,,percent of total billed charges,81.4% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,40.7,38,,,percent of total billed charges,38% of total billed charges,80.33,75,,,percent of total billed charges,75% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,40.7,99.6,
Sulfate 24 Hr. urine,1665,CDM,300,RC,84392,HCPCS,outpatient,,,44.17,33.13,,39.75,90,,,percent of total billed charges,90% of total billed charges,41.08,93,,,percent of total billed charges,93% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,37.54,85,,,percent of total billed charges,85% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,35.95,81.4,,,percent of total billed charges,81.4% of total billed charges,39.75,90,,,percent of total billed charges,90% of total billed charges,39.75,90,,,percent of total billed charges,90% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,33.13,75,,,percent of total billed charges,75% of total billed charges,37.54,85,,,percent of total billed charges,85% of total billed charges,16.78,41.08,
"(RES) TESTOSTERONE, FREE",1666,CDM,300,RC,84402,HCPCS,outpatient,,,137.09,102.82,,123.38,90,,,percent of total billed charges,90% of total billed charges,127.49,93,,,percent of total billed charges,93% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,111.59,81.4,,,percent of total billed charges,81.4% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,102.82,75,,,percent of total billed charges,75% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,127.49,
Testosterone - Free,1667,CDM,300,RC,84402,HCPCS,outpatient,,,487.09,365.32,,438.38,90,,,percent of total billed charges,90% of total billed charges,452.99,93,,,percent of total billed charges,93% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,414.03,85,,,percent of total billed charges,85% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,396.49,81.4,,,percent of total billed charges,81.4% of total billed charges,438.38,90,,,percent of total billed charges,90% of total billed charges,438.38,90,,,percent of total billed charges,90% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,365.32,75,,,percent of total billed charges,75% of total billed charges,414.03,85,,,percent of total billed charges,85% of total billed charges,185.09,452.99,
Testosterone - Total,1668,CDM,300,RC,84403,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
"(RES) TESTOSTERONE, TOTAL, MS",1669,CDM,300,RC,84403,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
Vitamin B1(thiamine) -blood,1670,CDM,300,RC,84425,HCPCS,outpatient,,,183.3,137.48,,164.97,90,,,percent of total billed charges,90% of total billed charges,170.47,93,,,percent of total billed charges,93% of total billed charges,69.65,38,,,percent of total billed charges,38% of total billed charges,69.65,38,,,percent of total billed charges,38% of total billed charges,155.81,85,,,percent of total billed charges,85% of total billed charges,69.65,38,,,percent of total billed charges,38% of total billed charges,149.21,81.4,,,percent of total billed charges,81.4% of total billed charges,164.97,90,,,percent of total billed charges,90% of total billed charges,164.97,90,,,percent of total billed charges,90% of total billed charges,69.65,38,,,percent of total billed charges,38% of total billed charges,69.65,38,,,percent of total billed charges,38% of total billed charges,69.65,38,,,percent of total billed charges,38% of total billed charges,137.48,75,,,percent of total billed charges,75% of total billed charges,155.81,85,,,percent of total billed charges,85% of total billed charges,69.65,170.47,
"Vitamin B1 (Thiamine), Plasma/Serum",1671,CDM,300,RC,84425,HCPCS,outpatient,,,190.54,142.91,,171.49,90,,,percent of total billed charges,90% of total billed charges,177.2,93,,,percent of total billed charges,93% of total billed charges,72.41,38,,,percent of total billed charges,38% of total billed charges,72.41,38,,,percent of total billed charges,38% of total billed charges,161.96,85,,,percent of total billed charges,85% of total billed charges,72.41,38,,,percent of total billed charges,38% of total billed charges,155.1,81.4,,,percent of total billed charges,81.4% of total billed charges,171.49,90,,,percent of total billed charges,90% of total billed charges,171.49,90,,,percent of total billed charges,90% of total billed charges,72.41,38,,,percent of total billed charges,38% of total billed charges,72.41,38,,,percent of total billed charges,38% of total billed charges,72.41,38,,,percent of total billed charges,38% of total billed charges,142.91,75,,,percent of total billed charges,75% of total billed charges,161.96,85,,,percent of total billed charges,85% of total billed charges,72.41,177.2,
Thyroglobulin,1672,CDM,300,RC,84432,HCPCS,outpatient,,,244.08,183.06,,219.67,90,,,percent of total billed charges,90% of total billed charges,226.99,93,,,percent of total billed charges,93% of total billed charges,92.75,38,,,percent of total billed charges,38% of total billed charges,92.75,38,,,percent of total billed charges,38% of total billed charges,207.47,85,,,percent of total billed charges,85% of total billed charges,92.75,38,,,percent of total billed charges,38% of total billed charges,198.68,81.4,,,percent of total billed charges,81.4% of total billed charges,219.67,90,,,percent of total billed charges,90% of total billed charges,219.67,90,,,percent of total billed charges,90% of total billed charges,92.75,38,,,percent of total billed charges,38% of total billed charges,92.75,38,,,percent of total billed charges,38% of total billed charges,92.75,38,,,percent of total billed charges,38% of total billed charges,183.06,75,,,percent of total billed charges,75% of total billed charges,207.47,85,,,percent of total billed charges,85% of total billed charges,92.75,226.99,
(RES) THYROGLOBULIN,1673,CDM,300,RC,84432,HCPCS,outpatient,,,120.54,90.41,,108.49,90,,,percent of total billed charges,90% of total billed charges,112.1,93,,,percent of total billed charges,93% of total billed charges,45.81,38,,,percent of total billed charges,38% of total billed charges,45.81,38,,,percent of total billed charges,38% of total billed charges,102.46,85,,,percent of total billed charges,85% of total billed charges,45.81,38,,,percent of total billed charges,38% of total billed charges,98.12,81.4,,,percent of total billed charges,81.4% of total billed charges,108.49,90,,,percent of total billed charges,90% of total billed charges,108.49,90,,,percent of total billed charges,90% of total billed charges,45.81,38,,,percent of total billed charges,38% of total billed charges,45.81,38,,,percent of total billed charges,38% of total billed charges,45.81,38,,,percent of total billed charges,38% of total billed charges,90.41,75,,,percent of total billed charges,75% of total billed charges,102.46,85,,,percent of total billed charges,85% of total billed charges,45.81,112.1,
"(Result) T-4, TOTAL",1674,CDM,300,RC,84436,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) T4 (Thyroxine), Total",1675,CDM,300,RC,84436,HCPCS,outpatient,,,54.15,40.61,,48.74,90,,,percent of total billed charges,90% of total billed charges,50.36,93,,,percent of total billed charges,93% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,46.03,85,,,percent of total billed charges,85% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,44.08,81.4,,,percent of total billed charges,81.4% of total billed charges,48.74,90,,,percent of total billed charges,90% of total billed charges,48.74,90,,,percent of total billed charges,90% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,40.61,75,,,percent of total billed charges,75% of total billed charges,46.03,85,,,percent of total billed charges,85% of total billed charges,20.58,50.36,
"T-4, Total",1676,CDM,300,RC,84436,HCPCS,outpatient,,,72.66,54.5,,65.39,90,,,percent of total billed charges,90% of total billed charges,67.57,93,,,percent of total billed charges,93% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,59.15,81.4,,,percent of total billed charges,81.4% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,54.5,75,,,percent of total billed charges,75% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,67.57,
Free T4,1677,CDM,300,RC,84439,HCPCS,outpatient,,,101.95,76.46,,91.76,90,,,percent of total billed charges,90% of total billed charges,94.81,93,,,percent of total billed charges,93% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,86.66,85,,,percent of total billed charges,85% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,82.99,81.4,,,percent of total billed charges,81.4% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,76.46,75,,,percent of total billed charges,75% of total billed charges,86.66,85,,,percent of total billed charges,85% of total billed charges,38.74,94.81,
"(Result) T4, Free",1678,CDM,300,RC,84439,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
T4 Free Direct Dialysis,1679,CDM,300,RC,84439,HCPCS,outpatient,,,236.69,177.52,,213.02,90,,,percent of total billed charges,90% of total billed charges,220.12,93,,,percent of total billed charges,93% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,201.19,85,,,percent of total billed charges,85% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,192.67,81.4,,,percent of total billed charges,81.4% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,177.52,75,,,percent of total billed charges,75% of total billed charges,201.19,85,,,percent of total billed charges,85% of total billed charges,89.94,220.12,
THYROXINE BINDING GLOBULIN,1680,CDM,300,RC,84442,HCPCS,outpatient,,,131.24,98.43,,118.12,90,,,percent of total billed charges,90% of total billed charges,122.05,93,,,percent of total billed charges,93% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,111.55,85,,,percent of total billed charges,85% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,106.83,81.4,,,percent of total billed charges,81.4% of total billed charges,118.12,90,,,percent of total billed charges,90% of total billed charges,118.12,90,,,percent of total billed charges,90% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,98.43,75,,,percent of total billed charges,75% of total billed charges,111.55,85,,,percent of total billed charges,85% of total billed charges,49.87,122.05,
TSH,1681,CDM,300,RC,84443,HCPCS,outpatient,,,100.78,75.59,,90.7,90,,,percent of total billed charges,90% of total billed charges,93.73,93,,,percent of total billed charges,93% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,85.66,85,,,percent of total billed charges,85% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,82.03,81.4,,,percent of total billed charges,81.4% of total billed charges,90.7,90,,,percent of total billed charges,90% of total billed charges,90.7,90,,,percent of total billed charges,90% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,75.59,75,,,percent of total billed charges,75% of total billed charges,85.66,85,,,percent of total billed charges,85% of total billed charges,38.3,93.73,
TSH,1682,CDM,300,RC,84443,HCPCS,outpatient,,,100.78,75.59,,90.7,90,,,percent of total billed charges,90% of total billed charges,93.73,93,,,percent of total billed charges,93% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,85.66,85,,,percent of total billed charges,85% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,82.03,81.4,,,percent of total billed charges,81.4% of total billed charges,90.7,90,,,percent of total billed charges,90% of total billed charges,90.7,90,,,percent of total billed charges,90% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,75.59,75,,,percent of total billed charges,75% of total billed charges,85.66,85,,,percent of total billed charges,85% of total billed charges,38.3,93.73,
"(RES) TSH, UNTREATED",1683,CDM,300,RC,84443,HCPCS,outpatient,,,61.2,45.9,,55.08,90,,,percent of total billed charges,90% of total billed charges,56.92,93,,,percent of total billed charges,93% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,52.02,85,,,percent of total billed charges,85% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,49.82,81.4,,,percent of total billed charges,81.4% of total billed charges,55.08,90,,,percent of total billed charges,90% of total billed charges,55.08,90,,,percent of total billed charges,90% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,45.9,75,,,percent of total billed charges,75% of total billed charges,52.02,85,,,percent of total billed charges,85% of total billed charges,23.26,56.92,
"(RES) TSH, HAMA TREATED",1684,CDM,300,RC,84443,HCPCS,outpatient,,,132.6,99.45,,119.34,90,,,percent of total billed charges,90% of total billed charges,123.32,93,,,percent of total billed charges,93% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,112.71,85,,,percent of total billed charges,85% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,107.94,81.4,,,percent of total billed charges,81.4% of total billed charges,119.34,90,,,percent of total billed charges,90% of total billed charges,119.34,90,,,percent of total billed charges,90% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,99.45,75,,,percent of total billed charges,75% of total billed charges,112.71,85,,,percent of total billed charges,85% of total billed charges,50.39,123.32,
(RES) TSH,1685,CDM,300,RC,84443,HCPCS,outpatient,,,100.94,75.71,,90.85,90,,,percent of total billed charges,90% of total billed charges,93.87,93,,,percent of total billed charges,93% of total billed charges,38.36,38,,,percent of total billed charges,38% of total billed charges,38.36,38,,,percent of total billed charges,38% of total billed charges,85.8,85,,,percent of total billed charges,85% of total billed charges,38.36,38,,,percent of total billed charges,38% of total billed charges,82.17,81.4,,,percent of total billed charges,81.4% of total billed charges,90.85,90,,,percent of total billed charges,90% of total billed charges,90.85,90,,,percent of total billed charges,90% of total billed charges,38.36,38,,,percent of total billed charges,38% of total billed charges,38.36,38,,,percent of total billed charges,38% of total billed charges,38.36,38,,,percent of total billed charges,38% of total billed charges,75.71,75,,,percent of total billed charges,75% of total billed charges,85.8,85,,,percent of total billed charges,85% of total billed charges,38.36,93.87,
TSI (Thyroid Stimulating Immunogloblins),1686,CDM,300,RC,84445,HCPCS,outpatient,,,449.95,337.46,,404.96,90,,,percent of total billed charges,90% of total billed charges,418.45,93,,,percent of total billed charges,93% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,382.46,85,,,percent of total billed charges,85% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,366.26,81.4,,,percent of total billed charges,81.4% of total billed charges,404.96,90,,,percent of total billed charges,90% of total billed charges,404.96,90,,,percent of total billed charges,90% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,337.46,75,,,percent of total billed charges,75% of total billed charges,382.46,85,,,percent of total billed charges,85% of total billed charges,170.98,418.45,
Vitamin E,1687,CDM,300,RC,84446,HCPCS,outpatient,,,131.24,98.43,,118.12,90,,,percent of total billed charges,90% of total billed charges,122.05,93,,,percent of total billed charges,93% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,111.55,85,,,percent of total billed charges,85% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,106.83,81.4,,,percent of total billed charges,81.4% of total billed charges,118.12,90,,,percent of total billed charges,90% of total billed charges,118.12,90,,,percent of total billed charges,90% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,98.43,75,,,percent of total billed charges,75% of total billed charges,111.55,85,,,percent of total billed charges,85% of total billed charges,49.87,122.05,
AST (SGOT),1688,CDM,300,RC,84450,HCPCS,outpatient,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
ALT (SGPT),1689,CDM,300,RC,84460,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Transferin,1690,CDM,300,RC,84466,HCPCS,outpatient,,,110.17,82.63,,99.15,90,,,percent of total billed charges,90% of total billed charges,102.46,93,,,percent of total billed charges,93% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,93.64,85,,,percent of total billed charges,85% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,89.68,81.4,,,percent of total billed charges,81.4% of total billed charges,99.15,90,,,percent of total billed charges,90% of total billed charges,99.15,90,,,percent of total billed charges,90% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,82.63,75,,,percent of total billed charges,75% of total billed charges,93.64,85,,,percent of total billed charges,85% of total billed charges,41.86,102.46,
(RES) TRANSFERRIN,1691,CDM,300,RC,84466,HCPCS,outpatient,,,78.03,58.52,,70.23,90,,,percent of total billed charges,90% of total billed charges,72.57,93,,,percent of total billed charges,93% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,66.33,85,,,percent of total billed charges,85% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,63.52,81.4,,,percent of total billed charges,81.4% of total billed charges,70.23,90,,,percent of total billed charges,90% of total billed charges,70.23,90,,,percent of total billed charges,90% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,58.52,75,,,percent of total billed charges,75% of total billed charges,66.33,85,,,percent of total billed charges,85% of total billed charges,29.65,72.57,
Triglyceride,1692,CDM,300,RC,84478,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Triglyceride-pleural fluid SLVH,1693,CDM,300,RC,84478,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
(RES) TRIGLYCERIDES,1694,CDM,300,RC,84478,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) T3 Uptake,1695,CDM,300,RC,84479,HCPCS,outpatient,,,54.15,40.61,,48.74,90,,,percent of total billed charges,90% of total billed charges,50.36,93,,,percent of total billed charges,93% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,46.03,85,,,percent of total billed charges,85% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,44.08,81.4,,,percent of total billed charges,81.4% of total billed charges,48.74,90,,,percent of total billed charges,90% of total billed charges,48.74,90,,,percent of total billed charges,90% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,20.58,38,,,percent of total billed charges,38% of total billed charges,40.61,75,,,percent of total billed charges,75% of total billed charges,46.03,85,,,percent of total billed charges,85% of total billed charges,20.58,50.36,
T3 UPTAKE,1696,CDM,300,RC,84479,HCPCS,outpatient,,,56.46,42.35,,50.81,90,,,percent of total billed charges,90% of total billed charges,52.51,93,,,percent of total billed charges,93% of total billed charges,21.45,38,,,percent of total billed charges,38% of total billed charges,21.45,38,,,percent of total billed charges,38% of total billed charges,47.99,85,,,percent of total billed charges,85% of total billed charges,21.45,38,,,percent of total billed charges,38% of total billed charges,45.96,81.4,,,percent of total billed charges,81.4% of total billed charges,50.81,90,,,percent of total billed charges,90% of total billed charges,50.81,90,,,percent of total billed charges,90% of total billed charges,21.45,38,,,percent of total billed charges,38% of total billed charges,21.45,38,,,percent of total billed charges,38% of total billed charges,21.45,38,,,percent of total billed charges,38% of total billed charges,42.35,75,,,percent of total billed charges,75% of total billed charges,47.99,85,,,percent of total billed charges,85% of total billed charges,21.45,52.51,
T-3 TOTAL,1697,CDM,300,RC,84480,HCPCS,outpatient,,,114.83,86.12,,103.35,90,,,percent of total billed charges,90% of total billed charges,106.79,93,,,percent of total billed charges,93% of total billed charges,43.64,38,,,percent of total billed charges,38% of total billed charges,43.64,38,,,percent of total billed charges,38% of total billed charges,97.61,85,,,percent of total billed charges,85% of total billed charges,43.64,38,,,percent of total billed charges,38% of total billed charges,93.47,81.4,,,percent of total billed charges,81.4% of total billed charges,103.35,90,,,percent of total billed charges,90% of total billed charges,103.35,90,,,percent of total billed charges,90% of total billed charges,43.64,38,,,percent of total billed charges,38% of total billed charges,43.64,38,,,percent of total billed charges,38% of total billed charges,43.64,38,,,percent of total billed charges,38% of total billed charges,86.12,75,,,percent of total billed charges,75% of total billed charges,97.61,85,,,percent of total billed charges,85% of total billed charges,43.64,106.79,
"(Result) T-3, TOTAL",1698,CDM,300,RC,84480,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(Result) T3, Free",1699,CDM,300,RC,84481,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Free T3,1700,CDM,300,RC,84481,HCPCS,outpatient,,,72.66,54.5,,65.39,90,,,percent of total billed charges,90% of total billed charges,67.57,93,,,percent of total billed charges,93% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,59.15,81.4,,,percent of total billed charges,81.4% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,54.5,75,,,percent of total billed charges,75% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,67.57,
"T-3,REVERSE",1701,CDM,300,RC,84482,HCPCS,outpatient,,,301.16,225.87,,271.04,90,,,percent of total billed charges,90% of total billed charges,280.08,93,,,percent of total billed charges,93% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,255.99,85,,,percent of total billed charges,85% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,245.14,81.4,,,percent of total billed charges,81.4% of total billed charges,271.04,90,,,percent of total billed charges,90% of total billed charges,271.04,90,,,percent of total billed charges,90% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,225.87,75,,,percent of total billed charges,75% of total billed charges,255.99,85,,,percent of total billed charges,85% of total billed charges,114.44,280.08,
Troponin,1702,CDM,300,RC,84484,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
Troponin 6hr after initial,1703,CDM,300,RC,84484,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
Troponin I HS,1704,CDM,300,RC,84484,HCPCS,outpatient,,,80.12,60.09,,72.11,90,,,percent of total billed charges,90% of total billed charges,74.51,93,,,percent of total billed charges,93% of total billed charges,30.45,38,,,percent of total billed charges,38% of total billed charges,30.45,38,,,percent of total billed charges,38% of total billed charges,68.1,85,,,percent of total billed charges,85% of total billed charges,30.45,38,,,percent of total billed charges,38% of total billed charges,65.22,81.4,,,percent of total billed charges,81.4% of total billed charges,72.11,90,,,percent of total billed charges,90% of total billed charges,72.11,90,,,percent of total billed charges,90% of total billed charges,30.45,38,,,percent of total billed charges,38% of total billed charges,30.45,38,,,percent of total billed charges,38% of total billed charges,30.45,38,,,percent of total billed charges,38% of total billed charges,60.09,75,,,percent of total billed charges,75% of total billed charges,68.1,85,,,percent of total billed charges,85% of total billed charges,30.45,74.51,
Troponin 12 hr after initial,1705,CDM,300,RC,84484,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
"Troponin, I-Stat",1706,CDM,300,RC,84484,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
Quest - Troponin I,1707,CDM,300,RC,84484,HCPCS,outpatient,,,133.14,99.86,,119.83,90,,,percent of total billed charges,90% of total billed charges,123.82,93,,,percent of total billed charges,93% of total billed charges,50.59,38,,,percent of total billed charges,38% of total billed charges,50.59,38,,,percent of total billed charges,38% of total billed charges,113.17,85,,,percent of total billed charges,85% of total billed charges,50.59,38,,,percent of total billed charges,38% of total billed charges,108.38,81.4,,,percent of total billed charges,81.4% of total billed charges,119.83,90,,,percent of total billed charges,90% of total billed charges,119.83,90,,,percent of total billed charges,90% of total billed charges,50.59,38,,,percent of total billed charges,38% of total billed charges,50.59,38,,,percent of total billed charges,38% of total billed charges,50.59,38,,,percent of total billed charges,38% of total billed charges,99.86,75,,,percent of total billed charges,75% of total billed charges,113.17,85,,,percent of total billed charges,85% of total billed charges,50.59,123.82,
Troponin T,1708,CDM,300,RC,84484,HCPCS,outpatient,,,151.54,113.66,,136.39,90,,,percent of total billed charges,90% of total billed charges,140.93,93,,,percent of total billed charges,93% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,128.81,85,,,percent of total billed charges,85% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,123.35,81.4,,,percent of total billed charges,81.4% of total billed charges,136.39,90,,,percent of total billed charges,90% of total billed charges,136.39,90,,,percent of total billed charges,90% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,113.66,75,,,percent of total billed charges,75% of total billed charges,128.81,85,,,percent of total billed charges,85% of total billed charges,57.59,140.93,
Tyrosine,1709,CDM,300,RC,84510,HCPCS,outpatient,,,151.54,113.66,,136.39,90,,,percent of total billed charges,90% of total billed charges,140.93,93,,,percent of total billed charges,93% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,128.81,85,,,percent of total billed charges,85% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,123.35,81.4,,,percent of total billed charges,81.4% of total billed charges,136.39,90,,,percent of total billed charges,90% of total billed charges,136.39,90,,,percent of total billed charges,90% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,113.66,75,,,percent of total billed charges,75% of total billed charges,128.81,85,,,percent of total billed charges,85% of total billed charges,57.59,140.93,
BUN,1710,CDM,300,RC,84520,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Urea Nitrogen - Urine,1711,CDM,300,RC,84540,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
"Urea Nitrogen, 24-hr Urine w/o Creat",1712,CDM,300,RC,84540,HCPCS,outpatient,,,65.66,49.25,,59.09,90,,,percent of total billed charges,90% of total billed charges,61.06,93,,,percent of total billed charges,93% of total billed charges,24.95,38,,,percent of total billed charges,38% of total billed charges,24.95,38,,,percent of total billed charges,38% of total billed charges,55.81,85,,,percent of total billed charges,85% of total billed charges,24.95,38,,,percent of total billed charges,38% of total billed charges,53.45,81.4,,,percent of total billed charges,81.4% of total billed charges,59.09,90,,,percent of total billed charges,90% of total billed charges,59.09,90,,,percent of total billed charges,90% of total billed charges,24.95,38,,,percent of total billed charges,38% of total billed charges,24.95,38,,,percent of total billed charges,38% of total billed charges,24.95,38,,,percent of total billed charges,38% of total billed charges,49.25,75,,,percent of total billed charges,75% of total billed charges,55.81,85,,,percent of total billed charges,85% of total billed charges,24.95,61.06,
Urea Clearance,1713,CDM,300,RC,84545,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Uric Acid,1714,CDM,300,RC,84550,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Uric Acid 24hr Urine,1715,CDM,300,RC,84560,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,51.34,
Uric Acid - Synovial Fluid,1716,CDM,300,RC,84560,HCPCS,outpatient,,,72.32,54.24,,65.09,90,,,percent of total billed charges,90% of total billed charges,67.26,93,,,percent of total billed charges,93% of total billed charges,27.48,38,,,percent of total billed charges,38% of total billed charges,27.48,38,,,percent of total billed charges,38% of total billed charges,61.47,85,,,percent of total billed charges,85% of total billed charges,27.48,38,,,percent of total billed charges,38% of total billed charges,58.87,81.4,,,percent of total billed charges,81.4% of total billed charges,65.09,90,,,percent of total billed charges,90% of total billed charges,65.09,90,,,percent of total billed charges,90% of total billed charges,27.48,38,,,percent of total billed charges,38% of total billed charges,27.48,38,,,percent of total billed charges,38% of total billed charges,27.48,38,,,percent of total billed charges,38% of total billed charges,54.24,75,,,percent of total billed charges,75% of total billed charges,61.47,85,,,percent of total billed charges,85% of total billed charges,27.48,67.26,
Uric Acid-UR RAND w/CREAT,1717,CDM,300,RC,84560,HCPCS,outpatient,,,66.24,49.68,,59.62,90,,,percent of total billed charges,90% of total billed charges,61.6,93,,,percent of total billed charges,93% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,56.3,85,,,percent of total billed charges,85% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,53.92,81.4,,,percent of total billed charges,81.4% of total billed charges,59.62,90,,,percent of total billed charges,90% of total billed charges,59.62,90,,,percent of total billed charges,90% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,49.68,75,,,percent of total billed charges,75% of total billed charges,56.3,85,,,percent of total billed charges,85% of total billed charges,25.17,61.6,
Uric Acid- Urine w/o creatinine,1718,CDM,300,RC,84560,HCPCS,outpatient,,,68.91,51.68,,62.02,90,,,percent of total billed charges,90% of total billed charges,64.09,93,,,percent of total billed charges,93% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,56.09,81.4,,,percent of total billed charges,81.4% of total billed charges,62.02,90,,,percent of total billed charges,90% of total billed charges,62.02,90,,,percent of total billed charges,90% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,26.19,38,,,percent of total billed charges,38% of total billed charges,51.68,75,,,percent of total billed charges,75% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,26.19,64.09,
VMA(Vanillylmandelic Acid) 24hr Urine,1719,CDM,300,RC,84585,HCPCS,outpatient,,,149.05,111.79,,134.15,90,,,percent of total billed charges,90% of total billed charges,138.62,93,,,percent of total billed charges,93% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,126.69,85,,,percent of total billed charges,85% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,121.33,81.4,,,percent of total billed charges,81.4% of total billed charges,134.15,90,,,percent of total billed charges,90% of total billed charges,134.15,90,,,percent of total billed charges,90% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,111.79,75,,,percent of total billed charges,75% of total billed charges,126.69,85,,,percent of total billed charges,85% of total billed charges,56.64,138.62,
Vasoactive Intestinal Polypeptide,1720,CDM,300,RC,84586,HCPCS,outpatient,,,122.87,92.15,,110.58,90,,,percent of total billed charges,90% of total billed charges,114.27,93,,,percent of total billed charges,93% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,104.44,85,,,percent of total billed charges,85% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,100.02,81.4,,,percent of total billed charges,81.4% of total billed charges,110.58,90,,,percent of total billed charges,90% of total billed charges,110.58,90,,,percent of total billed charges,90% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,46.69,38,,,percent of total billed charges,38% of total billed charges,92.15,75,,,percent of total billed charges,75% of total billed charges,104.44,85,,,percent of total billed charges,85% of total billed charges,46.69,114.27,
Vitamin A,1721,CDM,300,RC,84590,HCPCS,outpatient,,,31.63,23.72,,28.47,90,,,percent of total billed charges,90% of total billed charges,29.42,93,,,percent of total billed charges,93% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,26.89,85,,,percent of total billed charges,85% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,25.75,81.4,,,percent of total billed charges,81.4% of total billed charges,28.47,90,,,percent of total billed charges,90% of total billed charges,28.47,90,,,percent of total billed charges,90% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,23.72,75,,,percent of total billed charges,75% of total billed charges,26.89,85,,,percent of total billed charges,85% of total billed charges,12.02,29.42,
Vitamin B3,1722,CDM,300,RC,84591,HCPCS,outpatient,,,209.77,157.33,,188.79,90,,,percent of total billed charges,90% of total billed charges,195.09,93,,,percent of total billed charges,93% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,178.3,85,,,percent of total billed charges,85% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,170.75,81.4,,,percent of total billed charges,81.4% of total billed charges,188.79,90,,,percent of total billed charges,90% of total billed charges,188.79,90,,,percent of total billed charges,90% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,157.33,75,,,percent of total billed charges,75% of total billed charges,178.3,85,,,percent of total billed charges,85% of total billed charges,79.71,195.09,
Vitamin B,1723,CDM,300,RC,84591,HCPCS,outpatient,,,209.77,157.33,,188.79,90,,,percent of total billed charges,90% of total billed charges,195.09,93,,,percent of total billed charges,93% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,178.3,85,,,percent of total billed charges,85% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,170.75,81.4,,,percent of total billed charges,81.4% of total billed charges,188.79,90,,,percent of total billed charges,90% of total billed charges,188.79,90,,,percent of total billed charges,90% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,79.71,38,,,percent of total billed charges,38% of total billed charges,157.33,75,,,percent of total billed charges,75% of total billed charges,178.3,85,,,percent of total billed charges,85% of total billed charges,79.71,195.09,
Vitamin K,1724,CDM,300,RC,84597,HCPCS,outpatient,,,350.22,262.67,,315.2,90,,,percent of total billed charges,90% of total billed charges,325.7,93,,,percent of total billed charges,93% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,297.69,85,,,percent of total billed charges,85% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,285.08,81.4,,,percent of total billed charges,81.4% of total billed charges,315.2,90,,,percent of total billed charges,90% of total billed charges,315.2,90,,,percent of total billed charges,90% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,133.08,38,,,percent of total billed charges,38% of total billed charges,262.67,75,,,percent of total billed charges,75% of total billed charges,297.69,85,,,percent of total billed charges,85% of total billed charges,133.08,325.7,
ZINC,1725,CDM,300,RC,84630,HCPCS,outpatient,,,137.09,102.82,,123.38,90,,,percent of total billed charges,90% of total billed charges,127.49,93,,,percent of total billed charges,93% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,111.59,81.4,,,percent of total billed charges,81.4% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,102.82,75,,,percent of total billed charges,75% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,127.49,
C-Peptide,1726,CDM,300,RC,84681,HCPCS,outpatient,,,195.71,146.78,,176.14,90,,,percent of total billed charges,90% of total billed charges,182.01,93,,,percent of total billed charges,93% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,166.35,85,,,percent of total billed charges,85% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,159.31,81.4,,,percent of total billed charges,81.4% of total billed charges,176.14,90,,,percent of total billed charges,90% of total billed charges,176.14,90,,,percent of total billed charges,90% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,146.78,75,,,percent of total billed charges,75% of total billed charges,166.35,85,,,percent of total billed charges,85% of total billed charges,74.37,182.01,
C-Peptide (24 hr.) Urine,1727,CDM,300,RC,84681,HCPCS,outpatient,,,194.84,146.13,,175.36,90,,,percent of total billed charges,90% of total billed charges,181.2,93,,,percent of total billed charges,93% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,165.61,85,,,percent of total billed charges,85% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,158.6,81.4,,,percent of total billed charges,81.4% of total billed charges,175.36,90,,,percent of total billed charges,90% of total billed charges,175.36,90,,,percent of total billed charges,90% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,146.13,75,,,percent of total billed charges,75% of total billed charges,165.61,85,,,percent of total billed charges,85% of total billed charges,74.04,181.2,
"(RES) C-PEPTIDE, LC/MS/MS",1728,CDM,300,RC,84681,HCPCS,outpatient,,,96.9,72.68,,87.21,90,,,percent of total billed charges,90% of total billed charges,90.12,93,,,percent of total billed charges,93% of total billed charges,36.82,38,,,percent of total billed charges,38% of total billed charges,36.82,38,,,percent of total billed charges,38% of total billed charges,82.37,85,,,percent of total billed charges,85% of total billed charges,36.82,38,,,percent of total billed charges,38% of total billed charges,78.88,81.4,,,percent of total billed charges,81.4% of total billed charges,87.21,90,,,percent of total billed charges,90% of total billed charges,87.21,90,,,percent of total billed charges,90% of total billed charges,36.82,38,,,percent of total billed charges,38% of total billed charges,36.82,38,,,percent of total billed charges,38% of total billed charges,36.82,38,,,percent of total billed charges,38% of total billed charges,72.68,75,,,percent of total billed charges,75% of total billed charges,82.37,85,,,percent of total billed charges,85% of total billed charges,36.82,90.12,
"(Result) HCG, Total, QN",1729,CDM,300,RC,84702,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HCG Quantitative Serum,1730,CDM,300,RC,84702,HCPCS,outpatient,,,167.78,125.84,,151,90,,,percent of total billed charges,90% of total billed charges,156.04,93,,,percent of total billed charges,93% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,136.57,81.4,,,percent of total billed charges,81.4% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,125.84,75,,,percent of total billed charges,75% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,156.04,
HCG Quant Serum (Alamosa),1731,CDM,300,RC,84702,HCPCS,outpatient,,,167.78,125.84,,151,90,,,percent of total billed charges,90% of total billed charges,156.04,93,,,percent of total billed charges,93% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,136.57,81.4,,,percent of total billed charges,81.4% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,125.84,75,,,percent of total billed charges,75% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,156.04,
"HCG, Quant (SLVRMC)",1732,CDM,300,RC,84702,HCPCS,outpatient,,,167.78,125.84,,151,90,,,percent of total billed charges,90% of total billed charges,156.04,93,,,percent of total billed charges,93% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,136.57,81.4,,,percent of total billed charges,81.4% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,125.84,75,,,percent of total billed charges,75% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,156.04,
HCG - Blood,1733,CDM,300,RC,84703,HCPCS,outpatient,,,72.66,54.5,,65.39,90,,,percent of total billed charges,90% of total billed charges,67.57,93,,,percent of total billed charges,93% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,59.15,81.4,,,percent of total billed charges,81.4% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,54.5,75,,,percent of total billed charges,75% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,67.57,
HCG - Blood,1734,CDM,300,RC,84703,HCPCS,outpatient,,,72.66,54.5,,65.39,90,,,percent of total billed charges,90% of total billed charges,67.57,93,,,percent of total billed charges,93% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,59.15,81.4,,,percent of total billed charges,81.4% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,54.5,75,,,percent of total billed charges,75% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,67.57,
Manual Diff,1735,CDM,300,RC,85004,HCPCS,outpatient,,,30.4,22.8,,27.36,90,,,percent of total billed charges,90% of total billed charges,28.27,93,,,percent of total billed charges,93% of total billed charges,11.55,38,,,percent of total billed charges,38% of total billed charges,11.55,38,,,percent of total billed charges,38% of total billed charges,25.84,85,,,percent of total billed charges,85% of total billed charges,11.55,38,,,percent of total billed charges,38% of total billed charges,24.75,81.4,,,percent of total billed charges,81.4% of total billed charges,27.36,90,,,percent of total billed charges,90% of total billed charges,27.36,90,,,percent of total billed charges,90% of total billed charges,11.55,38,,,percent of total billed charges,38% of total billed charges,11.55,38,,,percent of total billed charges,38% of total billed charges,11.55,38,,,percent of total billed charges,38% of total billed charges,22.8,75,,,percent of total billed charges,75% of total billed charges,25.84,85,,,percent of total billed charges,85% of total billed charges,11.55,28.27,
Platelet Estimate-MD,1736,CDM,300,RC,85004,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Profile-WBC DIFF for EOS panel,1737,CDM,300,RC,85004,HCPCS,outpatient,,,22.52,16.89,,20.27,90,,,percent of total billed charges,90% of total billed charges,20.94,93,,,percent of total billed charges,93% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,19.14,85,,,percent of total billed charges,85% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,18.33,81.4,,,percent of total billed charges,81.4% of total billed charges,20.27,90,,,percent of total billed charges,90% of total billed charges,20.27,90,,,percent of total billed charges,90% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,16.89,75,,,percent of total billed charges,75% of total billed charges,19.14,85,,,percent of total billed charges,85% of total billed charges,8.56,20.94,
(CBC) - Manual Differential,1738,CDM,300,RC,85007,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
YY - WBC-Diff,1739,CDM,300,RC,85007,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HCT,1740,CDM,300,RC,85014,HCPCS,outpatient,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
Clinic- Hematoctit (HCT),1741,CDM,300,RC,85014,HCPCS,outpatient,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
HGB,1742,CDM,300,RC,85018,HCPCS,outpatient,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
CBC w/ Auto Diff and Platelet,1743,CDM,300,RC,85025,HCPCS,outpatient,,,82.05,61.54,,73.85,90,,,percent of total billed charges,90% of total billed charges,76.31,93,,,percent of total billed charges,93% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,69.74,85,,,percent of total billed charges,85% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,66.79,81.4,,,percent of total billed charges,81.4% of total billed charges,73.85,90,,,percent of total billed charges,90% of total billed charges,73.85,90,,,percent of total billed charges,90% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,61.54,75,,,percent of total billed charges,75% of total billed charges,69.74,85,,,percent of total billed charges,85% of total billed charges,31.18,76.31,
CBC w/ Auto Diff and Platelet,1744,CDM,300,RC,85025,HCPCS,outpatient,,,82.05,61.54,,73.85,90,,,percent of total billed charges,90% of total billed charges,76.31,93,,,percent of total billed charges,93% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,69.74,85,,,percent of total billed charges,85% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,66.79,81.4,,,percent of total billed charges,81.4% of total billed charges,73.85,90,,,percent of total billed charges,90% of total billed charges,73.85,90,,,percent of total billed charges,90% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,61.54,75,,,percent of total billed charges,75% of total billed charges,69.74,85,,,percent of total billed charges,85% of total billed charges,31.18,76.31,
MCHC,1745,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MCV,1746,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
RDW,1747,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MPV,1748,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Neut#,1749,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Lymph#,1750,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Mono#,1751,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
EOS#,1752,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
BASO #,1753,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PLT,1754,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MCH,1755,CDM,300,RC,85025,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Quest - CBC (auto diff.),1756,CDM,300,RC,85025,HCPCS,outpatient,,,82.26,61.7,,74.03,90,,,percent of total billed charges,90% of total billed charges,76.5,93,,,percent of total billed charges,93% of total billed charges,31.26,38,,,percent of total billed charges,38% of total billed charges,31.26,38,,,percent of total billed charges,38% of total billed charges,69.92,85,,,percent of total billed charges,85% of total billed charges,31.26,38,,,percent of total billed charges,38% of total billed charges,66.96,81.4,,,percent of total billed charges,81.4% of total billed charges,74.03,90,,,percent of total billed charges,90% of total billed charges,74.03,90,,,percent of total billed charges,90% of total billed charges,31.26,38,,,percent of total billed charges,38% of total billed charges,31.26,38,,,percent of total billed charges,38% of total billed charges,31.26,38,,,percent of total billed charges,38% of total billed charges,61.7,75,,,percent of total billed charges,75% of total billed charges,69.92,85,,,percent of total billed charges,85% of total billed charges,31.26,76.5,
WBC,1757,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
RED BLOOD CELLS,1758,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MEAN CELL VOLUME,1759,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
NEUT%,1760,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
LYMPH%,1761,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MONO%,1762,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
EOS%,1763,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
BASO%,1764,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
NEUTROPHILS-Segmented %,1765,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
NEUTROPHILS BAND %,1766,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
LYMPHOCYTES  %,1767,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MONOCYTES %,1768,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
EOSINOPHILS,1769,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
BASOPHILS,1770,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ATYPICAL LYMPHS,1771,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
METAMYELOCYTES,1772,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MYELOCYTES,1773,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PROMYELOCYTES,1774,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
BLAST CELLS,1775,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
NUCLEATED RBCS,1776,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
POIKILOCYTES,1777,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
POLYCHROMASIA,1778,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HYPOCHROMASIA,1779,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ANISOCYTOSIS,1780,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MICROCYTOSIS,1781,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PLATELET ESTIMATE,1782,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TARGET CELLS,1783,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
OVALOCYTES,1784,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SPHEROCYTES,1785,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ACANTHOCYTES,1786,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MACROCYTOSIS,1787,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HOWELL JOLLY BODIES,1788,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
CABOT RINGS,1789,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SICKLE CELLS,1790,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
BASOPHILIC  STIPPLING,1791,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SIDEROCYTES,1792,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
* Comment 4,1793,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HEINZ BODIES,1794,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TEARDROP,1795,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SCHISTOCYTES,1796,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
CRENATED CELLS,1797,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VACUOLES,1798,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PAPPENHEIMER,1799,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TOXIC GRANULATION,1800,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
* Comment 3,1801,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
* Comment 1,1802,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
* Comment 2,1803,CDM,300,RC,85031,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
RBC,1804,CDM,300,RC,85041,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Reticulocytes, Automated[Panel]",1805,CDM,300,RC,85045,HCPCS,outpatient,,,66.24,49.68,,59.62,90,,,percent of total billed charges,90% of total billed charges,61.6,93,,,percent of total billed charges,93% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,56.3,85,,,percent of total billed charges,85% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,53.92,81.4,,,percent of total billed charges,81.4% of total billed charges,59.62,90,,,percent of total billed charges,90% of total billed charges,59.62,90,,,percent of total billed charges,90% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,25.17,38,,,percent of total billed charges,38% of total billed charges,49.68,75,,,percent of total billed charges,75% of total billed charges,56.3,85,,,percent of total billed charges,85% of total billed charges,25.17,61.6,
Profile-WBC Count FOR eos PANEL,1806,CDM,300,RC,85048,HCPCS,outpatient,,,19.92,14.94,,17.93,90,,,percent of total billed charges,90% of total billed charges,18.53,93,,,percent of total billed charges,93% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.21,81.4,,,percent of total billed charges,81.4% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,14.94,75,,,percent of total billed charges,75% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,18.53,
Platelet Count,1807,CDM,300,RC,85049,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Factor II Activity,1808,CDM,300,RC,85210,HCPCS,outpatient,,,233.18,174.89,,209.86,90,,,percent of total billed charges,90% of total billed charges,216.86,93,,,percent of total billed charges,93% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,198.2,85,,,percent of total billed charges,85% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,189.81,81.4,,,percent of total billed charges,81.4% of total billed charges,209.86,90,,,percent of total billed charges,90% of total billed charges,209.86,90,,,percent of total billed charges,90% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,174.89,75,,,percent of total billed charges,75% of total billed charges,198.2,85,,,percent of total billed charges,85% of total billed charges,88.61,216.86,
Factor V Human Inhibitor,1809,CDM,300,RC,85220,HCPCS,outpatient,,,246.96,185.22,,222.26,90,,,percent of total billed charges,90% of total billed charges,229.67,93,,,percent of total billed charges,93% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,209.92,85,,,percent of total billed charges,85% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,201.03,81.4,,,percent of total billed charges,81.4% of total billed charges,222.26,90,,,percent of total billed charges,90% of total billed charges,222.26,90,,,percent of total billed charges,90% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,185.22,75,,,percent of total billed charges,75% of total billed charges,209.92,85,,,percent of total billed charges,85% of total billed charges,93.84,229.67,
Factor VII Activity,1810,CDM,300,RC,85230,HCPCS,outpatient,,,233.18,174.89,,209.86,90,,,percent of total billed charges,90% of total billed charges,216.86,93,,,percent of total billed charges,93% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,198.2,85,,,percent of total billed charges,85% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,189.81,81.4,,,percent of total billed charges,81.4% of total billed charges,209.86,90,,,percent of total billed charges,90% of total billed charges,209.86,90,,,percent of total billed charges,90% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,88.61,38,,,percent of total billed charges,38% of total billed charges,174.89,75,,,percent of total billed charges,75% of total billed charges,198.2,85,,,percent of total billed charges,85% of total billed charges,88.61,216.86,
"Factor VIII Activity, Clotting",1811,CDM,300,RC,85240,HCPCS,outpatient,,,264.98,198.74,,238.48,90,,,percent of total billed charges,90% of total billed charges,246.43,93,,,percent of total billed charges,93% of total billed charges,100.69,38,,,percent of total billed charges,38% of total billed charges,100.69,38,,,percent of total billed charges,38% of total billed charges,225.23,85,,,percent of total billed charges,85% of total billed charges,100.69,38,,,percent of total billed charges,38% of total billed charges,215.69,81.4,,,percent of total billed charges,81.4% of total billed charges,238.48,90,,,percent of total billed charges,90% of total billed charges,238.48,90,,,percent of total billed charges,90% of total billed charges,100.69,38,,,percent of total billed charges,38% of total billed charges,100.69,38,,,percent of total billed charges,38% of total billed charges,100.69,38,,,percent of total billed charges,38% of total billed charges,198.74,75,,,percent of total billed charges,75% of total billed charges,225.23,85,,,percent of total billed charges,85% of total billed charges,100.69,246.43,
"(RES) FACTOR VIII ACTIVITY, CLOTTING",1812,CDM,300,RC,85240,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
(RES) RISTOCETIN COFACTOR,1813,CDM,300,RC,85245,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
(RES) VON WILLEBRAND FACTOR ANTIGEN,1814,CDM,300,RC,85246,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
"(RES) VWF AG, MULTIMETRIC",1815,CDM,300,RC,85247,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
Factor IX Avtivity,1816,CDM,300,RC,85250,HCPCS,outpatient,,,239.05,179.29,,215.15,90,,,percent of total billed charges,90% of total billed charges,222.32,93,,,percent of total billed charges,93% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,203.19,85,,,percent of total billed charges,85% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,194.59,81.4,,,percent of total billed charges,81.4% of total billed charges,215.15,90,,,percent of total billed charges,90% of total billed charges,215.15,90,,,percent of total billed charges,90% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,179.29,75,,,percent of total billed charges,75% of total billed charges,203.19,85,,,percent of total billed charges,85% of total billed charges,90.84,222.32,
Factor X Activity,1817,CDM,300,RC,85260,HCPCS,outpatient,,,239.05,179.29,,215.15,90,,,percent of total billed charges,90% of total billed charges,222.32,93,,,percent of total billed charges,93% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,203.19,85,,,percent of total billed charges,85% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,194.59,81.4,,,percent of total billed charges,81.4% of total billed charges,215.15,90,,,percent of total billed charges,90% of total billed charges,215.15,90,,,percent of total billed charges,90% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,179.29,75,,,percent of total billed charges,75% of total billed charges,203.19,85,,,percent of total billed charges,85% of total billed charges,90.84,222.32,
Antithrombin III Antigen,1818,CDM,300,RC,85300,HCPCS,outpatient,,,251.92,188.94,,226.73,90,,,percent of total billed charges,90% of total billed charges,234.29,93,,,percent of total billed charges,93% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,214.13,85,,,percent of total billed charges,85% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,205.06,81.4,,,percent of total billed charges,81.4% of total billed charges,226.73,90,,,percent of total billed charges,90% of total billed charges,226.73,90,,,percent of total billed charges,90% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,95.73,38,,,percent of total billed charges,38% of total billed charges,188.94,75,,,percent of total billed charges,75% of total billed charges,214.13,85,,,percent of total billed charges,85% of total billed charges,95.73,234.29,
Antithrombin III Activity,1819,CDM,300,RC,85300,HCPCS,outpatient,,,121.86,91.4,,109.67,90,,,percent of total billed charges,90% of total billed charges,113.33,93,,,percent of total billed charges,93% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,99.19,81.4,,,percent of total billed charges,81.4% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,91.4,75,,,percent of total billed charges,75% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,113.33,
Protein C Antigen,1820,CDM,300,RC,85302,HCPCS,outpatient,,,287.17,215.38,,258.45,90,,,percent of total billed charges,90% of total billed charges,267.07,93,,,percent of total billed charges,93% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,244.09,85,,,percent of total billed charges,85% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,233.76,81.4,,,percent of total billed charges,81.4% of total billed charges,258.45,90,,,percent of total billed charges,90% of total billed charges,258.45,90,,,percent of total billed charges,90% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,215.38,75,,,percent of total billed charges,75% of total billed charges,244.09,85,,,percent of total billed charges,85% of total billed charges,109.12,267.07,
Protein C Activity,1821,CDM,300,RC,85303,HCPCS,outpatient,,,257.28,192.96,,231.55,90,,,percent of total billed charges,90% of total billed charges,239.27,93,,,percent of total billed charges,93% of total billed charges,97.77,38,,,percent of total billed charges,38% of total billed charges,97.77,38,,,percent of total billed charges,38% of total billed charges,218.69,85,,,percent of total billed charges,85% of total billed charges,97.77,38,,,percent of total billed charges,38% of total billed charges,209.43,81.4,,,percent of total billed charges,81.4% of total billed charges,231.55,90,,,percent of total billed charges,90% of total billed charges,231.55,90,,,percent of total billed charges,90% of total billed charges,97.77,38,,,percent of total billed charges,38% of total billed charges,97.77,38,,,percent of total billed charges,38% of total billed charges,97.77,38,,,percent of total billed charges,38% of total billed charges,192.96,75,,,percent of total billed charges,75% of total billed charges,218.69,85,,,percent of total billed charges,85% of total billed charges,97.77,239.27,
Protein S Antigen-total,1822,CDM,300,RC,85305,HCPCS,outpatient,,,191.45,143.59,,172.31,90,,,percent of total billed charges,90% of total billed charges,178.05,93,,,percent of total billed charges,93% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,162.73,85,,,percent of total billed charges,85% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,155.84,81.4,,,percent of total billed charges,81.4% of total billed charges,172.31,90,,,percent of total billed charges,90% of total billed charges,172.31,90,,,percent of total billed charges,90% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,143.59,75,,,percent of total billed charges,75% of total billed charges,162.73,85,,,percent of total billed charges,85% of total billed charges,72.75,178.05,
"(RES) PROTEIN S ANTIGEN, TOTAL",1823,CDM,300,RC,85305,HCPCS,outpatient,,,191.45,143.59,,172.31,90,,,percent of total billed charges,90% of total billed charges,178.05,93,,,percent of total billed charges,93% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,162.73,85,,,percent of total billed charges,85% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,155.84,81.4,,,percent of total billed charges,81.4% of total billed charges,172.31,90,,,percent of total billed charges,90% of total billed charges,172.31,90,,,percent of total billed charges,90% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,143.59,75,,,percent of total billed charges,75% of total billed charges,162.73,85,,,percent of total billed charges,85% of total billed charges,72.75,178.05,
"Protein S AG, Free",1824,CDM,300,RC,85306,HCPCS,outpatient,,,316.38,237.29,,284.74,90,,,percent of total billed charges,90% of total billed charges,294.23,93,,,percent of total billed charges,93% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,257.53,81.4,,,percent of total billed charges,81.4% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,237.29,75,,,percent of total billed charges,75% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,294.23,
Protein S Activity,1825,CDM,300,RC,85306,HCPCS,outpatient,,,271.21,203.41,,244.09,90,,,percent of total billed charges,90% of total billed charges,252.23,93,,,percent of total billed charges,93% of total billed charges,103.06,38,,,percent of total billed charges,38% of total billed charges,103.06,38,,,percent of total billed charges,38% of total billed charges,230.53,85,,,percent of total billed charges,85% of total billed charges,103.06,38,,,percent of total billed charges,38% of total billed charges,220.76,81.4,,,percent of total billed charges,81.4% of total billed charges,244.09,90,,,percent of total billed charges,90% of total billed charges,244.09,90,,,percent of total billed charges,90% of total billed charges,103.06,38,,,percent of total billed charges,38% of total billed charges,103.06,38,,,percent of total billed charges,38% of total billed charges,103.06,38,,,percent of total billed charges,38% of total billed charges,203.41,75,,,percent of total billed charges,75% of total billed charges,230.53,85,,,percent of total billed charges,85% of total billed charges,103.06,252.23,
"(RES) PROTEIN S ANTIGEN, FREE",1826,CDM,300,RC,85306,HCPCS,outpatient,,,316.38,237.29,,284.74,90,,,percent of total billed charges,90% of total billed charges,294.23,93,,,percent of total billed charges,93% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,257.53,81.4,,,percent of total billed charges,81.4% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,237.29,75,,,percent of total billed charges,75% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,294.23,
Activated Protein C Resistance,1827,CDM,300,RC,85307,HCPCS,outpatient,,,175.77,131.83,,158.19,90,,,percent of total billed charges,90% of total billed charges,163.47,93,,,percent of total billed charges,93% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,143.08,81.4,,,percent of total billed charges,81.4% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,131.83,75,,,percent of total billed charges,75% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,163.47,
Activated Protein C Resist. w Factor V Rflx,1828,CDM,300,RC,85307,HCPCS,outpatient,,,253.96,190.47,,228.56,90,,,percent of total billed charges,90% of total billed charges,236.18,93,,,percent of total billed charges,93% of total billed charges,96.5,38,,,percent of total billed charges,38% of total billed charges,96.5,38,,,percent of total billed charges,38% of total billed charges,215.87,85,,,percent of total billed charges,85% of total billed charges,96.5,38,,,percent of total billed charges,38% of total billed charges,206.72,81.4,,,percent of total billed charges,81.4% of total billed charges,228.56,90,,,percent of total billed charges,90% of total billed charges,228.56,90,,,percent of total billed charges,90% of total billed charges,96.5,38,,,percent of total billed charges,38% of total billed charges,96.5,38,,,percent of total billed charges,38% of total billed charges,96.5,38,,,percent of total billed charges,38% of total billed charges,190.47,75,,,percent of total billed charges,75% of total billed charges,215.87,85,,,percent of total billed charges,85% of total billed charges,96.5,236.18,
(RES) ACTIVATED PROTEIN C RESISTANCE,1829,CDM,300,RC,85307,HCPCS,outpatient,,,175.77,131.83,,158.19,90,,,percent of total billed charges,90% of total billed charges,163.47,93,,,percent of total billed charges,93% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,143.08,81.4,,,percent of total billed charges,81.4% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,131.83,75,,,percent of total billed charges,75% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,163.47,
(RES) LUPUS ANTICOAGULANT,1830,CDM,300,RC,85307,HCPCS,outpatient,,,270.61,202.96,,243.55,90,,,percent of total billed charges,90% of total billed charges,251.67,93,,,percent of total billed charges,93% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,220.28,81.4,,,percent of total billed charges,81.4% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,202.96,75,,,percent of total billed charges,75% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,251.67,
Factor V Activity,1831,CDM,300,RC,85335,HCPCS,outpatient,,,246.96,185.22,,222.26,90,,,percent of total billed charges,90% of total billed charges,229.67,93,,,percent of total billed charges,93% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,209.92,85,,,percent of total billed charges,85% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,201.03,81.4,,,percent of total billed charges,81.4% of total billed charges,222.26,90,,,percent of total billed charges,90% of total billed charges,222.26,90,,,percent of total billed charges,90% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,93.84,38,,,percent of total billed charges,38% of total billed charges,185.22,75,,,percent of total billed charges,75% of total billed charges,209.92,85,,,percent of total billed charges,85% of total billed charges,93.84,229.67,
D Dimer,1832,CDM,300,RC,85379,HCPCS,outpatient,,,128.89,96.67,,116,90,,,percent of total billed charges,90% of total billed charges,119.87,93,,,percent of total billed charges,93% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,109.56,85,,,percent of total billed charges,85% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,104.92,81.4,,,percent of total billed charges,81.4% of total billed charges,116,90,,,percent of total billed charges,90% of total billed charges,116,90,,,percent of total billed charges,90% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,96.67,75,,,percent of total billed charges,75% of total billed charges,109.56,85,,,percent of total billed charges,85% of total billed charges,48.98,119.87,
Fibrinogen Activity Clauss,1833,CDM,300,RC,85384,HCPCS,outpatient,,,89.6,67.2,,80.64,90,,,percent of total billed charges,90% of total billed charges,83.33,93,,,percent of total billed charges,93% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,76.16,85,,,percent of total billed charges,85% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,72.93,81.4,,,percent of total billed charges,81.4% of total billed charges,80.64,90,,,percent of total billed charges,90% of total billed charges,80.64,90,,,percent of total billed charges,90% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,67.2,75,,,percent of total billed charges,75% of total billed charges,76.16,85,,,percent of total billed charges,85% of total billed charges,34.05,83.33,
Fibrinogen level,1834,CDM,300,RC,85384,HCPCS,outpatient,,,171.18,128.39,,154.06,90,,,percent of total billed charges,90% of total billed charges,159.2,93,,,percent of total billed charges,93% of total billed charges,65.05,38,,,percent of total billed charges,38% of total billed charges,65.05,38,,,percent of total billed charges,38% of total billed charges,145.5,85,,,percent of total billed charges,85% of total billed charges,65.05,38,,,percent of total billed charges,38% of total billed charges,139.34,81.4,,,percent of total billed charges,81.4% of total billed charges,154.06,90,,,percent of total billed charges,90% of total billed charges,154.06,90,,,percent of total billed charges,90% of total billed charges,65.05,38,,,percent of total billed charges,38% of total billed charges,65.05,38,,,percent of total billed charges,38% of total billed charges,65.05,38,,,percent of total billed charges,38% of total billed charges,128.39,75,,,percent of total billed charges,75% of total billed charges,145.5,85,,,percent of total billed charges,85% of total billed charges,65.05,159.2,
"Fibrinogen Antigen, Nephelometry",1835,CDM,300,RC,85385,HCPCS,outpatient,,,55.18,41.39,,49.66,90,,,percent of total billed charges,90% of total billed charges,51.32,93,,,percent of total billed charges,93% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,46.9,85,,,percent of total billed charges,85% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,44.92,81.4,,,percent of total billed charges,81.4% of total billed charges,49.66,90,,,percent of total billed charges,90% of total billed charges,49.66,90,,,percent of total billed charges,90% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,41.39,75,,,percent of total billed charges,75% of total billed charges,46.9,85,,,percent of total billed charges,85% of total billed charges,20.97,51.32,
Plasminogen Activator Inhibitor-1 (PAI-1),1836,CDM,300,RC,85415,HCPCS,outpatient,,,189.42,142.07,,170.48,90,,,percent of total billed charges,90% of total billed charges,176.16,93,,,percent of total billed charges,93% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,161.01,85,,,percent of total billed charges,85% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,154.19,81.4,,,percent of total billed charges,81.4% of total billed charges,170.48,90,,,percent of total billed charges,90% of total billed charges,170.48,90,,,percent of total billed charges,90% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,142.07,75,,,percent of total billed charges,75% of total billed charges,161.01,85,,,percent of total billed charges,85% of total billed charges,71.98,176.16,
"Lysozyme, Serum",1837,CDM,300,RC,85549,HCPCS,outpatient,,,153.5,115.13,,138.15,90,,,percent of total billed charges,90% of total billed charges,142.76,93,,,percent of total billed charges,93% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,130.48,85,,,percent of total billed charges,85% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,124.95,81.4,,,percent of total billed charges,81.4% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,115.13,75,,,percent of total billed charges,75% of total billed charges,130.48,85,,,percent of total billed charges,85% of total billed charges,58.33,142.76,
DRVVT confirm,1838,CDM,300,RC,85597,HCPCS,outpatient,,,144.15,108.11,,129.74,90,,,percent of total billed charges,90% of total billed charges,134.06,93,,,percent of total billed charges,93% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,122.53,85,,,percent of total billed charges,85% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,117.34,81.4,,,percent of total billed charges,81.4% of total billed charges,129.74,90,,,percent of total billed charges,90% of total billed charges,129.74,90,,,percent of total billed charges,90% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,108.11,75,,,percent of total billed charges,75% of total billed charges,122.53,85,,,percent of total billed charges,85% of total billed charges,54.78,134.06,
(RES) DRVVT CONFIRM,1839,CDM,300,RC,85597,HCPCS,outpatient,,,144.15,108.11,,129.74,90,,,percent of total billed charges,90% of total billed charges,134.06,93,,,percent of total billed charges,93% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,122.53,85,,,percent of total billed charges,85% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,117.34,81.4,,,percent of total billed charges,81.4% of total billed charges,129.74,90,,,percent of total billed charges,90% of total billed charges,129.74,90,,,percent of total billed charges,90% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,54.78,38,,,percent of total billed charges,38% of total billed charges,108.11,75,,,percent of total billed charges,75% of total billed charges,122.53,85,,,percent of total billed charges,85% of total billed charges,54.78,134.06,
Hexagonal phase confirm,1840,CDM,300,RC,85598,HCPCS,outpatient,,,170.04,127.53,,153.04,90,,,percent of total billed charges,90% of total billed charges,158.14,93,,,percent of total billed charges,93% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,144.53,85,,,percent of total billed charges,85% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,138.41,81.4,,,percent of total billed charges,81.4% of total billed charges,153.04,90,,,percent of total billed charges,90% of total billed charges,153.04,90,,,percent of total billed charges,90% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,127.53,75,,,percent of total billed charges,75% of total billed charges,144.53,85,,,percent of total billed charges,85% of total billed charges,64.62,158.14,
(RES) HEXAGONAL PHASE CONFIRM,1841,CDM,300,RC,85598,HCPCS,outpatient,,,170.04,127.53,,153.04,90,,,percent of total billed charges,90% of total billed charges,158.14,93,,,percent of total billed charges,93% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,144.53,85,,,percent of total billed charges,85% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,138.41,81.4,,,percent of total billed charges,81.4% of total billed charges,153.04,90,,,percent of total billed charges,90% of total billed charges,153.04,90,,,percent of total billed charges,90% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,64.62,38,,,percent of total billed charges,38% of total billed charges,127.53,75,,,percent of total billed charges,75% of total billed charges,144.53,85,,,percent of total billed charges,85% of total billed charges,64.62,158.14,
(Result) Protime (PT),1842,CDM,300,RC,85610,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
INR-Whole Blood (Fingerstick),1843,CDM,300,RC,85610,HCPCS,outpatient,,,66.79,50.09,,60.11,90,,,percent of total billed charges,90% of total billed charges,62.11,93,,,percent of total billed charges,93% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,54.37,81.4,,,percent of total billed charges,81.4% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,50.09,75,,,percent of total billed charges,75% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,62.11,
Protime Panel w/ INR,1844,CDM,300,RC,85610,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
Protime Panel w/ INR,1845,CDM,300,RC,85610,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
(Result) INR,1846,CDM,300,RC,85610,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DRVVT SCREEN,1847,CDM,300,RC,85613,HCPCS,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,117.69,
dRVVT screen with reflex,1848,CDM,300,RC,85613,HCPCS,outpatient,,,79.25,59.44,,71.33,90,,,percent of total billed charges,90% of total billed charges,73.7,93,,,percent of total billed charges,93% of total billed charges,30.12,38,,,percent of total billed charges,38% of total billed charges,30.12,38,,,percent of total billed charges,38% of total billed charges,67.36,85,,,percent of total billed charges,85% of total billed charges,30.12,38,,,percent of total billed charges,38% of total billed charges,64.51,81.4,,,percent of total billed charges,81.4% of total billed charges,71.33,90,,,percent of total billed charges,90% of total billed charges,71.33,90,,,percent of total billed charges,90% of total billed charges,30.12,38,,,percent of total billed charges,38% of total billed charges,30.12,38,,,percent of total billed charges,38% of total billed charges,30.12,38,,,percent of total billed charges,38% of total billed charges,59.44,75,,,percent of total billed charges,75% of total billed charges,67.36,85,,,percent of total billed charges,85% of total billed charges,30.12,73.7,
Sed Rate(ESR),1849,CDM,300,RC,85651,HCPCS,outpatient,,,46.87,35.15,,42.18,90,,,percent of total billed charges,90% of total billed charges,43.59,93,,,percent of total billed charges,93% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,38.15,81.4,,,percent of total billed charges,81.4% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,35.15,75,,,percent of total billed charges,75% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,43.59,
Sickle Cell Screen,1850,CDM,300,RC,85660,HCPCS,outpatient,,,52.2,39.15,,46.98,90,,,percent of total billed charges,90% of total billed charges,48.55,93,,,percent of total billed charges,93% of total billed charges,19.84,38,,,percent of total billed charges,38% of total billed charges,19.84,38,,,percent of total billed charges,38% of total billed charges,44.37,85,,,percent of total billed charges,85% of total billed charges,19.84,38,,,percent of total billed charges,38% of total billed charges,42.49,81.4,,,percent of total billed charges,81.4% of total billed charges,46.98,90,,,percent of total billed charges,90% of total billed charges,46.98,90,,,percent of total billed charges,90% of total billed charges,19.84,38,,,percent of total billed charges,38% of total billed charges,19.84,38,,,percent of total billed charges,38% of total billed charges,19.84,38,,,percent of total billed charges,38% of total billed charges,39.15,75,,,percent of total billed charges,75% of total billed charges,44.37,85,,,percent of total billed charges,85% of total billed charges,19.84,48.55,
Thrombin Clotting Time,1851,CDM,300,RC,85670,HCPCS,outpatient,,,73.27,54.95,,65.94,90,,,percent of total billed charges,90% of total billed charges,68.14,93,,,percent of total billed charges,93% of total billed charges,27.84,38,,,percent of total billed charges,38% of total billed charges,27.84,38,,,percent of total billed charges,38% of total billed charges,62.28,85,,,percent of total billed charges,85% of total billed charges,27.84,38,,,percent of total billed charges,38% of total billed charges,59.64,81.4,,,percent of total billed charges,81.4% of total billed charges,65.94,90,,,percent of total billed charges,90% of total billed charges,65.94,90,,,percent of total billed charges,90% of total billed charges,27.84,38,,,percent of total billed charges,38% of total billed charges,27.84,38,,,percent of total billed charges,38% of total billed charges,27.84,38,,,percent of total billed charges,38% of total billed charges,54.95,75,,,percent of total billed charges,75% of total billed charges,62.28,85,,,percent of total billed charges,85% of total billed charges,27.84,68.14,
PTT,1852,CDM,300,RC,85730,HCPCS,outpatient,,,53.92,40.44,,48.53,90,,,percent of total billed charges,90% of total billed charges,50.15,93,,,percent of total billed charges,93% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,43.89,81.4,,,percent of total billed charges,81.4% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,40.44,75,,,percent of total billed charges,75% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,50.15,
(RES) PTT-LA SCREEN,1853,CDM,300,RC,85730,HCPCS,outpatient,,,42.17,31.63,,37.95,90,,,percent of total billed charges,90% of total billed charges,39.22,93,,,percent of total billed charges,93% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,35.84,85,,,percent of total billed charges,85% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,34.33,81.4,,,percent of total billed charges,81.4% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,31.63,75,,,percent of total billed charges,75% of total billed charges,35.84,85,,,percent of total billed charges,85% of total billed charges,16.02,39.22,
"(RES) PARTIAL THROMBOPLASTIN TIME, ACTIVATED",1854,CDM,300,RC,85730,HCPCS,outpatient,,,53.92,40.44,,48.53,90,,,percent of total billed charges,90% of total billed charges,50.15,93,,,percent of total billed charges,93% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,43.89,81.4,,,percent of total billed charges,81.4% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,40.44,75,,,percent of total billed charges,75% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,50.15,
Francisella tularemia antigen,1855,CDM,300,RC,86000,HCPCS,outpatient,,,182.8,137.1,,164.52,90,,,percent of total billed charges,90% of total billed charges,170,93,,,percent of total billed charges,93% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,148.8,81.4,,,percent of total billed charges,81.4% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,137.1,75,,,percent of total billed charges,75% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,170,
Francisella tularensis AB DA,1856,CDM,300,RC,86000,HCPCS,outpatient,,,182.44,136.83,,164.2,90,,,percent of total billed charges,90% of total billed charges,169.67,93,,,percent of total billed charges,93% of total billed charges,69.33,38,,,percent of total billed charges,38% of total billed charges,69.33,38,,,percent of total billed charges,38% of total billed charges,155.07,85,,,percent of total billed charges,85% of total billed charges,69.33,38,,,percent of total billed charges,38% of total billed charges,148.51,81.4,,,percent of total billed charges,81.4% of total billed charges,164.2,90,,,percent of total billed charges,90% of total billed charges,164.2,90,,,percent of total billed charges,90% of total billed charges,69.33,38,,,percent of total billed charges,38% of total billed charges,69.33,38,,,percent of total billed charges,38% of total billed charges,69.33,38,,,percent of total billed charges,38% of total billed charges,136.83,75,,,percent of total billed charges,75% of total billed charges,155.07,85,,,percent of total billed charges,85% of total billed charges,69.33,169.67,
Helminthosporium Halodes IGG,1857,CDM,300,RC,86001,HCPCS,outpatient,,,65.32,48.99,,58.79,90,,,percent of total billed charges,90% of total billed charges,60.75,93,,,percent of total billed charges,93% of total billed charges,24.82,38,,,percent of total billed charges,38% of total billed charges,24.82,38,,,percent of total billed charges,38% of total billed charges,55.52,85,,,percent of total billed charges,85% of total billed charges,24.82,38,,,percent of total billed charges,38% of total billed charges,53.17,81.4,,,percent of total billed charges,81.4% of total billed charges,58.79,90,,,percent of total billed charges,90% of total billed charges,58.79,90,,,percent of total billed charges,90% of total billed charges,24.82,38,,,percent of total billed charges,38% of total billed charges,24.82,38,,,percent of total billed charges,38% of total billed charges,24.82,38,,,percent of total billed charges,38% of total billed charges,48.99,75,,,percent of total billed charges,75% of total billed charges,55.52,85,,,percent of total billed charges,85% of total billed charges,24.82,60.75,
(RES) TRICHODERMA VIRIDE (M15) IGG,1858,CDM,300,RC,86001,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
(RES) PENICILLIUM NOTATUM (M1) IGG,1859,CDM,300,RC,86001,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
(RES) CLADOSPORIUM HERBARUM (M2)IGG,1860,CDM,300,RC,86001,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
(RES) AUREOBASIDIUM PULLULANS (M12) IGG,1861,CDM,300,RC,86001,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
(RES) ALTERNARIA ALTERNATA (M6) IGG,1862,CDM,300,RC,86001,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
aspergillus niger IgG,1863,CDM,300,RC,86001,HCPCS,outpatient,,,66.44,49.83,,59.8,90,,,percent of total billed charges,90% of total billed charges,61.79,93,,,percent of total billed charges,93% of total billed charges,25.25,38,,,percent of total billed charges,38% of total billed charges,25.25,38,,,percent of total billed charges,38% of total billed charges,56.47,85,,,percent of total billed charges,85% of total billed charges,25.25,38,,,percent of total billed charges,38% of total billed charges,54.08,81.4,,,percent of total billed charges,81.4% of total billed charges,59.8,90,,,percent of total billed charges,90% of total billed charges,59.8,90,,,percent of total billed charges,90% of total billed charges,25.25,38,,,percent of total billed charges,38% of total billed charges,25.25,38,,,percent of total billed charges,38% of total billed charges,25.25,38,,,percent of total billed charges,38% of total billed charges,49.83,75,,,percent of total billed charges,75% of total billed charges,56.47,85,,,percent of total billed charges,85% of total billed charges,25.25,61.79,
(RES) YEAST (F45) IGG,1864,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) WHEAT (F4) IGG,1865,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) TOMATO (F25) IGG,1866,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) EGG WHITE (F1) IGG,1867,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) CASEIN (F78) IGG,1868,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) MAIZE/CORN (F8) IGG,1869,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) PEANUT (F13) IGG,1870,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) SOYBEAN (F14) IGG,1871,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) CODFISH (F3) IGG,1872,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) CACAO (F93) IGG,1873,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) COFFEE (F221) IGG,1874,CDM,300,RC,86001,HCPCS,outpatient,,,60.55,45.41,,54.5,90,,,percent of total billed charges,90% of total billed charges,56.31,93,,,percent of total billed charges,93% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,49.29,81.4,,,percent of total billed charges,81.4% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,54.5,90,,,percent of total billed charges,90% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,23.01,38,,,percent of total billed charges,38% of total billed charges,45.41,75,,,percent of total billed charges,75% of total billed charges,51.47,85,,,percent of total billed charges,85% of total billed charges,23.01,56.31,
(RES) PHOMA SPP IGG,1875,CDM,300,RC,86001,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
Formaldehyde/Formalin (k80) IgE,1876,CDM,300,RC,86003,HCPCS,outpatient,,,32.47,24.35,,29.22,90,,,percent of total billed charges,90% of total billed charges,30.2,93,,,percent of total billed charges,93% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,27.6,85,,,percent of total billed charges,85% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,26.43,81.4,,,percent of total billed charges,81.4% of total billed charges,29.22,90,,,percent of total billed charges,90% of total billed charges,29.22,90,,,percent of total billed charges,90% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,24.35,75,,,percent of total billed charges,75% of total billed charges,27.6,85,,,percent of total billed charges,85% of total billed charges,12.34,30.2,
(RES) Food Allergy - Scallop,1877,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Baker  Brewers Yeast,1878,CDM,300,RC,86003,HCPCS,outpatient,,,36.43,27.32,,32.79,90,,,percent of total billed charges,90% of total billed charges,33.88,93,,,percent of total billed charges,93% of total billed charges,13.84,38,,,percent of total billed charges,38% of total billed charges,13.84,38,,,percent of total billed charges,38% of total billed charges,30.97,85,,,percent of total billed charges,85% of total billed charges,13.84,38,,,percent of total billed charges,38% of total billed charges,29.65,81.4,,,percent of total billed charges,81.4% of total billed charges,32.79,90,,,percent of total billed charges,90% of total billed charges,32.79,90,,,percent of total billed charges,90% of total billed charges,13.84,38,,,percent of total billed charges,38% of total billed charges,13.84,38,,,percent of total billed charges,38% of total billed charges,13.84,38,,,percent of total billed charges,38% of total billed charges,27.32,75,,,percent of total billed charges,75% of total billed charges,30.97,85,,,percent of total billed charges,85% of total billed charges,13.84,33.88,
BEEF (f27) IgE,1879,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
Shrimp (f24) IgE,1880,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
Latex (k82) IgE,1881,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
CHICKEN MEAT (f83) IgE,1882,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
PORK (f26) IgE,1883,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
TURKEY MEAT (f284) IgE,1884,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
WHEAT (f4) IgE,1885,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
OAT (f7) IgE,1886,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
CHEDDAR CHEESE (f81) IgE,1887,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
(RES) Food Allergy - Tuna,1888,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Cocoa (f93) IgE,1889,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
Avocado (f96) IgE,1890,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
Banana (f92) IgE,1891,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
Cat Dander (e1) IgE,1892,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
(RES) Food Allergy - Egg Whole,1893,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Food Allergy - Peanut,1894,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Pine Nut (f253) IgE,1895,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Egg White (f1) IgE,1896,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Cow's Milk (f2) IgE,1897,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Food Allergy - Cow Milk,1898,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) HONEY BEE (I1) IgE,1899,CDM,300,RC,86003,HCPCS,outpatient,,,35.02,26.27,,31.52,90,,,percent of total billed charges,90% of total billed charges,32.57,93,,,percent of total billed charges,93% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,28.51,81.4,,,percent of total billed charges,81.4% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,26.27,75,,,percent of total billed charges,75% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,32.57,
(RES) WHITE FACED HORNET (I2) IgE,1900,CDM,300,RC,86003,HCPCS,outpatient,,,35.02,26.27,,31.52,90,,,percent of total billed charges,90% of total billed charges,32.57,93,,,percent of total billed charges,93% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,28.51,81.4,,,percent of total billed charges,81.4% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,26.27,75,,,percent of total billed charges,75% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,32.57,
(RES) YELLOW JACKET (I3) IgE,1901,CDM,300,RC,86003,HCPCS,outpatient,,,35.02,26.27,,31.52,90,,,percent of total billed charges,90% of total billed charges,32.57,93,,,percent of total billed charges,93% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,28.51,81.4,,,percent of total billed charges,81.4% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,26.27,75,,,percent of total billed charges,75% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,32.57,
(RES) PAPER WASP (I4) IgE,1902,CDM,300,RC,86003,HCPCS,outpatient,,,35.02,26.27,,31.52,90,,,percent of total billed charges,90% of total billed charges,32.57,93,,,percent of total billed charges,93% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,28.51,81.4,,,percent of total billed charges,81.4% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,26.27,75,,,percent of total billed charges,75% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,32.57,
(RES) YELLOW HORNET (I5) IgE,1903,CDM,300,RC,86003,HCPCS,outpatient,,,35.02,26.27,,31.52,90,,,percent of total billed charges,90% of total billed charges,32.57,93,,,percent of total billed charges,93% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,28.51,81.4,,,percent of total billed charges,81.4% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,31.52,90,,,percent of total billed charges,90% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,13.31,38,,,percent of total billed charges,38% of total billed charges,26.27,75,,,percent of total billed charges,75% of total billed charges,29.77,85,,,percent of total billed charges,85% of total billed charges,13.31,32.57,
(RES) Food Allergy - Salmon,1904,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) CELERY (F85) IgE,1905,CDM,300,RC,86003,HCPCS,outpatient,,,33.27,24.95,,29.94,90,,,percent of total billed charges,90% of total billed charges,30.94,93,,,percent of total billed charges,93% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,27.08,81.4,,,percent of total billed charges,81.4% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,24.95,75,,,percent of total billed charges,75% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,30.94,
(RES) LETTUCE (F215) IgE,1906,CDM,300,RC,86003,HCPCS,outpatient,,,33.27,24.95,,29.94,90,,,percent of total billed charges,90% of total billed charges,30.94,93,,,percent of total billed charges,93% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,27.08,81.4,,,percent of total billed charges,81.4% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,24.95,75,,,percent of total billed charges,75% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,30.94,
(RES) ORANGE (F33) IgE,1907,CDM,300,RC,86003,HCPCS,outpatient,,,33.27,24.95,,29.94,90,,,percent of total billed charges,90% of total billed charges,30.94,93,,,percent of total billed charges,93% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,27.08,81.4,,,percent of total billed charges,81.4% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,24.95,75,,,percent of total billed charges,75% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,30.94,
(RES) PARSLEY (F86) IgE,1908,CDM,300,RC,86003,HCPCS,outpatient,,,33.27,24.95,,29.94,90,,,percent of total billed charges,90% of total billed charges,30.94,93,,,percent of total billed charges,93% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,27.08,81.4,,,percent of total billed charges,81.4% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,24.95,75,,,percent of total billed charges,75% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,30.94,
(RES) TOMATO (F25) IgE,1909,CDM,300,RC,86003,HCPCS,outpatient,,,33.27,24.95,,29.94,90,,,percent of total billed charges,90% of total billed charges,30.94,93,,,percent of total billed charges,93% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,27.08,81.4,,,percent of total billed charges,81.4% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,29.94,90,,,percent of total billed charges,90% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,12.64,38,,,percent of total billed charges,38% of total billed charges,24.95,75,,,percent of total billed charges,75% of total billed charges,28.28,85,,,percent of total billed charges,85% of total billed charges,12.64,30.94,
(RES) Resp allergy Alder,1910,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
Caraway (Carum carvi) (f265) IgE,1911,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
"Allergen, Pepper Jalapeno IgE",1912,CDM,300,RC,86003,HCPCS,outpatient,,,67.28,50.46,,60.55,90,,,percent of total billed charges,90% of total billed charges,62.57,93,,,percent of total billed charges,93% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,57.19,85,,,percent of total billed charges,85% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,54.77,81.4,,,percent of total billed charges,81.4% of total billed charges,60.55,90,,,percent of total billed charges,90% of total billed charges,60.55,90,,,percent of total billed charges,90% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,25.57,38,,,percent of total billed charges,38% of total billed charges,50.46,75,,,percent of total billed charges,75% of total billed charges,57.19,85,,,percent of total billed charges,85% of total billed charges,25.57,62.57,
Paprika/Sweet Pepper (f218) IgE,1913,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
Chili Pepper (f279) IgE,1914,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
Coriander/Cilantro (f317) IgE,1915,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
(RES) Resp allergy Alternaria,1916,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
Cashew Nut (f202) IgE,1917,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Pistachio (f203) IgE,1918,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Resp allergy Aspergillus,1919,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy Bermuda grass,1920,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy Cat dander,1921,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy cladosporium,1922,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy ragweed,1923,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy Cockroach,1924,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Food Allergy - Shrimp,1925,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Resp allergy cottonwood,1926,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
Pinto Bean IgE,1927,CDM,300,RC,86003,HCPCS,outpatient,,,60.81,45.61,,54.73,90,,,percent of total billed charges,90% of total billed charges,56.55,93,,,percent of total billed charges,93% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,51.69,85,,,percent of total billed charges,85% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,49.5,81.4,,,percent of total billed charges,81.4% of total billed charges,54.73,90,,,percent of total billed charges,90% of total billed charges,54.73,90,,,percent of total billed charges,90% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,45.61,75,,,percent of total billed charges,75% of total billed charges,51.69,85,,,percent of total billed charges,85% of total billed charges,23.11,56.55,
(RES) Food Allergy - Almond,1928,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Food Allergy - Cashew,1929,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Macadamia IgE,1930,CDM,300,RC,86003,HCPCS,outpatient,,,60.81,45.61,,54.73,90,,,percent of total billed charges,90% of total billed charges,56.55,93,,,percent of total billed charges,93% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,51.69,85,,,percent of total billed charges,85% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,49.5,81.4,,,percent of total billed charges,81.4% of total billed charges,54.73,90,,,percent of total billed charges,90% of total billed charges,54.73,90,,,percent of total billed charges,90% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,45.61,75,,,percent of total billed charges,75% of total billed charges,51.69,85,,,percent of total billed charges,85% of total billed charges,23.11,56.55,
(RES) Food Allergy - Sesame Seed,1931,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Food Allergy - Walnut,1932,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Resp allergy dermatopha fannae,1933,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy Dermatopha ptero,1934,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy dog dander,1935,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy Elm,1936,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy box elder,1937,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy cedar,1938,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy Mouse Urine,1939,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy mugwort,1940,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy oak,1941,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Food Allergy - Codfish,1942,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Food Allergy - Brazil Nut,1943,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
(RES) Food Allergy - Soybean,1944,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Resp allergy olive,1945,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy penicillium,1946,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp Allergy pigweed,1947,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy thistle,1948,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy sheep sorrel,1949,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy timothy grass,1950,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Resp allergy white mulberry,1951,CDM,300,RC,86003,HCPCS,outpatient,,,40.2,30.15,,36.18,90,,,percent of total billed charges,90% of total billed charges,37.39,93,,,percent of total billed charges,93% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,32.72,81.4,,,percent of total billed charges,81.4% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,36.18,90,,,percent of total billed charges,90% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,15.28,38,,,percent of total billed charges,38% of total billed charges,30.15,75,,,percent of total billed charges,75% of total billed charges,34.17,85,,,percent of total billed charges,85% of total billed charges,15.28,37.39,
(RES) Food Allergy - Wheat,1952,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Cinnamon (f220) IgE,1953,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Lamb/Mutton IgE,1954,CDM,300,RC,86003,HCPCS,outpatient,,,30.04,22.53,,27.04,90,,,percent of total billed charges,90% of total billed charges,27.94,93,,,percent of total billed charges,93% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,25.53,85,,,percent of total billed charges,85% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,24.45,81.4,,,percent of total billed charges,81.4% of total billed charges,27.04,90,,,percent of total billed charges,90% of total billed charges,27.04,90,,,percent of total billed charges,90% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,22.53,75,,,percent of total billed charges,75% of total billed charges,25.53,85,,,percent of total billed charges,85% of total billed charges,11.42,27.94,
(RES) Pork IgE,1955,CDM,300,RC,86003,HCPCS,outpatient,,,30.04,22.53,,27.04,90,,,percent of total billed charges,90% of total billed charges,27.94,93,,,percent of total billed charges,93% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,25.53,85,,,percent of total billed charges,85% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,24.45,81.4,,,percent of total billed charges,81.4% of total billed charges,27.04,90,,,percent of total billed charges,90% of total billed charges,27.04,90,,,percent of total billed charges,90% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,22.53,75,,,percent of total billed charges,75% of total billed charges,25.53,85,,,percent of total billed charges,85% of total billed charges,11.42,27.94,
(RES) Food Allergy - Pistachio,1956,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
(RES) Food Allergy - Macadamia Nut,1957,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
(RES) Beef IgE,1958,CDM,300,RC,86003,HCPCS,outpatient,,,30.04,22.53,,27.04,90,,,percent of total billed charges,90% of total billed charges,27.94,93,,,percent of total billed charges,93% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,25.53,85,,,percent of total billed charges,85% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,24.45,81.4,,,percent of total billed charges,81.4% of total billed charges,27.04,90,,,percent of total billed charges,90% of total billed charges,27.04,90,,,percent of total billed charges,90% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,22.53,75,,,percent of total billed charges,75% of total billed charges,25.53,85,,,percent of total billed charges,85% of total billed charges,11.42,27.94,
(RES) Food Allergy - Hazelnut,1959,CDM,300,RC,86003,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(RES) Food Allergy - Pecan Nut,1960,CDM,300,RC,86003,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
Mold allergen,1961,CDM,300,RC,86003,HCPCS,outpatient,,,44.17,33.13,,39.75,90,,,percent of total billed charges,90% of total billed charges,41.08,93,,,percent of total billed charges,93% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,37.54,85,,,percent of total billed charges,85% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,35.95,81.4,,,percent of total billed charges,81.4% of total billed charges,39.75,90,,,percent of total billed charges,90% of total billed charges,39.75,90,,,percent of total billed charges,90% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,16.78,38,,,percent of total billed charges,38% of total billed charges,33.13,75,,,percent of total billed charges,75% of total billed charges,37.54,85,,,percent of total billed charges,85% of total billed charges,16.78,41.08,
"(RES) Galactose Alpha 1,3 Galactose IgE",1962,CDM,300,RC,86008,HCPCS,outpatient,,,30.04,22.53,,27.04,90,,,percent of total billed charges,90% of total billed charges,27.94,93,,,percent of total billed charges,93% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,25.53,85,,,percent of total billed charges,85% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,24.45,81.4,,,percent of total billed charges,81.4% of total billed charges,27.04,90,,,percent of total billed charges,90% of total billed charges,27.04,90,,,percent of total billed charges,90% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,11.42,38,,,percent of total billed charges,38% of total billed charges,22.53,75,,,percent of total billed charges,75% of total billed charges,25.53,85,,,percent of total billed charges,85% of total billed charges,11.42,27.94,
CASEIN (f78) IgE,1963,CDM,300,RC,86008,HCPCS,outpatient,,,34.62,25.97,,31.16,90,,,percent of total billed charges,90% of total billed charges,32.2,93,,,percent of total billed charges,93% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,28.18,81.4,,,percent of total billed charges,81.4% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,31.16,90,,,percent of total billed charges,90% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,13.16,38,,,percent of total billed charges,38% of total billed charges,25.97,75,,,percent of total billed charges,75% of total billed charges,29.43,85,,,percent of total billed charges,85% of total billed charges,13.16,32.2,
"GALACTOSE-ALPHA-1,3-GALACTOSE IgE",1964,CDM,300,RC,86008,HCPCS,outpatient,,,37.23,27.92,,33.51,90,,,percent of total billed charges,90% of total billed charges,34.62,93,,,percent of total billed charges,93% of total billed charges,14.15,38,,,percent of total billed charges,38% of total billed charges,14.15,38,,,percent of total billed charges,38% of total billed charges,31.65,85,,,percent of total billed charges,85% of total billed charges,14.15,38,,,percent of total billed charges,38% of total billed charges,30.31,81.4,,,percent of total billed charges,81.4% of total billed charges,33.51,90,,,percent of total billed charges,90% of total billed charges,33.51,90,,,percent of total billed charges,90% of total billed charges,14.15,38,,,percent of total billed charges,38% of total billed charges,14.15,38,,,percent of total billed charges,38% of total billed charges,14.15,38,,,percent of total billed charges,38% of total billed charges,27.92,75,,,percent of total billed charges,75% of total billed charges,31.65,85,,,percent of total billed charges,85% of total billed charges,14.15,34.62,
Actin (Smooth mus) AB IgG,1965,CDM,300,RC,86015,HCPCS,outpatient,,,109.14,81.86,,98.23,90,,,percent of total billed charges,90% of total billed charges,101.5,93,,,percent of total billed charges,93% of total billed charges,41.47,38,,,percent of total billed charges,38% of total billed charges,41.47,38,,,percent of total billed charges,38% of total billed charges,92.77,85,,,percent of total billed charges,85% of total billed charges,41.47,38,,,percent of total billed charges,38% of total billed charges,88.84,81.4,,,percent of total billed charges,81.4% of total billed charges,98.23,90,,,percent of total billed charges,90% of total billed charges,98.23,90,,,percent of total billed charges,90% of total billed charges,41.47,38,,,percent of total billed charges,38% of total billed charges,41.47,38,,,percent of total billed charges,38% of total billed charges,41.47,38,,,percent of total billed charges,38% of total billed charges,81.86,75,,,percent of total billed charges,75% of total billed charges,92.77,85,,,percent of total billed charges,85% of total billed charges,41.47,101.5,
Smooth Muscle AB w Rflx,1966,CDM,300,RC,86015,HCPCS,outpatient,,,144.43,108.32,,129.99,90,,,percent of total billed charges,90% of total billed charges,134.32,93,,,percent of total billed charges,93% of total billed charges,54.88,38,,,percent of total billed charges,38% of total billed charges,54.88,38,,,percent of total billed charges,38% of total billed charges,122.77,85,,,percent of total billed charges,85% of total billed charges,54.88,38,,,percent of total billed charges,38% of total billed charges,117.57,81.4,,,percent of total billed charges,81.4% of total billed charges,129.99,90,,,percent of total billed charges,90% of total billed charges,129.99,90,,,percent of total billed charges,90% of total billed charges,54.88,38,,,percent of total billed charges,38% of total billed charges,54.88,38,,,percent of total billed charges,38% of total billed charges,54.88,38,,,percent of total billed charges,38% of total billed charges,108.32,75,,,percent of total billed charges,75% of total billed charges,122.77,85,,,percent of total billed charges,85% of total billed charges,54.88,134.32,
(RES) MYELOPEROXIDASE AB,1967,CDM,300,RC,86021,HCPCS,outpatient,,,194.86,146.15,,175.37,90,,,percent of total billed charges,90% of total billed charges,181.22,93,,,percent of total billed charges,93% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,165.63,85,,,percent of total billed charges,85% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,158.62,81.4,,,percent of total billed charges,81.4% of total billed charges,175.37,90,,,percent of total billed charges,90% of total billed charges,175.37,90,,,percent of total billed charges,90% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,146.15,75,,,percent of total billed charges,75% of total billed charges,165.63,85,,,percent of total billed charges,85% of total billed charges,74.05,181.22,
(RES) PROTEINASE-3 AB,1968,CDM,300,RC,86021,HCPCS,outpatient,,,194.86,146.15,,175.37,90,,,percent of total billed charges,90% of total billed charges,181.22,93,,,percent of total billed charges,93% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,165.63,85,,,percent of total billed charges,85% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,158.62,81.4,,,percent of total billed charges,81.4% of total billed charges,175.37,90,,,percent of total billed charges,90% of total billed charges,175.37,90,,,percent of total billed charges,90% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,74.05,38,,,percent of total billed charges,38% of total billed charges,146.15,75,,,percent of total billed charges,75% of total billed charges,165.63,85,,,percent of total billed charges,85% of total billed charges,74.05,181.22,
ANCA ATYPICAL P-ANCA,1969,CDM,300,RC,86021,HCPCS,outpatient,,,157.66,118.25,,141.89,90,,,percent of total billed charges,90% of total billed charges,146.62,93,,,percent of total billed charges,93% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,128.34,81.4,,,percent of total billed charges,81.4% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,118.25,75,,,percent of total billed charges,75% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,146.62,
"Neutrophil AB, Flow Cytometry",1970,CDM,300,RC,86021,HCPCS,outpatient,,,254.37,190.78,,228.93,90,,,percent of total billed charges,90% of total billed charges,236.56,93,,,percent of total billed charges,93% of total billed charges,96.66,38,,,percent of total billed charges,38% of total billed charges,96.66,38,,,percent of total billed charges,38% of total billed charges,216.21,85,,,percent of total billed charges,85% of total billed charges,96.66,38,,,percent of total billed charges,38% of total billed charges,207.06,81.4,,,percent of total billed charges,81.4% of total billed charges,228.93,90,,,percent of total billed charges,90% of total billed charges,228.93,90,,,percent of total billed charges,90% of total billed charges,96.66,38,,,percent of total billed charges,38% of total billed charges,96.66,38,,,percent of total billed charges,38% of total billed charges,96.66,38,,,percent of total billed charges,38% of total billed charges,190.78,75,,,percent of total billed charges,75% of total billed charges,216.21,85,,,percent of total billed charges,85% of total billed charges,96.66,236.56,
IBD Panel,1971,CDM,300,RC,86021,HCPCS,outpatient,,,1295.98,971.99,,1166.38,90,,,percent of total billed charges,90% of total billed charges,1205.26,93,,,percent of total billed charges,93% of total billed charges,492.47,38,,,percent of total billed charges,38% of total billed charges,492.47,38,,,percent of total billed charges,38% of total billed charges,1101.58,85,,,percent of total billed charges,85% of total billed charges,492.47,38,,,percent of total billed charges,38% of total billed charges,1054.93,81.4,,,percent of total billed charges,81.4% of total billed charges,1166.38,90,,,percent of total billed charges,90% of total billed charges,1166.38,90,,,percent of total billed charges,90% of total billed charges,492.47,38,,,percent of total billed charges,38% of total billed charges,492.47,38,,,percent of total billed charges,38% of total billed charges,492.47,38,,,percent of total billed charges,38% of total billed charges,971.99,75,,,percent of total billed charges,75% of total billed charges,1101.58,85,,,percent of total billed charges,85% of total billed charges,492.47,1205.26,
Myelopreoxidase AB,1972,CDM,300,RC,86021,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,150.39,
Proteinase-3AB,1973,CDM,300,RC,86021,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,150.39,
(Result) PLATELET AB (IGG),1974,CDM,300,RC,86022,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Platelet AB Direct flow cytom,1975,CDM,300,RC,86023,HCPCS,outpatient,,,286.05,214.54,,257.45,90,,,percent of total billed charges,90% of total billed charges,266.03,93,,,percent of total billed charges,93% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,243.14,85,,,percent of total billed charges,85% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,232.84,81.4,,,percent of total billed charges,81.4% of total billed charges,257.45,90,,,percent of total billed charges,90% of total billed charges,257.45,90,,,percent of total billed charges,90% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,108.7,38,,,percent of total billed charges,38% of total billed charges,214.54,75,,,percent of total billed charges,75% of total billed charges,243.14,85,,,percent of total billed charges,85% of total billed charges,108.7,266.03,
Beef IgE,1976,CDM,300,RC,86033,HCPCS,outpatient,,,60.81,45.61,,54.73,90,,,percent of total billed charges,90% of total billed charges,56.55,93,,,percent of total billed charges,93% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,51.69,85,,,percent of total billed charges,85% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,49.5,81.4,,,percent of total billed charges,81.4% of total billed charges,54.73,90,,,percent of total billed charges,90% of total billed charges,54.73,90,,,percent of total billed charges,90% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,23.11,38,,,percent of total billed charges,38% of total billed charges,45.61,75,,,percent of total billed charges,75% of total billed charges,51.69,85,,,percent of total billed charges,85% of total billed charges,23.11,56.55,
ANCA Screen,1977,CDM,300,RC,86036,HCPCS,outpatient,,,161.2,120.9,,145.08,90,,,percent of total billed charges,90% of total billed charges,149.92,93,,,percent of total billed charges,93% of total billed charges,61.26,38,,,percent of total billed charges,38% of total billed charges,61.26,38,,,percent of total billed charges,38% of total billed charges,137.02,85,,,percent of total billed charges,85% of total billed charges,61.26,38,,,percent of total billed charges,38% of total billed charges,131.22,81.4,,,percent of total billed charges,81.4% of total billed charges,145.08,90,,,percent of total billed charges,90% of total billed charges,145.08,90,,,percent of total billed charges,90% of total billed charges,61.26,38,,,percent of total billed charges,38% of total billed charges,61.26,38,,,percent of total billed charges,38% of total billed charges,61.26,38,,,percent of total billed charges,38% of total billed charges,120.9,75,,,percent of total billed charges,75% of total billed charges,137.02,85,,,percent of total billed charges,85% of total billed charges,61.26,149.92,
(RES) C-ANCA Titer,1978,CDM,300,RC,86037,HCPCS,outpatient,,,147.9,110.93,,133.11,90,,,percent of total billed charges,90% of total billed charges,137.55,93,,,percent of total billed charges,93% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,125.72,85,,,percent of total billed charges,85% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,120.39,81.4,,,percent of total billed charges,81.4% of total billed charges,133.11,90,,,percent of total billed charges,90% of total billed charges,133.11,90,,,percent of total billed charges,90% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,110.93,75,,,percent of total billed charges,75% of total billed charges,125.72,85,,,percent of total billed charges,85% of total billed charges,56.2,137.55,
ANCA Screen  P ANCA,1979,CDM,300,RC,86037,HCPCS,outpatient,,,157.66,118.25,,141.89,90,,,percent of total billed charges,90% of total billed charges,146.62,93,,,percent of total billed charges,93% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,128.34,81.4,,,percent of total billed charges,81.4% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,118.25,75,,,percent of total billed charges,75% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,146.62,
ANCA SCREEN C-ANCA,1980,CDM,300,RC,86037,HCPCS,outpatient,,,157.66,118.25,,141.89,90,,,percent of total billed charges,90% of total billed charges,146.62,93,,,percent of total billed charges,93% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,128.34,81.4,,,percent of total billed charges,81.4% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,118.25,75,,,percent of total billed charges,75% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,146.62,
(RES) Atypical P ANCA Titer,1981,CDM,300,RC,86037,HCPCS,outpatient,,,147.9,110.93,,133.11,90,,,percent of total billed charges,90% of total billed charges,137.55,93,,,percent of total billed charges,93% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,125.72,85,,,percent of total billed charges,85% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,120.39,81.4,,,percent of total billed charges,81.4% of total billed charges,133.11,90,,,percent of total billed charges,90% of total billed charges,133.11,90,,,percent of total billed charges,90% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,110.93,75,,,percent of total billed charges,75% of total billed charges,125.72,85,,,percent of total billed charges,85% of total billed charges,56.2,137.55,
Centromere B Antibody,1982,CDM,300,RC,86038,HCPCS,outpatient,,,95.14,71.36,,85.63,90,,,percent of total billed charges,90% of total billed charges,88.48,93,,,percent of total billed charges,93% of total billed charges,36.15,38,,,percent of total billed charges,38% of total billed charges,36.15,38,,,percent of total billed charges,38% of total billed charges,80.87,85,,,percent of total billed charges,85% of total billed charges,36.15,38,,,percent of total billed charges,38% of total billed charges,77.44,81.4,,,percent of total billed charges,81.4% of total billed charges,85.63,90,,,percent of total billed charges,90% of total billed charges,85.63,90,,,percent of total billed charges,90% of total billed charges,36.15,38,,,percent of total billed charges,38% of total billed charges,36.15,38,,,percent of total billed charges,38% of total billed charges,36.15,38,,,percent of total billed charges,38% of total billed charges,71.36,75,,,percent of total billed charges,75% of total billed charges,80.87,85,,,percent of total billed charges,85% of total billed charges,36.15,88.48,
(Result) ANA Choice (TM),1983,CDM,300,RC,86038,HCPCS,outpatient,,,239.06,179.3,,215.15,90,,,percent of total billed charges,90% of total billed charges,222.33,93,,,percent of total billed charges,93% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,203.2,85,,,percent of total billed charges,85% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,194.59,81.4,,,percent of total billed charges,81.4% of total billed charges,215.15,90,,,percent of total billed charges,90% of total billed charges,215.15,90,,,percent of total billed charges,90% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,90.84,38,,,percent of total billed charges,38% of total billed charges,179.3,75,,,percent of total billed charges,75% of total billed charges,203.2,85,,,percent of total billed charges,85% of total billed charges,90.84,222.33,
ANA Screen w Rflx to Titer/Pattern/Lupus 1,1984,CDM,300,RC,86038,HCPCS,outpatient,,,98.43,73.82,,88.59,90,,,percent of total billed charges,90% of total billed charges,91.54,93,,,percent of total billed charges,93% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,83.67,85,,,percent of total billed charges,85% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,80.12,81.4,,,percent of total billed charges,81.4% of total billed charges,88.59,90,,,percent of total billed charges,90% of total billed charges,88.59,90,,,percent of total billed charges,90% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,73.82,75,,,percent of total billed charges,75% of total billed charges,83.67,85,,,percent of total billed charges,85% of total billed charges,37.4,91.54,
"(RES) ANA SCREEN, IFA w/RFLX",1985,CDM,300,RC,86038,HCPCS,outpatient,,,98.43,73.82,,88.59,90,,,percent of total billed charges,90% of total billed charges,91.54,93,,,percent of total billed charges,93% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,83.67,85,,,percent of total billed charges,85% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,80.12,81.4,,,percent of total billed charges,81.4% of total billed charges,88.59,90,,,percent of total billed charges,90% of total billed charges,88.59,90,,,percent of total billed charges,90% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,73.82,75,,,percent of total billed charges,75% of total billed charges,83.67,85,,,percent of total billed charges,85% of total billed charges,37.4,91.54,
ANA screen IFA w reflex titer/pattern,1986,CDM,300,RC,86038,HCPCS,outpatient,,,98.43,73.82,,88.59,90,,,percent of total billed charges,90% of total billed charges,91.54,93,,,percent of total billed charges,93% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,83.67,85,,,percent of total billed charges,85% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,80.12,81.4,,,percent of total billed charges,81.4% of total billed charges,88.59,90,,,percent of total billed charges,90% of total billed charges,88.59,90,,,percent of total billed charges,90% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,73.82,75,,,percent of total billed charges,75% of total billed charges,83.67,85,,,percent of total billed charges,85% of total billed charges,37.4,91.54,
Profile - ANA screen IFA w reflex titer/pattern,1987,CDM,300,RC,86038,HCPCS,outpatient,,,98.43,73.82,,88.59,90,,,percent of total billed charges,90% of total billed charges,91.54,93,,,percent of total billed charges,93% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,83.67,85,,,percent of total billed charges,85% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,80.12,81.4,,,percent of total billed charges,81.4% of total billed charges,88.59,90,,,percent of total billed charges,90% of total billed charges,88.59,90,,,percent of total billed charges,90% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,37.4,38,,,percent of total billed charges,38% of total billed charges,73.82,75,,,percent of total billed charges,75% of total billed charges,83.67,85,,,percent of total billed charges,85% of total billed charges,37.4,91.54,
(RES) ANA TITER 2,1988,CDM,300,RC,86038,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
(RES) ANA TITER 1,1989,CDM,300,RC,86038,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
ANA centromere,1990,CDM,300,RC,86038,HCPCS,outpatient,,,142.95,107.21,,128.66,90,,,percent of total billed charges,90% of total billed charges,132.94,93,,,percent of total billed charges,93% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,116.36,81.4,,,percent of total billed charges,81.4% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,107.21,75,,,percent of total billed charges,75% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,132.94,
(RES) ANA PATTERN 2,1991,CDM,300,RC,86039,HCPCS,outpatient,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
(RES) ANA PATTERN 1,1992,CDM,300,RC,86039,HCPCS,outpatient,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
Aquaporin-4 (AQP4) AB (NMO-IgG),1993,CDM,300,RC,86051,HCPCS,outpatient,,,619.04,464.28,,557.14,90,,,percent of total billed charges,90% of total billed charges,575.71,93,,,percent of total billed charges,93% of total billed charges,235.24,38,,,percent of total billed charges,38% of total billed charges,235.24,38,,,percent of total billed charges,38% of total billed charges,526.18,85,,,percent of total billed charges,85% of total billed charges,235.24,38,,,percent of total billed charges,38% of total billed charges,503.9,81.4,,,percent of total billed charges,81.4% of total billed charges,557.14,90,,,percent of total billed charges,90% of total billed charges,557.14,90,,,percent of total billed charges,90% of total billed charges,235.24,38,,,percent of total billed charges,38% of total billed charges,235.24,38,,,percent of total billed charges,38% of total billed charges,235.24,38,,,percent of total billed charges,38% of total billed charges,464.28,75,,,percent of total billed charges,75% of total billed charges,526.18,85,,,percent of total billed charges,85% of total billed charges,235.24,575.71,
"(RES) AQUAPORIN 4 AB, CBA IFA",1994,CDM,300,RC,86052,HCPCS,outpatient,,,303.23,227.42,,272.91,90,,,percent of total billed charges,90% of total billed charges,282,93,,,percent of total billed charges,93% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,257.75,85,,,percent of total billed charges,85% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,246.83,81.4,,,percent of total billed charges,81.4% of total billed charges,272.91,90,,,percent of total billed charges,90% of total billed charges,272.91,90,,,percent of total billed charges,90% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,227.42,75,,,percent of total billed charges,75% of total billed charges,257.75,85,,,percent of total billed charges,85% of total billed charges,115.23,282,
Anti Streptolysin-O,1995,CDM,300,RC,86060,HCPCS,outpatient,,,83.21,62.41,,74.89,90,,,percent of total billed charges,90% of total billed charges,77.39,93,,,percent of total billed charges,93% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,70.73,85,,,percent of total billed charges,85% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,67.73,81.4,,,percent of total billed charges,81.4% of total billed charges,74.89,90,,,percent of total billed charges,90% of total billed charges,74.89,90,,,percent of total billed charges,90% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,62.41,75,,,percent of total billed charges,75% of total billed charges,70.73,85,,,percent of total billed charges,85% of total billed charges,31.62,77.39,
RCRP,1996,CDM,300,RC,86140,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
(Result) HSCRP,1997,CDM,300,RC,86141,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Cardio CRP(quest),1998,CDM,300,RC,86141,HCPCS,outpatient,,,104.42,78.32,,93.98,90,,,percent of total billed charges,90% of total billed charges,97.11,93,,,percent of total billed charges,93% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,85,81.4,,,percent of total billed charges,81.4% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,78.32,75,,,percent of total billed charges,75% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,97.11,
High Sensitivity - CRP,1999,CDM,300,RC,86141,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,71.94,
(RES) Cardio IQ hs-CRP,2000,CDM,300,RC,86141,HCPCS,outpatient,,,46.56,34.92,,41.9,90,,,percent of total billed charges,90% of total billed charges,43.3,93,,,percent of total billed charges,93% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,39.58,85,,,percent of total billed charges,85% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,37.9,81.4,,,percent of total billed charges,81.4% of total billed charges,41.9,90,,,percent of total billed charges,90% of total billed charges,41.9,90,,,percent of total billed charges,90% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,17.69,38,,,percent of total billed charges,38% of total billed charges,34.92,75,,,percent of total billed charges,75% of total billed charges,39.58,85,,,percent of total billed charges,85% of total billed charges,17.69,43.3,
Profile - Beta 2 IGA,2001,CDM,301,RC,86146,HCPCS,outpatient,,,84.46,63.35,,76.01,90,,,percent of total billed charges,90% of total billed charges,78.55,93,,,percent of total billed charges,93% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,68.75,81.4,,,percent of total billed charges,81.4% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,63.35,75,,,percent of total billed charges,75% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,78.55,
Beta 2 Glyco I AB IgA,2002,CDM,300,RC,86146,HCPCS,outpatient,,,166.67,125,,150,90,,,percent of total billed charges,90% of total billed charges,155,93,,,percent of total billed charges,93% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,135.67,81.4,,,percent of total billed charges,81.4% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,125,75,,,percent of total billed charges,75% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,155,
Profile - Beta 2 IGG,2003,CDM,301,RC,86146,HCPCS,outpatient,,,75.45,56.59,,67.91,90,,,percent of total billed charges,90% of total billed charges,70.17,93,,,percent of total billed charges,93% of total billed charges,28.67,38,,,percent of total billed charges,38% of total billed charges,28.67,38,,,percent of total billed charges,38% of total billed charges,64.13,85,,,percent of total billed charges,85% of total billed charges,28.67,38,,,percent of total billed charges,38% of total billed charges,61.42,81.4,,,percent of total billed charges,81.4% of total billed charges,67.91,90,,,percent of total billed charges,90% of total billed charges,67.91,90,,,percent of total billed charges,90% of total billed charges,28.67,38,,,percent of total billed charges,38% of total billed charges,28.67,38,,,percent of total billed charges,38% of total billed charges,28.67,38,,,percent of total billed charges,38% of total billed charges,56.59,75,,,percent of total billed charges,75% of total billed charges,64.13,85,,,percent of total billed charges,85% of total billed charges,28.67,70.17,
Profile - Beta 2 IGM,2004,CDM,301,RC,86146,HCPCS,outpatient,,,78.85,59.14,,70.97,90,,,percent of total billed charges,90% of total billed charges,73.33,93,,,percent of total billed charges,93% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,67.02,85,,,percent of total billed charges,85% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,64.18,81.4,,,percent of total billed charges,81.4% of total billed charges,70.97,90,,,percent of total billed charges,90% of total billed charges,70.97,90,,,percent of total billed charges,90% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,59.14,75,,,percent of total billed charges,75% of total billed charges,67.02,85,,,percent of total billed charges,85% of total billed charges,29.96,73.33,
(RES) B2 GLYCOPROTEIN I (IGG)AB,2005,CDM,300,RC,86146,HCPCS,outpatient,,,149.38,112.04,,134.44,90,,,percent of total billed charges,90% of total billed charges,138.92,93,,,percent of total billed charges,93% of total billed charges,56.76,38,,,percent of total billed charges,38% of total billed charges,56.76,38,,,percent of total billed charges,38% of total billed charges,126.97,85,,,percent of total billed charges,85% of total billed charges,56.76,38,,,percent of total billed charges,38% of total billed charges,121.6,81.4,,,percent of total billed charges,81.4% of total billed charges,134.44,90,,,percent of total billed charges,90% of total billed charges,134.44,90,,,percent of total billed charges,90% of total billed charges,56.76,38,,,percent of total billed charges,38% of total billed charges,56.76,38,,,percent of total billed charges,38% of total billed charges,56.76,38,,,percent of total billed charges,38% of total billed charges,112.04,75,,,percent of total billed charges,75% of total billed charges,126.97,85,,,percent of total billed charges,85% of total billed charges,56.76,138.92,
(RES) B2 GLYCOPROTEIN I (IGA)AB,2006,CDM,300,RC,86146,HCPCS,outpatient,,,167.78,125.84,,151,90,,,percent of total billed charges,90% of total billed charges,156.04,93,,,percent of total billed charges,93% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,136.57,81.4,,,percent of total billed charges,81.4% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,151,90,,,percent of total billed charges,90% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,63.76,38,,,percent of total billed charges,38% of total billed charges,125.84,75,,,percent of total billed charges,75% of total billed charges,142.61,85,,,percent of total billed charges,85% of total billed charges,63.76,156.04,
(RES) B2 GLYCOPROTEIN I (IGM)AB,2007,CDM,300,RC,86146,HCPCS,outpatient,,,156.96,117.72,,141.26,90,,,percent of total billed charges,90% of total billed charges,145.97,93,,,percent of total billed charges,93% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,127.77,81.4,,,percent of total billed charges,81.4% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,117.72,75,,,percent of total billed charges,75% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,145.97,
Beta-2-Glycoprotein I AB (IgM),2008,CDM,300,RC,86146,HCPCS,outpatient,,,130.78,98.09,,117.7,90,,,percent of total billed charges,90% of total billed charges,121.63,93,,,percent of total billed charges,93% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,106.45,81.4,,,percent of total billed charges,81.4% of total billed charges,117.7,90,,,percent of total billed charges,90% of total billed charges,117.7,90,,,percent of total billed charges,90% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,98.09,75,,,percent of total billed charges,75% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,49.7,121.63,
Beta-2-Glycoprotein I AB (IgG),2009,CDM,300,RC,86146,HCPCS,outpatient,,,130.78,98.09,,117.7,90,,,percent of total billed charges,90% of total billed charges,121.63,93,,,percent of total billed charges,93% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,106.45,81.4,,,percent of total billed charges,81.4% of total billed charges,117.7,90,,,percent of total billed charges,90% of total billed charges,117.7,90,,,percent of total billed charges,90% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,49.7,38,,,percent of total billed charges,38% of total billed charges,98.09,75,,,percent of total billed charges,75% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,49.7,121.63,
(RES) CARDIOLIPIN AB (IGA),2010,CDM,300,RC,86147,HCPCS,outpatient,,,121.23,90.92,,109.11,90,,,percent of total billed charges,90% of total billed charges,112.74,93,,,percent of total billed charges,93% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,103.05,85,,,percent of total billed charges,85% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,98.68,81.4,,,percent of total billed charges,81.4% of total billed charges,109.11,90,,,percent of total billed charges,90% of total billed charges,109.11,90,,,percent of total billed charges,90% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,46.07,38,,,percent of total billed charges,38% of total billed charges,90.92,75,,,percent of total billed charges,75% of total billed charges,103.05,85,,,percent of total billed charges,85% of total billed charges,46.07,112.74,
(RES) CARDIOLIPIN AB (IGG),2011,CDM,300,RC,86147,HCPCS,outpatient,,,152.62,114.47,,137.36,90,,,percent of total billed charges,90% of total billed charges,141.94,93,,,percent of total billed charges,93% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,129.73,85,,,percent of total billed charges,85% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,124.23,81.4,,,percent of total billed charges,81.4% of total billed charges,137.36,90,,,percent of total billed charges,90% of total billed charges,137.36,90,,,percent of total billed charges,90% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,114.47,75,,,percent of total billed charges,75% of total billed charges,129.73,85,,,percent of total billed charges,85% of total billed charges,58,141.94,
(RES) CARDIOLIPIN AB (IGM),2012,CDM,300,RC,86147,HCPCS,outpatient,,,152.62,114.47,,137.36,90,,,percent of total billed charges,90% of total billed charges,141.94,93,,,percent of total billed charges,93% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,129.73,85,,,percent of total billed charges,85% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,124.23,81.4,,,percent of total billed charges,81.4% of total billed charges,137.36,90,,,percent of total billed charges,90% of total billed charges,137.36,90,,,percent of total billed charges,90% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,58,38,,,percent of total billed charges,38% of total billed charges,114.47,75,,,percent of total billed charges,75% of total billed charges,129.73,85,,,percent of total billed charges,85% of total billed charges,58,141.94,
(RES) PHOSPHATIDYLETHANOLAMINE AB (IGG),2013,CDM,300,RC,86148,HCPCS,outpatient,,,111.49,83.62,,100.34,90,,,percent of total billed charges,90% of total billed charges,103.69,93,,,percent of total billed charges,93% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,90.75,81.4,,,percent of total billed charges,81.4% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,83.62,75,,,percent of total billed charges,75% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,103.69,
(RES) PHOSPHATIDYLETHANOLAMINE AB (IGM),2014,CDM,300,RC,86148,HCPCS,outpatient,,,111.49,83.62,,100.34,90,,,percent of total billed charges,90% of total billed charges,103.69,93,,,percent of total billed charges,93% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,90.75,81.4,,,percent of total billed charges,81.4% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,83.62,75,,,percent of total billed charges,75% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,103.69,
(RES) PHOSPHATIDYLETHANOLAMINE AB (IGA),2015,CDM,300,RC,86148,HCPCS,outpatient,,,111.49,83.62,,100.34,90,,,percent of total billed charges,90% of total billed charges,103.69,93,,,percent of total billed charges,93% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,90.75,81.4,,,percent of total billed charges,81.4% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,83.62,75,,,percent of total billed charges,75% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,103.69,
Hemagglutinins,2016,CDM,300,RC,86157,HCPCS,outpatient,,,59.68,44.76,,53.71,90,,,percent of total billed charges,90% of total billed charges,55.5,93,,,percent of total billed charges,93% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,50.73,85,,,percent of total billed charges,85% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,48.58,81.4,,,percent of total billed charges,81.4% of total billed charges,53.71,90,,,percent of total billed charges,90% of total billed charges,53.71,90,,,percent of total billed charges,90% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,44.76,75,,,percent of total billed charges,75% of total billed charges,50.73,85,,,percent of total billed charges,85% of total billed charges,22.68,55.5,
Complement C4,2017,CDM,300,RC,86160,HCPCS,outpatient,,,145.37,109.03,,130.83,90,,,percent of total billed charges,90% of total billed charges,135.19,93,,,percent of total billed charges,93% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,123.56,85,,,percent of total billed charges,85% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,118.33,81.4,,,percent of total billed charges,81.4% of total billed charges,130.83,90,,,percent of total billed charges,90% of total billed charges,130.83,90,,,percent of total billed charges,90% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,109.03,75,,,percent of total billed charges,75% of total billed charges,123.56,85,,,percent of total billed charges,85% of total billed charges,55.24,135.19,
Complement C3,2018,CDM,300,RC,86160,HCPCS,outpatient,,,145.37,109.03,,130.83,90,,,percent of total billed charges,90% of total billed charges,135.19,93,,,percent of total billed charges,93% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,123.56,85,,,percent of total billed charges,85% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,118.33,81.4,,,percent of total billed charges,81.4% of total billed charges,130.83,90,,,percent of total billed charges,90% of total billed charges,130.83,90,,,percent of total billed charges,90% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,109.03,75,,,percent of total billed charges,75% of total billed charges,123.56,85,,,percent of total billed charges,85% of total billed charges,55.24,135.19,
C3C4CH50,2019,CDM,300,RC,86160,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Complement Component C1q,2020,CDM,300,RC,86160,HCPCS,outpatient,,,138.55,103.91,,124.7,90,,,percent of total billed charges,90% of total billed charges,128.85,93,,,percent of total billed charges,93% of total billed charges,52.65,38,,,percent of total billed charges,38% of total billed charges,52.65,38,,,percent of total billed charges,38% of total billed charges,117.77,85,,,percent of total billed charges,85% of total billed charges,52.65,38,,,percent of total billed charges,38% of total billed charges,112.78,81.4,,,percent of total billed charges,81.4% of total billed charges,124.7,90,,,percent of total billed charges,90% of total billed charges,124.7,90,,,percent of total billed charges,90% of total billed charges,52.65,38,,,percent of total billed charges,38% of total billed charges,52.65,38,,,percent of total billed charges,38% of total billed charges,52.65,38,,,percent of total billed charges,38% of total billed charges,103.91,75,,,percent of total billed charges,75% of total billed charges,117.77,85,,,percent of total billed charges,85% of total billed charges,52.65,128.85,
"C1 ESTERASE INHIBITOR, PROTEIN",2021,CDM,300,RC,86160,HCPCS,outpatient,,,145.53,109.15,,130.98,90,,,percent of total billed charges,90% of total billed charges,135.34,93,,,percent of total billed charges,93% of total billed charges,55.3,38,,,percent of total billed charges,38% of total billed charges,55.3,38,,,percent of total billed charges,38% of total billed charges,123.7,85,,,percent of total billed charges,85% of total billed charges,55.3,38,,,percent of total billed charges,38% of total billed charges,118.46,81.4,,,percent of total billed charges,81.4% of total billed charges,130.98,90,,,percent of total billed charges,90% of total billed charges,130.98,90,,,percent of total billed charges,90% of total billed charges,55.3,38,,,percent of total billed charges,38% of total billed charges,55.3,38,,,percent of total billed charges,38% of total billed charges,55.3,38,,,percent of total billed charges,38% of total billed charges,109.15,75,,,percent of total billed charges,75% of total billed charges,123.7,85,,,percent of total billed charges,85% of total billed charges,55.3,135.34,
"C1 ESTERASE INHIBITOR, FUNCTIONAL",2022,CDM,300,RC,86161,HCPCS,outpatient,,,116.01,87.01,,104.41,90,,,percent of total billed charges,90% of total billed charges,107.89,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.43,81.4,,,percent of total billed charges,81.4% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87.01,75,,,percent of total billed charges,75% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,107.89,
Complement CH50,2023,CDM,300,RC,86162,HCPCS,outpatient,,,145.37,109.03,,130.83,90,,,percent of total billed charges,90% of total billed charges,135.19,93,,,percent of total billed charges,93% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,123.56,85,,,percent of total billed charges,85% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,118.33,81.4,,,percent of total billed charges,81.4% of total billed charges,130.83,90,,,percent of total billed charges,90% of total billed charges,130.83,90,,,percent of total billed charges,90% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,55.24,38,,,percent of total billed charges,38% of total billed charges,109.03,75,,,percent of total billed charges,75% of total billed charges,123.56,85,,,percent of total billed charges,85% of total billed charges,55.24,135.19,
CYCLIC CITRULLINE PEP IGG,2024,CDM,300,RC,86200,HCPCS,outpatient,,,155.85,116.89,,140.27,90,,,percent of total billed charges,90% of total billed charges,144.94,93,,,percent of total billed charges,93% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,126.86,81.4,,,percent of total billed charges,81.4% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,116.89,75,,,percent of total billed charges,75% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,144.94,
DNA (ds) Antibody,2025,CDM,300,RC,86225,HCPCS,outpatient,,,124.48,93.36,,112.03,90,,,percent of total billed charges,90% of total billed charges,115.77,93,,,percent of total billed charges,93% of total billed charges,47.3,38,,,percent of total billed charges,38% of total billed charges,47.3,38,,,percent of total billed charges,38% of total billed charges,105.81,85,,,percent of total billed charges,85% of total billed charges,47.3,38,,,percent of total billed charges,38% of total billed charges,101.33,81.4,,,percent of total billed charges,81.4% of total billed charges,112.03,90,,,percent of total billed charges,90% of total billed charges,112.03,90,,,percent of total billed charges,90% of total billed charges,47.3,38,,,percent of total billed charges,38% of total billed charges,47.3,38,,,percent of total billed charges,38% of total billed charges,47.3,38,,,percent of total billed charges,38% of total billed charges,93.36,75,,,percent of total billed charges,75% of total billed charges,105.81,85,,,percent of total billed charges,85% of total billed charges,47.3,115.77,
Endomysial (IgG) AB Screen w rflx Titer,2026,CDM,300,RC,86231,HCPCS,outpatient,,,129.9,97.43,,116.91,90,,,percent of total billed charges,90% of total billed charges,120.81,93,,,percent of total billed charges,93% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,110.42,85,,,percent of total billed charges,85% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,105.74,81.4,,,percent of total billed charges,81.4% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,97.43,75,,,percent of total billed charges,75% of total billed charges,110.42,85,,,percent of total billed charges,85% of total billed charges,49.36,120.81,
Endomysial AB Titer,2027,CDM,300,RC,86231,HCPCS,outpatient,,,241.13,180.85,,217.02,90,,,percent of total billed charges,90% of total billed charges,224.25,93,,,percent of total billed charges,93% of total billed charges,91.63,38,,,percent of total billed charges,38% of total billed charges,91.63,38,,,percent of total billed charges,38% of total billed charges,204.96,85,,,percent of total billed charges,85% of total billed charges,91.63,38,,,percent of total billed charges,38% of total billed charges,196.28,81.4,,,percent of total billed charges,81.4% of total billed charges,217.02,90,,,percent of total billed charges,90% of total billed charges,217.02,90,,,percent of total billed charges,90% of total billed charges,91.63,38,,,percent of total billed charges,38% of total billed charges,91.63,38,,,percent of total billed charges,38% of total billed charges,91.63,38,,,percent of total billed charges,38% of total billed charges,180.85,75,,,percent of total billed charges,75% of total billed charges,204.96,85,,,percent of total billed charges,85% of total billed charges,91.63,224.25,
Endomysial AB Screen (IGA) w rflx,2028,CDM,300,RC,86231,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
(RES) ENDOMYSIAL TITER,2029,CDM,300,RC,86231,HCPCS,outpatient,,,236.4,177.3,,212.76,90,,,percent of total billed charges,90% of total billed charges,219.85,93,,,percent of total billed charges,93% of total billed charges,89.83,38,,,percent of total billed charges,38% of total billed charges,89.83,38,,,percent of total billed charges,38% of total billed charges,200.94,85,,,percent of total billed charges,85% of total billed charges,89.83,38,,,percent of total billed charges,38% of total billed charges,192.43,81.4,,,percent of total billed charges,81.4% of total billed charges,212.76,90,,,percent of total billed charges,90% of total billed charges,212.76,90,,,percent of total billed charges,90% of total billed charges,89.83,38,,,percent of total billed charges,38% of total billed charges,89.83,38,,,percent of total billed charges,38% of total billed charges,89.83,38,,,percent of total billed charges,38% of total billed charges,177.3,75,,,percent of total billed charges,75% of total billed charges,200.94,85,,,percent of total billed charges,85% of total billed charges,89.83,219.85,
SM Antibody,2030,CDM,300,RC,86235,HCPCS,outpatient,,,104.42,78.32,,93.98,90,,,percent of total billed charges,90% of total billed charges,97.11,93,,,percent of total billed charges,93% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,85,81.4,,,percent of total billed charges,81.4% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,78.32,75,,,percent of total billed charges,75% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,97.11,
SM/RNP AB,2031,CDM,300,RC,86235,HCPCS,outpatient,,,121.44,91.08,,109.3,90,,,percent of total billed charges,90% of total billed charges,112.94,93,,,percent of total billed charges,93% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,103.22,85,,,percent of total billed charges,85% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,98.85,81.4,,,percent of total billed charges,81.4% of total billed charges,109.3,90,,,percent of total billed charges,90% of total billed charges,109.3,90,,,percent of total billed charges,90% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,91.08,75,,,percent of total billed charges,75% of total billed charges,103.22,85,,,percent of total billed charges,85% of total billed charges,46.15,112.94,
Anti-PM/Scl-100 AB,2032,CDM,300,RC,86235,HCPCS,outpatient,,,156.77,117.58,,141.09,90,,,percent of total billed charges,90% of total billed charges,145.8,93,,,percent of total billed charges,93% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,127.61,81.4,,,percent of total billed charges,81.4% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,117.58,75,,,percent of total billed charges,75% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,145.8,
(RES) SJOGREN'S ANTIBODY (SS-B),2033,CDM,300,RC,86235,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
(RES) SJOGREN'S ANTIBODY (SS-A),2034,CDM,300,RC,86235,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
(RES) SJOGREN'S ANTIBODY (SS-A),2035,CDM,300,RC,86235,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
(RES) SM/RNP ANTIBODY,2036,CDM,300,RC,86235,HCPCS,outpatient,,,116.01,87.01,,104.41,90,,,percent of total billed charges,90% of total billed charges,107.89,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.43,81.4,,,percent of total billed charges,81.4% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87.01,75,,,percent of total billed charges,75% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,107.89,
(RES) SM/RNP ANTIBODY,2037,CDM,300,RC,86235,HCPCS,outpatient,,,116.01,87.01,,104.41,90,,,percent of total billed charges,90% of total billed charges,107.89,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.43,81.4,,,percent of total billed charges,81.4% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87.01,75,,,percent of total billed charges,75% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,107.89,
(RES) SM ANTIBODY,2038,CDM,300,RC,86235,HCPCS,outpatient,,,104.42,78.32,,93.98,90,,,percent of total billed charges,90% of total billed charges,97.11,93,,,percent of total billed charges,93% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,85,81.4,,,percent of total billed charges,81.4% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,78.32,75,,,percent of total billed charges,75% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,97.11,
(RES) SM ANTIBODY,2039,CDM,300,RC,86235,HCPCS,outpatient,,,104.42,78.32,,93.98,90,,,percent of total billed charges,90% of total billed charges,97.11,93,,,percent of total billed charges,93% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,85,81.4,,,percent of total billed charges,81.4% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,78.32,75,,,percent of total billed charges,75% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,97.11,
(RES) SCL-70 ANTIBODY,2040,CDM,300,RC,86235,HCPCS,outpatient,,,125,93.75,,112.5,90,,,percent of total billed charges,90% of total billed charges,116.25,93,,,percent of total billed charges,93% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,101.75,81.4,,,percent of total billed charges,81.4% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,93.75,75,,,percent of total billed charges,75% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,116.25,
(RES) SCL-70 ANTIBODY,2041,CDM,300,RC,86235,HCPCS,outpatient,,,125,93.75,,112.5,90,,,percent of total billed charges,90% of total billed charges,116.25,93,,,percent of total billed charges,93% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,101.75,81.4,,,percent of total billed charges,81.4% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,93.75,75,,,percent of total billed charges,75% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,116.25,
(RES) DNA (DS) ANTIBODY,2042,CDM,300,RC,86235,HCPCS,outpatient,,,72.66,54.5,,65.39,90,,,percent of total billed charges,90% of total billed charges,67.57,93,,,percent of total billed charges,93% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,59.15,81.4,,,percent of total billed charges,81.4% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,54.5,75,,,percent of total billed charges,75% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,67.57,
Jo-1 Antibody,2043,CDM,300,RC,86235,HCPCS,outpatient,,,117.47,88.1,,105.72,90,,,percent of total billed charges,90% of total billed charges,109.25,93,,,percent of total billed charges,93% of total billed charges,44.64,38,,,percent of total billed charges,38% of total billed charges,44.64,38,,,percent of total billed charges,38% of total billed charges,99.85,85,,,percent of total billed charges,85% of total billed charges,44.64,38,,,percent of total billed charges,38% of total billed charges,95.62,81.4,,,percent of total billed charges,81.4% of total billed charges,105.72,90,,,percent of total billed charges,90% of total billed charges,105.72,90,,,percent of total billed charges,90% of total billed charges,44.64,38,,,percent of total billed charges,38% of total billed charges,44.64,38,,,percent of total billed charges,38% of total billed charges,44.64,38,,,percent of total billed charges,38% of total billed charges,88.1,75,,,percent of total billed charges,75% of total billed charges,99.85,85,,,percent of total billed charges,85% of total billed charges,44.64,109.25,
RNP Antibody,2044,CDM,300,RC,86235,HCPCS,outpatient,,,118.12,88.59,,106.31,90,,,percent of total billed charges,90% of total billed charges,109.85,93,,,percent of total billed charges,93% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,100.4,85,,,percent of total billed charges,85% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,96.15,81.4,,,percent of total billed charges,81.4% of total billed charges,106.31,90,,,percent of total billed charges,90% of total billed charges,106.31,90,,,percent of total billed charges,90% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,88.59,75,,,percent of total billed charges,75% of total billed charges,100.4,85,,,percent of total billed charges,85% of total billed charges,44.89,109.85,
ANA  RNP,2045,CDM,300,RC,86235,HCPCS,outpatient,,,123.87,92.9,,111.48,90,,,percent of total billed charges,90% of total billed charges,115.2,93,,,percent of total billed charges,93% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,105.29,85,,,percent of total billed charges,85% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,100.83,81.4,,,percent of total billed charges,81.4% of total billed charges,111.48,90,,,percent of total billed charges,90% of total billed charges,111.48,90,,,percent of total billed charges,90% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,92.9,75,,,percent of total billed charges,75% of total billed charges,105.29,85,,,percent of total billed charges,85% of total billed charges,47.07,115.2,
Myositis profile SRP Autoab,2046,CDM,300,RC,86235,HCPCS,outpatient,,,128.28,96.21,,115.45,90,,,percent of total billed charges,90% of total billed charges,119.3,93,,,percent of total billed charges,93% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,104.42,81.4,,,percent of total billed charges,81.4% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,96.21,75,,,percent of total billed charges,75% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,119.3,
Myositis profile Jo-1 ab,2047,CDM,300,RC,86235,HCPCS,outpatient,,,128.28,96.21,,115.45,90,,,percent of total billed charges,90% of total billed charges,119.3,93,,,percent of total billed charges,93% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,104.42,81.4,,,percent of total billed charges,81.4% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,96.21,75,,,percent of total billed charges,75% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,119.3,
Myositis profile OJ autoab,2048,CDM,300,RC,86235,HCPCS,outpatient,,,128.28,96.21,,115.45,90,,,percent of total billed charges,90% of total billed charges,119.3,93,,,percent of total billed charges,93% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,104.42,81.4,,,percent of total billed charges,81.4% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,96.21,75,,,percent of total billed charges,75% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,119.3,
(RES) CHROMATIN (NUCLEOSOMAL) AB,2049,CDM,300,RC,86235,HCPCS,outpatient,,,120.29,90.22,,108.26,90,,,percent of total billed charges,90% of total billed charges,111.87,93,,,percent of total billed charges,93% of total billed charges,45.71,38,,,percent of total billed charges,38% of total billed charges,45.71,38,,,percent of total billed charges,38% of total billed charges,102.25,85,,,percent of total billed charges,85% of total billed charges,45.71,38,,,percent of total billed charges,38% of total billed charges,97.92,81.4,,,percent of total billed charges,81.4% of total billed charges,108.26,90,,,percent of total billed charges,90% of total billed charges,108.26,90,,,percent of total billed charges,90% of total billed charges,45.71,38,,,percent of total billed charges,38% of total billed charges,45.71,38,,,percent of total billed charges,38% of total billed charges,45.71,38,,,percent of total billed charges,38% of total billed charges,90.22,75,,,percent of total billed charges,75% of total billed charges,102.25,85,,,percent of total billed charges,85% of total billed charges,45.71,111.87,
Sjogren's Antibody(SS-A),2050,CDM,300,RC,86235,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Sjogren's Antibody(SS-A),2051,CDM,300,RC,86235,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
(RES) MI-2 ALPHA AB,2052,CDM,300,RC,86235,HCPCS,outpatient,,,258.94,194.21,,233.05,90,,,percent of total billed charges,90% of total billed charges,240.81,93,,,percent of total billed charges,93% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,210.78,81.4,,,percent of total billed charges,81.4% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,194.21,75,,,percent of total billed charges,75% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,240.81,
(RES) MI-2 BETA AB,2053,CDM,300,RC,86235,HCPCS,outpatient,,,258.94,194.21,,233.05,90,,,percent of total billed charges,90% of total billed charges,240.81,93,,,percent of total billed charges,93% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,210.78,81.4,,,percent of total billed charges,81.4% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,194.21,75,,,percent of total billed charges,75% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,240.81,
(RES) MDA5 AB,2054,CDM,300,RC,86235,HCPCS,outpatient,,,258.94,194.21,,233.05,90,,,percent of total billed charges,90% of total billed charges,240.81,93,,,percent of total billed charges,93% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,210.78,81.4,,,percent of total billed charges,81.4% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,194.21,75,,,percent of total billed charges,75% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,240.81,
(RES) TIF1 GAMMA AB,2055,CDM,300,RC,86235,HCPCS,outpatient,,,258.94,194.21,,233.05,90,,,percent of total billed charges,90% of total billed charges,240.81,93,,,percent of total billed charges,93% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,210.78,81.4,,,percent of total billed charges,81.4% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,194.21,75,,,percent of total billed charges,75% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,240.81,
(RES) NXP-2 AB,2056,CDM,300,RC,86235,HCPCS,outpatient,,,258.94,194.21,,233.05,90,,,percent of total billed charges,90% of total billed charges,240.81,93,,,percent of total billed charges,93% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,210.78,81.4,,,percent of total billed charges,81.4% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,233.05,90,,,percent of total billed charges,90% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,194.21,75,,,percent of total billed charges,75% of total billed charges,220.1,85,,,percent of total billed charges,85% of total billed charges,98.4,240.81,
Sjogrens Antibody(SS-B),2057,CDM,300,RC,86235,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Chromatin (Nucleosomal) AB,2058,CDM,300,RC,86235,HCPCS,outpatient,,,117.25,87.94,,105.53,90,,,percent of total billed charges,90% of total billed charges,109.04,93,,,percent of total billed charges,93% of total billed charges,44.56,38,,,percent of total billed charges,38% of total billed charges,44.56,38,,,percent of total billed charges,38% of total billed charges,99.66,85,,,percent of total billed charges,85% of total billed charges,44.56,38,,,percent of total billed charges,38% of total billed charges,95.44,81.4,,,percent of total billed charges,81.4% of total billed charges,105.53,90,,,percent of total billed charges,90% of total billed charges,105.53,90,,,percent of total billed charges,90% of total billed charges,44.56,38,,,percent of total billed charges,38% of total billed charges,44.56,38,,,percent of total billed charges,38% of total billed charges,44.56,38,,,percent of total billed charges,38% of total billed charges,87.94,75,,,percent of total billed charges,75% of total billed charges,99.66,85,,,percent of total billed charges,85% of total billed charges,44.56,109.04,
ANA Pro SCL-70,2059,CDM,300,RC,86235,HCPCS,outpatient,,,125,93.75,,112.5,90,,,percent of total billed charges,90% of total billed charges,116.25,93,,,percent of total billed charges,93% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,101.75,81.4,,,percent of total billed charges,81.4% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,93.75,75,,,percent of total billed charges,75% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,116.25,
ANA Pro SCL-70,2060,CDM,300,RC,86235,HCPCS,outpatient,,,125,93.75,,112.5,90,,,percent of total billed charges,90% of total billed charges,116.25,93,,,percent of total billed charges,93% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,101.75,81.4,,,percent of total billed charges,81.4% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,93.75,75,,,percent of total billed charges,75% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,116.25,
ANA Pro JO-1 ab,2061,CDM,300,RC,86235,HCPCS,outpatient,,,106.63,79.97,,95.97,90,,,percent of total billed charges,90% of total billed charges,99.17,93,,,percent of total billed charges,93% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,90.64,85,,,percent of total billed charges,85% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,86.8,81.4,,,percent of total billed charges,81.4% of total billed charges,95.97,90,,,percent of total billed charges,90% of total billed charges,95.97,90,,,percent of total billed charges,90% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,79.97,75,,,percent of total billed charges,75% of total billed charges,90.64,85,,,percent of total billed charges,85% of total billed charges,40.52,99.17,
Smooth muscle AB iGG,2062,CDM,300,RC,86255,HCPCS,outpatient,,,104.31,78.23,,93.88,90,,,percent of total billed charges,90% of total billed charges,97.01,93,,,percent of total billed charges,93% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,88.66,85,,,percent of total billed charges,85% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,84.91,81.4,,,percent of total billed charges,81.4% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,78.23,75,,,percent of total billed charges,75% of total billed charges,88.66,85,,,percent of total billed charges,85% of total billed charges,39.64,97.01,
"(RES) ANNA1 (HU) AB, IFA",2063,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
(RES) NMDA Receptor (NR1 sub) AutoAB,2064,CDM,300,RC,86255,HCPCS,outpatient,,,662.44,496.83,,596.2,90,,,percent of total billed charges,90% of total billed charges,616.07,93,,,percent of total billed charges,93% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,563.07,85,,,percent of total billed charges,85% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,539.23,81.4,,,percent of total billed charges,81.4% of total billed charges,596.2,90,,,percent of total billed charges,90% of total billed charges,596.2,90,,,percent of total billed charges,90% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,496.83,75,,,percent of total billed charges,75% of total billed charges,563.07,85,,,percent of total billed charges,85% of total billed charges,251.73,616.07,
(RES) LGI1 AB,2065,CDM,300,RC,86255,HCPCS,outpatient,,,662.44,496.83,,596.2,90,,,percent of total billed charges,90% of total billed charges,616.07,93,,,percent of total billed charges,93% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,563.07,85,,,percent of total billed charges,85% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,539.23,81.4,,,percent of total billed charges,81.4% of total billed charges,596.2,90,,,percent of total billed charges,90% of total billed charges,596.2,90,,,percent of total billed charges,90% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,496.83,75,,,percent of total billed charges,75% of total billed charges,563.07,85,,,percent of total billed charges,85% of total billed charges,251.73,616.07,
(RES) CASPR2 AB,2066,CDM,300,RC,86255,HCPCS,outpatient,,,662.44,496.83,,596.2,90,,,percent of total billed charges,90% of total billed charges,616.07,93,,,percent of total billed charges,93% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,563.07,85,,,percent of total billed charges,85% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,539.23,81.4,,,percent of total billed charges,81.4% of total billed charges,596.2,90,,,percent of total billed charges,90% of total billed charges,596.2,90,,,percent of total billed charges,90% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,251.73,38,,,percent of total billed charges,38% of total billed charges,496.83,75,,,percent of total billed charges,75% of total billed charges,563.07,85,,,percent of total billed charges,85% of total billed charges,251.73,616.07,
"(RES) ANNA2 (RI) AB, IFA",2067,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
Striated Muscle AB,2068,CDM,300,RC,86255,HCPCS,outpatient,,,180.18,135.14,,162.16,90,,,percent of total billed charges,90% of total billed charges,167.57,93,,,percent of total billed charges,93% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,153.15,85,,,percent of total billed charges,85% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,146.67,81.4,,,percent of total billed charges,81.4% of total billed charges,162.16,90,,,percent of total billed charges,90% of total billed charges,162.16,90,,,percent of total billed charges,90% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,135.14,75,,,percent of total billed charges,75% of total billed charges,153.15,85,,,percent of total billed charges,85% of total billed charges,68.47,167.57,
"(RES) ANNA3 AB, IFA",2069,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) PCA1 (YO) AB, IFA",2070,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"DNA (ds) AB, Crithidia w Rflx",2071,CDM,300,RC,86255,HCPCS,outpatient,,,140.08,105.06,,126.07,90,,,percent of total billed charges,90% of total billed charges,130.27,93,,,percent of total billed charges,93% of total billed charges,53.23,38,,,percent of total billed charges,38% of total billed charges,53.23,38,,,percent of total billed charges,38% of total billed charges,119.07,85,,,percent of total billed charges,85% of total billed charges,53.23,38,,,percent of total billed charges,38% of total billed charges,114.03,81.4,,,percent of total billed charges,81.4% of total billed charges,126.07,90,,,percent of total billed charges,90% of total billed charges,126.07,90,,,percent of total billed charges,90% of total billed charges,53.23,38,,,percent of total billed charges,38% of total billed charges,53.23,38,,,percent of total billed charges,38% of total billed charges,53.23,38,,,percent of total billed charges,38% of total billed charges,105.06,75,,,percent of total billed charges,75% of total billed charges,119.07,85,,,percent of total billed charges,85% of total billed charges,53.23,130.27,
"(RES) PCA2 AB, IFA",2072,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) PCA TR (DNER) AB, IFA",2073,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) AGNA/SOX1 AB, IFA",2074,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) AMPHIPHYSIN AB, IFA",2075,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) CRMP5/CV2 AB, IFA",2076,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
(RES) STRIATED MUSCLE AB SCREEN,2077,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) ANNA1 (HU) AB, CSF",2078,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
"(RES) ANNA2 (RI) AB, CSF",2079,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
Copeptin,2080,CDM,300,RC,86255,HCPCS,outpatient,,,275.2,206.4,,247.68,90,,,percent of total billed charges,90% of total billed charges,255.94,93,,,percent of total billed charges,93% of total billed charges,104.58,38,,,percent of total billed charges,38% of total billed charges,104.58,38,,,percent of total billed charges,38% of total billed charges,233.92,85,,,percent of total billed charges,85% of total billed charges,104.58,38,,,percent of total billed charges,38% of total billed charges,224.01,81.4,,,percent of total billed charges,81.4% of total billed charges,247.68,90,,,percent of total billed charges,90% of total billed charges,247.68,90,,,percent of total billed charges,90% of total billed charges,104.58,38,,,percent of total billed charges,38% of total billed charges,104.58,38,,,percent of total billed charges,38% of total billed charges,104.58,38,,,percent of total billed charges,38% of total billed charges,206.4,75,,,percent of total billed charges,75% of total billed charges,233.92,85,,,percent of total billed charges,85% of total billed charges,104.58,255.94,
"NMO Spectrum Eval w rflx, Serum",2081,CDM,300,RC,86255,HCPCS,outpatient,,,716.27,537.2,,644.64,90,,,percent of total billed charges,90% of total billed charges,666.13,93,,,percent of total billed charges,93% of total billed charges,272.18,38,,,percent of total billed charges,38% of total billed charges,272.18,38,,,percent of total billed charges,38% of total billed charges,608.83,85,,,percent of total billed charges,85% of total billed charges,272.18,38,,,percent of total billed charges,38% of total billed charges,583.04,81.4,,,percent of total billed charges,81.4% of total billed charges,644.64,90,,,percent of total billed charges,90% of total billed charges,644.64,90,,,percent of total billed charges,90% of total billed charges,272.18,38,,,percent of total billed charges,38% of total billed charges,272.18,38,,,percent of total billed charges,38% of total billed charges,272.18,38,,,percent of total billed charges,38% of total billed charges,537.2,75,,,percent of total billed charges,75% of total billed charges,608.83,85,,,percent of total billed charges,85% of total billed charges,272.18,666.13,
"(RES) ANNA3 AB, CSF",2082,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
"(RES) PCA1 (YO) AB, CSF",2083,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
"(RES) PCA2 AB, CSF",2084,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
"(RES) PCA TR (DNER) AB, CSF",2085,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
"(RES) AGNA/SOX1 AB, CSF",2086,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
"(RES) AMPHIPHYSIN AB, CSF",2087,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
"(RES) CRMP5/CV2 AB, CSF",2088,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
"(RES) AQUAPORIN 4 AB, CSF",2089,CDM,300,RC,86255,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
Neuronal Nuclear AB(Hu),2090,CDM,300,RC,86255,HCPCS,outpatient,,,509.71,382.28,,458.74,90,,,percent of total billed charges,90% of total billed charges,474.03,93,,,percent of total billed charges,93% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,433.25,85,,,percent of total billed charges,85% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,414.9,81.4,,,percent of total billed charges,81.4% of total billed charges,458.74,90,,,percent of total billed charges,90% of total billed charges,458.74,90,,,percent of total billed charges,90% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,382.28,75,,,percent of total billed charges,75% of total billed charges,433.25,85,,,percent of total billed charges,85% of total billed charges,193.69,474.03,
"Aquaporin-4 IgG, CBA",2091,CDM,300,RC,86255,HCPCS,outpatient,,,752.94,564.71,,677.65,90,,,percent of total billed charges,90% of total billed charges,700.23,93,,,percent of total billed charges,93% of total billed charges,286.12,38,,,percent of total billed charges,38% of total billed charges,286.12,38,,,percent of total billed charges,38% of total billed charges,640,85,,,percent of total billed charges,85% of total billed charges,286.12,38,,,percent of total billed charges,38% of total billed charges,612.89,81.4,,,percent of total billed charges,81.4% of total billed charges,677.65,90,,,percent of total billed charges,90% of total billed charges,677.65,90,,,percent of total billed charges,90% of total billed charges,286.12,38,,,percent of total billed charges,38% of total billed charges,286.12,38,,,percent of total billed charges,38% of total billed charges,286.12,38,,,percent of total billed charges,38% of total billed charges,564.71,75,,,percent of total billed charges,75% of total billed charges,640,85,,,percent of total billed charges,85% of total billed charges,286.12,700.23,
"(RES) PLA2R AB, IFA",2092,CDM,300,RC,86255,HCPCS,outpatient,,,179.45,134.59,,161.51,90,,,percent of total billed charges,90% of total billed charges,166.89,93,,,percent of total billed charges,93% of total billed charges,68.19,38,,,percent of total billed charges,38% of total billed charges,68.19,38,,,percent of total billed charges,38% of total billed charges,152.53,85,,,percent of total billed charges,85% of total billed charges,68.19,38,,,percent of total billed charges,38% of total billed charges,146.07,81.4,,,percent of total billed charges,81.4% of total billed charges,161.51,90,,,percent of total billed charges,90% of total billed charges,161.51,90,,,percent of total billed charges,90% of total billed charges,68.19,38,,,percent of total billed charges,38% of total billed charges,68.19,38,,,percent of total billed charges,38% of total billed charges,68.19,38,,,percent of total billed charges,38% of total billed charges,134.59,75,,,percent of total billed charges,75% of total billed charges,152.53,85,,,percent of total billed charges,85% of total billed charges,68.19,166.89,
Purkinje Cell Cytoplasmic AB (DNER),2093,CDM,300,RC,86255,HCPCS,outpatient,,,441.63,331.22,,397.47,90,,,percent of total billed charges,90% of total billed charges,410.72,93,,,percent of total billed charges,93% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,375.39,85,,,percent of total billed charges,85% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,359.49,81.4,,,percent of total billed charges,81.4% of total billed charges,397.47,90,,,percent of total billed charges,90% of total billed charges,397.47,90,,,percent of total billed charges,90% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,167.82,38,,,percent of total billed charges,38% of total billed charges,331.22,75,,,percent of total billed charges,75% of total billed charges,375.39,85,,,percent of total billed charges,85% of total billed charges,167.82,410.72,
(RES) MA2/TA Antibody,2094,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) MYELIN AB, IFA",2095,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) AQUAPORIN 4 (NMO) AB, IFA",2096,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) NMDAR1 AB, CBA",2097,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) AMPAR1 AB, CBA",2098,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) AMPAR2 AB, CBA",2099,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) GABABR AB, CBA",2100,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
"(RES) DPPX RECEPTOR AB, CBA",2101,CDM,300,RC,86255,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
Gliadin(Deaminated) AB IGA,2102,CDM,300,RC,86258,HCPCS,outpatient,,,151.15,113.36,,136.04,90,,,percent of total billed charges,90% of total billed charges,140.57,93,,,percent of total billed charges,93% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,123.04,81.4,,,percent of total billed charges,81.4% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,113.36,75,,,percent of total billed charges,75% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,140.57,
Gliadin(Deaminated) AB IGG,2103,CDM,300,RC,86258,HCPCS,outpatient,,,316.38,237.29,,284.74,90,,,percent of total billed charges,90% of total billed charges,294.23,93,,,percent of total billed charges,93% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,257.53,81.4,,,percent of total billed charges,81.4% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,237.29,75,,,percent of total billed charges,75% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,294.23,
CA 27.29,2104,CDM,300,RC,86300,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
CA 15-3,2105,CDM,300,RC,86300,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
CA 19-9,2106,CDM,300,RC,86301,HCPCS,outpatient,,,202.73,152.05,,182.46,90,,,percent of total billed charges,90% of total billed charges,188.54,93,,,percent of total billed charges,93% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,172.32,85,,,percent of total billed charges,85% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,165.02,81.4,,,percent of total billed charges,81.4% of total billed charges,182.46,90,,,percent of total billed charges,90% of total billed charges,182.46,90,,,percent of total billed charges,90% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,152.05,75,,,percent of total billed charges,75% of total billed charges,172.32,85,,,percent of total billed charges,85% of total billed charges,77.04,188.54,
CA 125,2107,CDM,300,RC,86304,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
MONO test,2108,CDM,300,RC,86308,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
"Heterophile, Mono Screen",2109,CDM,300,RC,86308,HCPCS,outpatient,,,56.1,42.08,,50.49,90,,,percent of total billed charges,90% of total billed charges,52.17,93,,,percent of total billed charges,93% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,45.67,81.4,,,percent of total billed charges,81.4% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,42.08,75,,,percent of total billed charges,75% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,52.17,
"(RES) GAD65 AB, CSF",2110,CDM,300,RC,86314,HCPCS,outpatient,,,330.03,247.52,,297.03,90,,,percent of total billed charges,90% of total billed charges,306.93,93,,,percent of total billed charges,93% of total billed charges,125.41,38,,,percent of total billed charges,38% of total billed charges,125.41,38,,,percent of total billed charges,38% of total billed charges,280.53,85,,,percent of total billed charges,85% of total billed charges,125.41,38,,,percent of total billed charges,38% of total billed charges,268.64,81.4,,,percent of total billed charges,81.4% of total billed charges,297.03,90,,,percent of total billed charges,90% of total billed charges,297.03,90,,,percent of total billed charges,90% of total billed charges,125.41,38,,,percent of total billed charges,38% of total billed charges,125.41,38,,,percent of total billed charges,38% of total billed charges,125.41,38,,,percent of total billed charges,38% of total billed charges,247.52,75,,,percent of total billed charges,75% of total billed charges,280.53,85,,,percent of total billed charges,85% of total billed charges,125.41,306.93,
Chromogranin A,2111,CDM,300,RC,86316,HCPCS,outpatient,,,185.14,138.86,,166.63,90,,,percent of total billed charges,90% of total billed charges,172.18,93,,,percent of total billed charges,93% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,157.37,85,,,percent of total billed charges,85% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,150.7,81.4,,,percent of total billed charges,81.4% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,138.86,75,,,percent of total billed charges,75% of total billed charges,157.37,85,,,percent of total billed charges,85% of total billed charges,70.35,172.18,
HEP B SURFACE AB QUANT (immunity),2112,CDM,300,RC,86317,HCPCS,outpatient,,,108.06,81.05,,97.25,90,,,percent of total billed charges,90% of total billed charges,100.5,93,,,percent of total billed charges,93% of total billed charges,41.06,38,,,percent of total billed charges,38% of total billed charges,41.06,38,,,percent of total billed charges,38% of total billed charges,91.85,85,,,percent of total billed charges,85% of total billed charges,41.06,38,,,percent of total billed charges,38% of total billed charges,87.96,81.4,,,percent of total billed charges,81.4% of total billed charges,97.25,90,,,percent of total billed charges,90% of total billed charges,97.25,90,,,percent of total billed charges,90% of total billed charges,41.06,38,,,percent of total billed charges,38% of total billed charges,41.06,38,,,percent of total billed charges,38% of total billed charges,41.06,38,,,percent of total billed charges,38% of total billed charges,81.05,75,,,percent of total billed charges,75% of total billed charges,91.85,85,,,percent of total billed charges,85% of total billed charges,41.06,100.5,
(RES) SEROTYPE 1 (1),2113,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 12 (12F),2114,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 14 (14),2115,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 17 (17F),2116,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 19 (19F),2117,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
Strep pneumo Serotype (6),2118,CDM,300,RC,86317,HCPCS,outpatient,,,305.84,229.38,,275.26,90,,,percent of total billed charges,90% of total billed charges,284.43,93,,,percent of total billed charges,93% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,259.96,85,,,percent of total billed charges,85% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,248.95,81.4,,,percent of total billed charges,81.4% of total billed charges,275.26,90,,,percent of total billed charges,90% of total billed charges,275.26,90,,,percent of total billed charges,90% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,229.38,75,,,percent of total billed charges,75% of total billed charges,259.96,85,,,percent of total billed charges,85% of total billed charges,116.22,284.43,
(RES) SEROTYPE 20 (20),2119,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 22 (22F),2120,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 23 (23F),2121,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 26 (6B),2122,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 2 (2),2123,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 34 (10A),2124,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 43 (11A),2125,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 3 (3),2126,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 51 (7F),2127,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 54 (15B),2128,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 56 (18C),2129,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 57 (19A),2130,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 4 (4),2131,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 68 (9V),2132,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 5 (5),2133,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 70 (33F),2134,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 8 (8),2135,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
(RES) SEROTYPE 9 (9N),2136,CDM,300,RC,86317,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
"C4 Binding Protein, Serum",2137,CDM,300,RC,86329,HCPCS,outpatient,,,144.29,108.22,,129.86,90,,,percent of total billed charges,90% of total billed charges,134.19,93,,,percent of total billed charges,93% of total billed charges,54.83,38,,,percent of total billed charges,38% of total billed charges,54.83,38,,,percent of total billed charges,38% of total billed charges,122.65,85,,,percent of total billed charges,85% of total billed charges,54.83,38,,,percent of total billed charges,38% of total billed charges,117.45,81.4,,,percent of total billed charges,81.4% of total billed charges,129.86,90,,,percent of total billed charges,90% of total billed charges,129.86,90,,,percent of total billed charges,90% of total billed charges,54.83,38,,,percent of total billed charges,38% of total billed charges,54.83,38,,,percent of total billed charges,38% of total billed charges,54.83,38,,,percent of total billed charges,38% of total billed charges,108.22,75,,,percent of total billed charges,75% of total billed charges,122.65,85,,,percent of total billed charges,85% of total billed charges,54.83,134.19,
"Immunofixation (IFE), Serum",2138,CDM,300,RC,86334,HCPCS,outpatient,,,230.85,173.14,,207.77,90,,,percent of total billed charges,90% of total billed charges,214.69,93,,,percent of total billed charges,93% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,196.22,85,,,percent of total billed charges,85% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,187.91,81.4,,,percent of total billed charges,81.4% of total billed charges,207.77,90,,,percent of total billed charges,90% of total billed charges,207.77,90,,,percent of total billed charges,90% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,173.14,75,,,percent of total billed charges,75% of total billed charges,196.22,85,,,percent of total billed charges,85% of total billed charges,87.72,214.69,
(RES) IMMUNOFIXATION,2139,CDM,300,RC,86334,HCPCS,outpatient,,,208.7,156.53,,187.83,90,,,percent of total billed charges,90% of total billed charges,194.09,93,,,percent of total billed charges,93% of total billed charges,79.31,38,,,percent of total billed charges,38% of total billed charges,79.31,38,,,percent of total billed charges,38% of total billed charges,177.4,85,,,percent of total billed charges,85% of total billed charges,79.31,38,,,percent of total billed charges,38% of total billed charges,169.88,81.4,,,percent of total billed charges,81.4% of total billed charges,187.83,90,,,percent of total billed charges,90% of total billed charges,187.83,90,,,percent of total billed charges,90% of total billed charges,79.31,38,,,percent of total billed charges,38% of total billed charges,79.31,38,,,percent of total billed charges,38% of total billed charges,79.31,38,,,percent of total billed charges,38% of total billed charges,156.53,75,,,percent of total billed charges,75% of total billed charges,177.4,85,,,percent of total billed charges,85% of total billed charges,79.31,194.09,
Immunofixation Urine,2140,CDM,300,RC,86335,HCPCS,outpatient,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,201.61,
Beta-2 Transferrin,2141,CDM,300,RC,86335,HCPCS,outpatient,,,565.15,423.86,,508.64,90,,,percent of total billed charges,90% of total billed charges,525.59,93,,,percent of total billed charges,93% of total billed charges,214.76,38,,,percent of total billed charges,38% of total billed charges,214.76,38,,,percent of total billed charges,38% of total billed charges,480.38,85,,,percent of total billed charges,85% of total billed charges,214.76,38,,,percent of total billed charges,38% of total billed charges,460.03,81.4,,,percent of total billed charges,81.4% of total billed charges,508.64,90,,,percent of total billed charges,90% of total billed charges,508.64,90,,,percent of total billed charges,90% of total billed charges,214.76,38,,,percent of total billed charges,38% of total billed charges,214.76,38,,,percent of total billed charges,38% of total billed charges,214.76,38,,,percent of total billed charges,38% of total billed charges,423.86,75,,,percent of total billed charges,75% of total billed charges,480.38,85,,,percent of total billed charges,85% of total billed charges,214.76,525.59,
Inhibin A,2142,CDM,300,RC,86336,HCPCS,outpatient,,,254.06,190.55,,228.65,90,,,percent of total billed charges,90% of total billed charges,236.28,93,,,percent of total billed charges,93% of total billed charges,96.54,38,,,percent of total billed charges,38% of total billed charges,96.54,38,,,percent of total billed charges,38% of total billed charges,215.95,85,,,percent of total billed charges,85% of total billed charges,96.54,38,,,percent of total billed charges,38% of total billed charges,206.8,81.4,,,percent of total billed charges,81.4% of total billed charges,228.65,90,,,percent of total billed charges,90% of total billed charges,228.65,90,,,percent of total billed charges,90% of total billed charges,96.54,38,,,percent of total billed charges,38% of total billed charges,96.54,38,,,percent of total billed charges,38% of total billed charges,96.54,38,,,percent of total billed charges,38% of total billed charges,190.55,75,,,percent of total billed charges,75% of total billed charges,215.95,85,,,percent of total billed charges,85% of total billed charges,96.54,236.28,
Insulin Autoantibody,2143,CDM,300,RC,86337,HCPCS,outpatient,,,233.11,174.83,,209.8,90,,,percent of total billed charges,90% of total billed charges,216.79,93,,,percent of total billed charges,93% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,198.14,85,,,percent of total billed charges,85% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,189.75,81.4,,,percent of total billed charges,81.4% of total billed charges,209.8,90,,,percent of total billed charges,90% of total billed charges,209.8,90,,,percent of total billed charges,90% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,174.83,75,,,percent of total billed charges,75% of total billed charges,198.14,85,,,percent of total billed charges,85% of total billed charges,88.58,216.79,
(RES) Insulin Autoantibody,2144,CDM,300,RC,86337,HCPCS,outpatient,,,238.14,178.61,,214.33,90,,,percent of total billed charges,90% of total billed charges,221.47,93,,,percent of total billed charges,93% of total billed charges,90.49,38,,,percent of total billed charges,38% of total billed charges,90.49,38,,,percent of total billed charges,38% of total billed charges,202.42,85,,,percent of total billed charges,85% of total billed charges,90.49,38,,,percent of total billed charges,38% of total billed charges,193.85,81.4,,,percent of total billed charges,81.4% of total billed charges,214.33,90,,,percent of total billed charges,90% of total billed charges,214.33,90,,,percent of total billed charges,90% of total billed charges,90.49,38,,,percent of total billed charges,38% of total billed charges,90.49,38,,,percent of total billed charges,38% of total billed charges,90.49,38,,,percent of total billed charges,38% of total billed charges,178.61,75,,,percent of total billed charges,75% of total billed charges,202.42,85,,,percent of total billed charges,85% of total billed charges,90.49,221.47,
Intrinsic factor,2145,CDM,300,RC,86340,HCPCS,outpatient,,,151.84,113.88,,136.66,90,,,percent of total billed charges,90% of total billed charges,141.21,93,,,percent of total billed charges,93% of total billed charges,57.7,38,,,percent of total billed charges,38% of total billed charges,57.7,38,,,percent of total billed charges,38% of total billed charges,129.06,85,,,percent of total billed charges,85% of total billed charges,57.7,38,,,percent of total billed charges,38% of total billed charges,123.6,81.4,,,percent of total billed charges,81.4% of total billed charges,136.66,90,,,percent of total billed charges,90% of total billed charges,136.66,90,,,percent of total billed charges,90% of total billed charges,57.7,38,,,percent of total billed charges,38% of total billed charges,57.7,38,,,percent of total billed charges,38% of total billed charges,57.7,38,,,percent of total billed charges,38% of total billed charges,113.88,75,,,percent of total billed charges,75% of total billed charges,129.06,85,,,percent of total billed charges,85% of total billed charges,57.7,141.21,
Islet Cell Antibody,2146,CDM,300,RC,86341,HCPCS,outpatient,,,142.95,107.21,,128.66,90,,,percent of total billed charges,90% of total billed charges,132.94,93,,,percent of total billed charges,93% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,116.36,81.4,,,percent of total billed charges,81.4% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,107.21,75,,,percent of total billed charges,75% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,132.94,
IA-2 Antibody,2147,CDM,300,RC,86341,HCPCS,outpatient,,,234.37,175.78,,210.93,90,,,percent of total billed charges,90% of total billed charges,217.96,93,,,percent of total billed charges,93% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,199.21,85,,,percent of total billed charges,85% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,190.78,81.4,,,percent of total billed charges,81.4% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,175.78,75,,,percent of total billed charges,75% of total billed charges,199.21,85,,,percent of total billed charges,85% of total billed charges,89.06,217.96,
(RES) GAD65,2148,CDM,300,RC,86341,HCPCS,outpatient,,,231.9,173.93,,208.71,90,,,percent of total billed charges,90% of total billed charges,215.67,93,,,percent of total billed charges,93% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,197.12,85,,,percent of total billed charges,85% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,188.77,81.4,,,percent of total billed charges,81.4% of total billed charges,208.71,90,,,percent of total billed charges,90% of total billed charges,208.71,90,,,percent of total billed charges,90% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,173.93,75,,,percent of total billed charges,75% of total billed charges,197.12,85,,,percent of total billed charges,85% of total billed charges,88.12,215.67,
(RES) IA-2,2149,CDM,300,RC,86341,HCPCS,outpatient,,,231.9,173.93,,208.71,90,,,percent of total billed charges,90% of total billed charges,215.67,93,,,percent of total billed charges,93% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,197.12,85,,,percent of total billed charges,85% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,188.77,81.4,,,percent of total billed charges,81.4% of total billed charges,208.71,90,,,percent of total billed charges,90% of total billed charges,208.71,90,,,percent of total billed charges,90% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,88.12,38,,,percent of total billed charges,38% of total billed charges,173.93,75,,,percent of total billed charges,75% of total billed charges,197.12,85,,,percent of total billed charges,85% of total billed charges,88.12,215.67,
Zinc Transporter 8 (ZnT8) AB,2150,CDM,300,RC,86341,HCPCS,outpatient,,,213.1,159.83,,191.79,90,,,percent of total billed charges,90% of total billed charges,198.18,93,,,percent of total billed charges,93% of total billed charges,80.98,38,,,percent of total billed charges,38% of total billed charges,80.98,38,,,percent of total billed charges,38% of total billed charges,181.14,85,,,percent of total billed charges,85% of total billed charges,80.98,38,,,percent of total billed charges,38% of total billed charges,173.46,81.4,,,percent of total billed charges,81.4% of total billed charges,191.79,90,,,percent of total billed charges,90% of total billed charges,191.79,90,,,percent of total billed charges,90% of total billed charges,80.98,38,,,percent of total billed charges,38% of total billed charges,80.98,38,,,percent of total billed charges,38% of total billed charges,80.98,38,,,percent of total billed charges,38% of total billed charges,159.83,75,,,percent of total billed charges,75% of total billed charges,181.14,85,,,percent of total billed charges,85% of total billed charges,80.98,198.18,
Glutamic Acid Decarb-65 AB,2151,CDM,300,RC,86341,HCPCS,outpatient,,,261.9,196.43,,235.71,90,,,percent of total billed charges,90% of total billed charges,243.57,93,,,percent of total billed charges,93% of total billed charges,99.52,38,,,percent of total billed charges,38% of total billed charges,99.52,38,,,percent of total billed charges,38% of total billed charges,222.62,85,,,percent of total billed charges,85% of total billed charges,99.52,38,,,percent of total billed charges,38% of total billed charges,213.19,81.4,,,percent of total billed charges,81.4% of total billed charges,235.71,90,,,percent of total billed charges,90% of total billed charges,235.71,90,,,percent of total billed charges,90% of total billed charges,99.52,38,,,percent of total billed charges,38% of total billed charges,99.52,38,,,percent of total billed charges,38% of total billed charges,99.52,38,,,percent of total billed charges,38% of total billed charges,196.43,75,,,percent of total billed charges,75% of total billed charges,222.62,85,,,percent of total billed charges,85% of total billed charges,99.52,243.57,
(RES) GAD65 AB,2152,CDM,300,RC,86341,HCPCS,outpatient,,,262.77,197.08,,236.49,90,,,percent of total billed charges,90% of total billed charges,244.38,93,,,percent of total billed charges,93% of total billed charges,99.85,38,,,percent of total billed charges,38% of total billed charges,99.85,38,,,percent of total billed charges,38% of total billed charges,223.35,85,,,percent of total billed charges,85% of total billed charges,99.85,38,,,percent of total billed charges,38% of total billed charges,213.89,81.4,,,percent of total billed charges,81.4% of total billed charges,236.49,90,,,percent of total billed charges,90% of total billed charges,236.49,90,,,percent of total billed charges,90% of total billed charges,99.85,38,,,percent of total billed charges,38% of total billed charges,99.85,38,,,percent of total billed charges,38% of total billed charges,99.85,38,,,percent of total billed charges,38% of total billed charges,197.08,75,,,percent of total billed charges,75% of total billed charges,223.35,85,,,percent of total billed charges,85% of total billed charges,99.85,244.38,
(RES) GAD65 Antibody,2153,CDM,300,RC,86341,HCPCS,outpatient,,,303.23,227.42,,272.91,90,,,percent of total billed charges,90% of total billed charges,282,93,,,percent of total billed charges,93% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,257.75,85,,,percent of total billed charges,85% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,246.83,81.4,,,percent of total billed charges,81.4% of total billed charges,272.91,90,,,percent of total billed charges,90% of total billed charges,272.91,90,,,percent of total billed charges,90% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,115.23,38,,,percent of total billed charges,38% of total billed charges,227.42,75,,,percent of total billed charges,75% of total billed charges,257.75,85,,,percent of total billed charges,85% of total billed charges,115.23,282,
"(RES) GAD65 AB, LB",2154,CDM,300,RC,86341,HCPCS,outpatient,,,305.85,229.39,,275.27,90,,,percent of total billed charges,90% of total billed charges,284.44,93,,,percent of total billed charges,93% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,259.97,85,,,percent of total billed charges,85% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,248.96,81.4,,,percent of total billed charges,81.4% of total billed charges,275.27,90,,,percent of total billed charges,90% of total billed charges,275.27,90,,,percent of total billed charges,90% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,116.22,38,,,percent of total billed charges,38% of total billed charges,229.39,75,,,percent of total billed charges,75% of total billed charges,259.97,85,,,percent of total billed charges,85% of total billed charges,116.22,284.44,
Histamine Release (Chronic Urticaria),2155,CDM,300,RC,86343,HCPCS,outpatient,,,228.54,171.41,,205.69,90,,,percent of total billed charges,90% of total billed charges,212.54,93,,,percent of total billed charges,93% of total billed charges,86.85,38,,,percent of total billed charges,38% of total billed charges,86.85,38,,,percent of total billed charges,38% of total billed charges,194.26,85,,,percent of total billed charges,85% of total billed charges,86.85,38,,,percent of total billed charges,38% of total billed charges,186.03,81.4,,,percent of total billed charges,81.4% of total billed charges,205.69,90,,,percent of total billed charges,90% of total billed charges,205.69,90,,,percent of total billed charges,90% of total billed charges,86.85,38,,,percent of total billed charges,38% of total billed charges,86.85,38,,,percent of total billed charges,38% of total billed charges,86.85,38,,,percent of total billed charges,38% of total billed charges,171.41,75,,,percent of total billed charges,75% of total billed charges,194.26,85,,,percent of total billed charges,85% of total billed charges,86.85,212.54,
(RES) HISTAMINE RELEASE (CU),2156,CDM,300,RC,86343,HCPCS,outpatient,,,355.22,266.42,,319.7,90,,,percent of total billed charges,90% of total billed charges,330.35,93,,,percent of total billed charges,93% of total billed charges,134.98,38,,,percent of total billed charges,38% of total billed charges,134.98,38,,,percent of total billed charges,38% of total billed charges,301.94,85,,,percent of total billed charges,85% of total billed charges,134.98,38,,,percent of total billed charges,38% of total billed charges,289.15,81.4,,,percent of total billed charges,81.4% of total billed charges,319.7,90,,,percent of total billed charges,90% of total billed charges,319.7,90,,,percent of total billed charges,90% of total billed charges,134.98,38,,,percent of total billed charges,38% of total billed charges,134.98,38,,,percent of total billed charges,38% of total billed charges,134.98,38,,,percent of total billed charges,38% of total billed charges,266.42,75,,,percent of total billed charges,75% of total billed charges,301.94,85,,,percent of total billed charges,85% of total billed charges,134.98,330.35,
B cell Subset analysis,2157,CDM,300,RC,86355,HCPCS,outpatient,,,324.73,243.55,,292.26,90,,,percent of total billed charges,90% of total billed charges,302,93,,,percent of total billed charges,93% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,276.02,85,,,percent of total billed charges,85% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,264.33,81.4,,,percent of total billed charges,81.4% of total billed charges,292.26,90,,,percent of total billed charges,90% of total billed charges,292.26,90,,,percent of total billed charges,90% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,243.55,75,,,percent of total billed charges,75% of total billed charges,276.02,85,,,percent of total billed charges,85% of total billed charges,123.4,302,
"(RES) B CELLS, TOTAL",2158,CDM,300,RC,86355,HCPCS,outpatient,,,135.6,101.7,,122.04,90,,,percent of total billed charges,90% of total billed charges,126.11,93,,,percent of total billed charges,93% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,115.26,85,,,percent of total billed charges,85% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,110.38,81.4,,,percent of total billed charges,81.4% of total billed charges,122.04,90,,,percent of total billed charges,90% of total billed charges,122.04,90,,,percent of total billed charges,90% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,101.7,75,,,percent of total billed charges,75% of total billed charges,115.26,85,,,percent of total billed charges,85% of total billed charges,51.53,126.11,
Rituxan Sensitivity (CD20),2159,CDM,300,RC,86356,HCPCS,outpatient,,,235.97,176.98,,212.37,90,,,percent of total billed charges,90% of total billed charges,219.45,93,,,percent of total billed charges,93% of total billed charges,89.67,38,,,percent of total billed charges,38% of total billed charges,89.67,38,,,percent of total billed charges,38% of total billed charges,200.57,85,,,percent of total billed charges,85% of total billed charges,89.67,38,,,percent of total billed charges,38% of total billed charges,192.08,81.4,,,percent of total billed charges,81.4% of total billed charges,212.37,90,,,percent of total billed charges,90% of total billed charges,212.37,90,,,percent of total billed charges,90% of total billed charges,89.67,38,,,percent of total billed charges,38% of total billed charges,89.67,38,,,percent of total billed charges,38% of total billed charges,89.67,38,,,percent of total billed charges,38% of total billed charges,176.98,75,,,percent of total billed charges,75% of total billed charges,200.57,85,,,percent of total billed charges,85% of total billed charges,89.67,219.45,
(RES) CD57+/CD3-,2160,CDM,300,RC,86356,HCPCS,outpatient,,,211.24,158.43,,190.12,90,,,percent of total billed charges,90% of total billed charges,196.45,93,,,percent of total billed charges,93% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,179.55,85,,,percent of total billed charges,85% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,171.95,81.4,,,percent of total billed charges,81.4% of total billed charges,190.12,90,,,percent of total billed charges,90% of total billed charges,190.12,90,,,percent of total billed charges,90% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,158.43,75,,,percent of total billed charges,75% of total billed charges,179.55,85,,,percent of total billed charges,85% of total billed charges,80.27,196.45,
(RES) CD57+/CD8-,2161,CDM,300,RC,86356,HCPCS,outpatient,,,211.24,158.43,,190.12,90,,,percent of total billed charges,90% of total billed charges,196.45,93,,,percent of total billed charges,93% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,179.55,85,,,percent of total billed charges,85% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,171.95,81.4,,,percent of total billed charges,81.4% of total billed charges,190.12,90,,,percent of total billed charges,90% of total billed charges,190.12,90,,,percent of total billed charges,90% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,80.27,38,,,percent of total billed charges,38% of total billed charges,158.43,75,,,percent of total billed charges,75% of total billed charges,179.55,85,,,percent of total billed charges,85% of total billed charges,80.27,196.45,
"(RES) NATURAL KILLER CELLS, TOTAL",2162,CDM,300,RC,86357,HCPCS,outpatient,,,135.6,101.7,,122.04,90,,,percent of total billed charges,90% of total billed charges,126.11,93,,,percent of total billed charges,93% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,115.26,85,,,percent of total billed charges,85% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,110.38,81.4,,,percent of total billed charges,81.4% of total billed charges,122.04,90,,,percent of total billed charges,90% of total billed charges,122.04,90,,,percent of total billed charges,90% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,101.7,75,,,percent of total billed charges,75% of total billed charges,115.26,85,,,percent of total billed charges,85% of total billed charges,51.53,126.11,
"(RES) T CELLS, TOTAL",2163,CDM,300,RC,86359,HCPCS,outpatient,,,135.6,101.7,,122.04,90,,,percent of total billed charges,90% of total billed charges,126.11,93,,,percent of total billed charges,93% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,115.26,85,,,percent of total billed charges,85% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,110.38,81.4,,,percent of total billed charges,81.4% of total billed charges,122.04,90,,,percent of total billed charges,90% of total billed charges,122.04,90,,,percent of total billed charges,90% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,51.53,38,,,percent of total billed charges,38% of total billed charges,101.7,75,,,percent of total billed charges,75% of total billed charges,115.26,85,,,percent of total billed charges,85% of total billed charges,51.53,126.11,
(RES) CD57+/CD3-/CD8-,2164,CDM,300,RC,86359,HCPCS,outpatient,,,279.79,209.84,,251.81,90,,,percent of total billed charges,90% of total billed charges,260.2,93,,,percent of total billed charges,93% of total billed charges,106.32,38,,,percent of total billed charges,38% of total billed charges,106.32,38,,,percent of total billed charges,38% of total billed charges,237.82,85,,,percent of total billed charges,85% of total billed charges,106.32,38,,,percent of total billed charges,38% of total billed charges,227.75,81.4,,,percent of total billed charges,81.4% of total billed charges,251.81,90,,,percent of total billed charges,90% of total billed charges,251.81,90,,,percent of total billed charges,90% of total billed charges,106.32,38,,,percent of total billed charges,38% of total billed charges,106.32,38,,,percent of total billed charges,38% of total billed charges,106.32,38,,,percent of total billed charges,38% of total billed charges,209.84,75,,,percent of total billed charges,75% of total billed charges,237.82,85,,,percent of total billed charges,85% of total billed charges,106.32,260.2,
Lymphocyte Subset Panel 4,2165,CDM,300,RC,86360,HCPCS,outpatient,,,393.09,294.82,,353.78,90,,,percent of total billed charges,90% of total billed charges,365.57,93,,,percent of total billed charges,93% of total billed charges,149.37,38,,,percent of total billed charges,38% of total billed charges,149.37,38,,,percent of total billed charges,38% of total billed charges,334.13,85,,,percent of total billed charges,85% of total billed charges,149.37,38,,,percent of total billed charges,38% of total billed charges,319.98,81.4,,,percent of total billed charges,81.4% of total billed charges,353.78,90,,,percent of total billed charges,90% of total billed charges,353.78,90,,,percent of total billed charges,90% of total billed charges,149.37,38,,,percent of total billed charges,38% of total billed charges,149.37,38,,,percent of total billed charges,38% of total billed charges,149.37,38,,,percent of total billed charges,38% of total billed charges,294.82,75,,,percent of total billed charges,75% of total billed charges,334.13,85,,,percent of total billed charges,85% of total billed charges,149.37,365.57,
Lymphocyte Subset Panel 5,2166,CDM,300,RC,86361,HCPCS,outpatient,,,181.96,136.47,,163.76,90,,,percent of total billed charges,90% of total billed charges,169.22,93,,,percent of total billed charges,93% of total billed charges,69.14,38,,,percent of total billed charges,38% of total billed charges,69.14,38,,,percent of total billed charges,38% of total billed charges,154.67,85,,,percent of total billed charges,85% of total billed charges,69.14,38,,,percent of total billed charges,38% of total billed charges,148.12,81.4,,,percent of total billed charges,81.4% of total billed charges,163.76,90,,,percent of total billed charges,90% of total billed charges,163.76,90,,,percent of total billed charges,90% of total billed charges,69.14,38,,,percent of total billed charges,38% of total billed charges,69.14,38,,,percent of total billed charges,38% of total billed charges,69.14,38,,,percent of total billed charges,38% of total billed charges,136.47,75,,,percent of total billed charges,75% of total billed charges,154.67,85,,,percent of total billed charges,85% of total billed charges,69.14,169.22,
"(RES) T CELLS, ABS CD4 COUNT",2167,CDM,300,RC,86361,HCPCS,outpatient,,,55.28,41.46,,49.75,90,,,percent of total billed charges,90% of total billed charges,51.41,93,,,percent of total billed charges,93% of total billed charges,21.01,38,,,percent of total billed charges,38% of total billed charges,21.01,38,,,percent of total billed charges,38% of total billed charges,46.99,85,,,percent of total billed charges,85% of total billed charges,21.01,38,,,percent of total billed charges,38% of total billed charges,45,81.4,,,percent of total billed charges,81.4% of total billed charges,49.75,90,,,percent of total billed charges,90% of total billed charges,49.75,90,,,percent of total billed charges,90% of total billed charges,21.01,38,,,percent of total billed charges,38% of total billed charges,21.01,38,,,percent of total billed charges,38% of total billed charges,21.01,38,,,percent of total billed charges,38% of total billed charges,41.46,75,,,percent of total billed charges,75% of total billed charges,46.99,85,,,percent of total billed charges,85% of total billed charges,21.01,51.41,
"Lactoferritin, Qualitative Stool",2168,CDM,300,RC,86363,HCPCS,outpatient,,,220.29,165.22,,198.26,90,,,percent of total billed charges,90% of total billed charges,204.87,93,,,percent of total billed charges,93% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,187.25,85,,,percent of total billed charges,85% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,179.32,81.4,,,percent of total billed charges,81.4% of total billed charges,198.26,90,,,percent of total billed charges,90% of total billed charges,198.26,90,,,percent of total billed charges,90% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,165.22,75,,,percent of total billed charges,75% of total billed charges,187.25,85,,,percent of total billed charges,85% of total billed charges,83.71,204.87,
"(RES) TISSUE TRANSGLUTAMINASE AB, IGA",2169,CDM,300,RC,86364,HCPCS,outpatient,,,189.48,142.11,,170.53,90,,,percent of total billed charges,90% of total billed charges,176.22,93,,,percent of total billed charges,93% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,161.06,85,,,percent of total billed charges,85% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,154.24,81.4,,,percent of total billed charges,81.4% of total billed charges,170.53,90,,,percent of total billed charges,90% of total billed charges,170.53,90,,,percent of total billed charges,90% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,142.11,75,,,percent of total billed charges,75% of total billed charges,161.06,85,,,percent of total billed charges,85% of total billed charges,72,176.22,
Tissue Transglutaminase IgA,2170,CDM,300,RC,86364,HCPCS,outpatient,,,189.48,142.11,,170.53,90,,,percent of total billed charges,90% of total billed charges,176.22,93,,,percent of total billed charges,93% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,161.06,85,,,percent of total billed charges,85% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,154.24,81.4,,,percent of total billed charges,81.4% of total billed charges,170.53,90,,,percent of total billed charges,90% of total billed charges,170.53,90,,,percent of total billed charges,90% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,142.11,75,,,percent of total billed charges,75% of total billed charges,161.06,85,,,percent of total billed charges,85% of total billed charges,72,176.22,
"(RES) TISSUE TRANSGLUTAMINASE AB, IGG",2171,CDM,300,RC,86364,HCPCS,outpatient,,,189.48,142.11,,170.53,90,,,percent of total billed charges,90% of total billed charges,176.22,93,,,percent of total billed charges,93% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,161.06,85,,,percent of total billed charges,85% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,154.24,81.4,,,percent of total billed charges,81.4% of total billed charges,170.53,90,,,percent of total billed charges,90% of total billed charges,170.53,90,,,percent of total billed charges,90% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,72,38,,,percent of total billed charges,38% of total billed charges,142.11,75,,,percent of total billed charges,75% of total billed charges,161.06,85,,,percent of total billed charges,85% of total billed charges,72,176.22,
THYROID PEROXIDASE AB (TPO),2172,CDM,300,RC,86376,HCPCS,outpatient,,,72.87,54.65,,65.58,90,,,percent of total billed charges,90% of total billed charges,67.77,93,,,percent of total billed charges,93% of total billed charges,27.69,38,,,percent of total billed charges,38% of total billed charges,27.69,38,,,percent of total billed charges,38% of total billed charges,61.94,85,,,percent of total billed charges,85% of total billed charges,27.69,38,,,percent of total billed charges,38% of total billed charges,59.32,81.4,,,percent of total billed charges,81.4% of total billed charges,65.58,90,,,percent of total billed charges,90% of total billed charges,65.58,90,,,percent of total billed charges,90% of total billed charges,27.69,38,,,percent of total billed charges,38% of total billed charges,27.69,38,,,percent of total billed charges,38% of total billed charges,27.69,38,,,percent of total billed charges,38% of total billed charges,54.65,75,,,percent of total billed charges,75% of total billed charges,61.94,85,,,percent of total billed charges,85% of total billed charges,27.69,67.77,
(RES) LKM-1 ANTIBODY (IGG),2173,CDM,300,RC,86376,HCPCS,outpatient,,,99.58,74.69,,89.62,90,,,percent of total billed charges,90% of total billed charges,92.61,93,,,percent of total billed charges,93% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,84.64,85,,,percent of total billed charges,85% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,81.06,81.4,,,percent of total billed charges,81.4% of total billed charges,89.62,90,,,percent of total billed charges,90% of total billed charges,89.62,90,,,percent of total billed charges,90% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,74.69,75,,,percent of total billed charges,75% of total billed charges,84.64,85,,,percent of total billed charges,85% of total billed charges,37.84,92.61,
Liver Kidney Micros (LKM-1) AB (IgG),2174,CDM,300,RC,86376,HCPCS,outpatient,,,99.58,74.69,,89.62,90,,,percent of total billed charges,90% of total billed charges,92.61,93,,,percent of total billed charges,93% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,84.64,85,,,percent of total billed charges,85% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,81.06,81.4,,,percent of total billed charges,81.4% of total billed charges,89.62,90,,,percent of total billed charges,90% of total billed charges,89.62,90,,,percent of total billed charges,90% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,37.84,38,,,percent of total billed charges,38% of total billed charges,74.69,75,,,percent of total billed charges,75% of total billed charges,84.64,85,,,percent of total billed charges,85% of total billed charges,37.84,92.61,
(RES) THYROID PEROXIDASE AB (TPO),2175,CDM,300,RC,86376,HCPCS,outpatient,,,73.9,55.43,,66.51,90,,,percent of total billed charges,90% of total billed charges,68.73,93,,,percent of total billed charges,93% of total billed charges,28.08,38,,,percent of total billed charges,38% of total billed charges,28.08,38,,,percent of total billed charges,38% of total billed charges,62.82,85,,,percent of total billed charges,85% of total billed charges,28.08,38,,,percent of total billed charges,38% of total billed charges,60.15,81.4,,,percent of total billed charges,81.4% of total billed charges,66.51,90,,,percent of total billed charges,90% of total billed charges,66.51,90,,,percent of total billed charges,90% of total billed charges,28.08,38,,,percent of total billed charges,38% of total billed charges,28.08,38,,,percent of total billed charges,38% of total billed charges,28.08,38,,,percent of total billed charges,38% of total billed charges,55.43,75,,,percent of total billed charges,75% of total billed charges,62.82,85,,,percent of total billed charges,85% of total billed charges,28.08,68.73,
Mitochondrial AB w/reflex to titer,2176,CDM,300,RC,86381,HCPCS,outpatient,,,140.72,105.54,,126.65,90,,,percent of total billed charges,90% of total billed charges,130.87,93,,,percent of total billed charges,93% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,119.61,85,,,percent of total billed charges,85% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,114.55,81.4,,,percent of total billed charges,81.4% of total billed charges,126.65,90,,,percent of total billed charges,90% of total billed charges,126.65,90,,,percent of total billed charges,90% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,105.54,75,,,percent of total billed charges,75% of total billed charges,119.61,85,,,percent of total billed charges,85% of total billed charges,53.47,130.87,
(RES) MITOCHONDRIAL AB TITER,2177,CDM,300,RC,86381,HCPCS,outpatient,,,130.44,97.83,,117.4,90,,,percent of total billed charges,90% of total billed charges,121.31,93,,,percent of total billed charges,93% of total billed charges,49.57,38,,,percent of total billed charges,38% of total billed charges,49.57,38,,,percent of total billed charges,38% of total billed charges,110.87,85,,,percent of total billed charges,85% of total billed charges,49.57,38,,,percent of total billed charges,38% of total billed charges,106.18,81.4,,,percent of total billed charges,81.4% of total billed charges,117.4,90,,,percent of total billed charges,90% of total billed charges,117.4,90,,,percent of total billed charges,90% of total billed charges,49.57,38,,,percent of total billed charges,38% of total billed charges,49.57,38,,,percent of total billed charges,38% of total billed charges,49.57,38,,,percent of total billed charges,38% of total billed charges,97.83,75,,,percent of total billed charges,75% of total billed charges,110.87,85,,,percent of total billed charges,85% of total billed charges,49.57,121.31,
Mitochondria M2 Ab IgG,2178,CDM,300,RC,86381,HCPCS,outpatient,,,137.39,103.04,,123.65,90,,,percent of total billed charges,90% of total billed charges,127.77,93,,,percent of total billed charges,93% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,116.78,85,,,percent of total billed charges,85% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,111.84,81.4,,,percent of total billed charges,81.4% of total billed charges,123.65,90,,,percent of total billed charges,90% of total billed charges,123.65,90,,,percent of total billed charges,90% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,103.04,75,,,percent of total billed charges,75% of total billed charges,116.78,85,,,percent of total billed charges,85% of total billed charges,52.21,127.77,
(RES) MITOCHONDRAL AB SCREEN,2179,CDM,300,RC,86381,HCPCS,outpatient,,,115.97,86.98,,104.37,90,,,percent of total billed charges,90% of total billed charges,107.85,93,,,percent of total billed charges,93% of total billed charges,44.07,38,,,percent of total billed charges,38% of total billed charges,44.07,38,,,percent of total billed charges,38% of total billed charges,98.57,85,,,percent of total billed charges,85% of total billed charges,44.07,38,,,percent of total billed charges,38% of total billed charges,94.4,81.4,,,percent of total billed charges,81.4% of total billed charges,104.37,90,,,percent of total billed charges,90% of total billed charges,104.37,90,,,percent of total billed charges,90% of total billed charges,44.07,38,,,percent of total billed charges,38% of total billed charges,44.07,38,,,percent of total billed charges,38% of total billed charges,44.07,38,,,percent of total billed charges,38% of total billed charges,86.98,75,,,percent of total billed charges,75% of total billed charges,98.57,85,,,percent of total billed charges,85% of total billed charges,44.07,107.85,
Streptozyme Screen with Reflex,2180,CDM,300,RC,86403,HCPCS,outpatient,,,173.18,129.89,,155.86,90,,,percent of total billed charges,90% of total billed charges,161.06,93,,,percent of total billed charges,93% of total billed charges,65.81,38,,,percent of total billed charges,38% of total billed charges,65.81,38,,,percent of total billed charges,38% of total billed charges,147.2,85,,,percent of total billed charges,85% of total billed charges,65.81,38,,,percent of total billed charges,38% of total billed charges,140.97,81.4,,,percent of total billed charges,81.4% of total billed charges,155.86,90,,,percent of total billed charges,90% of total billed charges,155.86,90,,,percent of total billed charges,90% of total billed charges,65.81,38,,,percent of total billed charges,38% of total billed charges,65.81,38,,,percent of total billed charges,38% of total billed charges,65.81,38,,,percent of total billed charges,38% of total billed charges,129.89,75,,,percent of total billed charges,75% of total billed charges,147.2,85,,,percent of total billed charges,85% of total billed charges,65.81,161.06,
Strep Typing,2181,CDM,300,RC,86403,HCPCS,outpatient,,,51,38.25,,45.9,90,,,percent of total billed charges,90% of total billed charges,47.43,93,,,percent of total billed charges,93% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,41.51,81.4,,,percent of total billed charges,81.4% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,38.25,75,,,percent of total billed charges,75% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,47.43,
RHEUMATOID FACTOR,2182,CDM,300,RC,86430,HCPCS,outpatient,,,72.66,54.5,,65.39,90,,,percent of total billed charges,90% of total billed charges,67.57,93,,,percent of total billed charges,93% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,59.15,81.4,,,percent of total billed charges,81.4% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,54.5,75,,,percent of total billed charges,75% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,67.57,
(Result) Rheumatoid Factor,2183,CDM,300,RC,86430,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Quantiferon TB Gold,2184,CDM,300,RC,86480,HCPCS,outpatient,,,378.94,284.21,,341.05,90,,,percent of total billed charges,90% of total billed charges,352.41,93,,,percent of total billed charges,93% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,322.1,85,,,percent of total billed charges,85% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,308.46,81.4,,,percent of total billed charges,81.4% of total billed charges,341.05,90,,,percent of total billed charges,90% of total billed charges,341.05,90,,,percent of total billed charges,90% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,284.21,75,,,percent of total billed charges,75% of total billed charges,322.1,85,,,percent of total billed charges,85% of total billed charges,144,352.41,
"Quanti-FERON Gold Plus, 1 Tube",2185,CDM,300,RC,86480,HCPCS,outpatient,,,378.94,284.21,,341.05,90,,,percent of total billed charges,90% of total billed charges,352.41,93,,,percent of total billed charges,93% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,322.1,85,,,percent of total billed charges,85% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,308.46,81.4,,,percent of total billed charges,81.4% of total billed charges,341.05,90,,,percent of total billed charges,90% of total billed charges,341.05,90,,,percent of total billed charges,90% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,144,38,,,percent of total billed charges,38% of total billed charges,284.21,75,,,percent of total billed charges,75% of total billed charges,322.1,85,,,percent of total billed charges,85% of total billed charges,144,352.41,
T-SPOT. TB,2187,CDM,300,RC,86481,HCPCS,outpatient,,,313.06,234.8,,281.75,90,,,percent of total billed charges,90% of total billed charges,291.15,93,,,percent of total billed charges,93% of total billed charges,118.96,38,,,percent of total billed charges,38% of total billed charges,118.96,38,,,percent of total billed charges,38% of total billed charges,266.1,85,,,percent of total billed charges,85% of total billed charges,118.96,38,,,percent of total billed charges,38% of total billed charges,254.83,81.4,,,percent of total billed charges,81.4% of total billed charges,281.75,90,,,percent of total billed charges,90% of total billed charges,281.75,90,,,percent of total billed charges,90% of total billed charges,118.96,38,,,percent of total billed charges,38% of total billed charges,118.96,38,,,percent of total billed charges,38% of total billed charges,118.96,38,,,percent of total billed charges,38% of total billed charges,234.8,75,,,percent of total billed charges,75% of total billed charges,266.1,85,,,percent of total billed charges,85% of total billed charges,118.96,291.15,
RPR,2188,CDM,300,RC,86592,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
"VDRL, CSF",2189,CDM,300,RC,86592,HCPCS,outpatient,,,70.23,52.67,,63.21,90,,,percent of total billed charges,90% of total billed charges,65.31,93,,,percent of total billed charges,93% of total billed charges,26.69,38,,,percent of total billed charges,38% of total billed charges,26.69,38,,,percent of total billed charges,38% of total billed charges,59.7,85,,,percent of total billed charges,85% of total billed charges,26.69,38,,,percent of total billed charges,38% of total billed charges,57.17,81.4,,,percent of total billed charges,81.4% of total billed charges,63.21,90,,,percent of total billed charges,90% of total billed charges,63.21,90,,,percent of total billed charges,90% of total billed charges,26.69,38,,,percent of total billed charges,38% of total billed charges,26.69,38,,,percent of total billed charges,38% of total billed charges,26.69,38,,,percent of total billed charges,38% of total billed charges,52.67,75,,,percent of total billed charges,75% of total billed charges,59.7,85,,,percent of total billed charges,85% of total billed charges,26.69,65.31,
RPR Titer,2190,CDM,300,RC,86593,HCPCS,outpatient,,,55.18,41.39,,49.66,90,,,percent of total billed charges,90% of total billed charges,51.32,93,,,percent of total billed charges,93% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,46.9,85,,,percent of total billed charges,85% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,44.92,81.4,,,percent of total billed charges,81.4% of total billed charges,49.66,90,,,percent of total billed charges,90% of total billed charges,49.66,90,,,percent of total billed charges,90% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,41.39,75,,,percent of total billed charges,75% of total billed charges,46.9,85,,,percent of total billed charges,85% of total billed charges,20.97,51.32,
(RES) VOLTAGE GATED CALCIUM CHANNEL (VGCC)TYPE N AB,2191,CDM,300,RC,86596,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
(RES) VGCC TYPE P/Q AB,2192,CDM,300,RC,86596,HCPCS,outpatient,,,401.38,301.04,,361.24,90,,,percent of total billed charges,90% of total billed charges,373.28,93,,,percent of total billed charges,93% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,326.72,81.4,,,percent of total billed charges,81.4% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,361.24,90,,,percent of total billed charges,90% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,152.52,38,,,percent of total billed charges,38% of total billed charges,301.04,75,,,percent of total billed charges,75% of total billed charges,341.17,85,,,percent of total billed charges,85% of total billed charges,152.52,373.28,
VGCC Type P/Q Antibody,2193,CDM,300,RC,86596,HCPCS,outpatient,,,364.14,273.11,,327.73,90,,,percent of total billed charges,90% of total billed charges,338.65,93,,,percent of total billed charges,93% of total billed charges,138.37,38,,,percent of total billed charges,38% of total billed charges,138.37,38,,,percent of total billed charges,38% of total billed charges,309.52,85,,,percent of total billed charges,85% of total billed charges,138.37,38,,,percent of total billed charges,38% of total billed charges,296.41,81.4,,,percent of total billed charges,81.4% of total billed charges,327.73,90,,,percent of total billed charges,90% of total billed charges,327.73,90,,,percent of total billed charges,90% of total billed charges,138.37,38,,,percent of total billed charges,38% of total billed charges,138.37,38,,,percent of total billed charges,38% of total billed charges,138.37,38,,,percent of total billed charges,38% of total billed charges,273.11,75,,,percent of total billed charges,75% of total billed charges,309.52,85,,,percent of total billed charges,85% of total billed charges,138.37,338.65,
aspergillus niger IgE,2194,CDM,300,RC,86603,HCPCS,outpatient,,,37.16,27.87,,33.44,90,,,percent of total billed charges,90% of total billed charges,34.56,93,,,percent of total billed charges,93% of total billed charges,14.12,38,,,percent of total billed charges,38% of total billed charges,14.12,38,,,percent of total billed charges,38% of total billed charges,31.59,85,,,percent of total billed charges,85% of total billed charges,14.12,38,,,percent of total billed charges,38% of total billed charges,30.25,81.4,,,percent of total billed charges,81.4% of total billed charges,33.44,90,,,percent of total billed charges,90% of total billed charges,33.44,90,,,percent of total billed charges,90% of total billed charges,14.12,38,,,percent of total billed charges,38% of total billed charges,14.12,38,,,percent of total billed charges,38% of total billed charges,14.12,38,,,percent of total billed charges,38% of total billed charges,27.87,75,,,percent of total billed charges,75% of total billed charges,31.59,85,,,percent of total billed charges,85% of total billed charges,14.12,34.56,
Aspergillus fumigatus (IgG) AB,2195,CDM,300,RC,86606,HCPCS,outpatient,,,135.3,101.48,,121.77,90,,,percent of total billed charges,90% of total billed charges,125.83,93,,,percent of total billed charges,93% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,115.01,85,,,percent of total billed charges,85% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,110.13,81.4,,,percent of total billed charges,81.4% of total billed charges,121.77,90,,,percent of total billed charges,90% of total billed charges,121.77,90,,,percent of total billed charges,90% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,101.48,75,,,percent of total billed charges,75% of total billed charges,115.01,85,,,percent of total billed charges,85% of total billed charges,51.41,125.83,
(RES) SACCHAROMONOSPORA VIRIDIS,2196,CDM,300,RC,86606,HCPCS,outpatient,,,82.8,62.1,,74.52,90,,,percent of total billed charges,90% of total billed charges,77,93,,,percent of total billed charges,93% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,70.38,85,,,percent of total billed charges,85% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,67.4,81.4,,,percent of total billed charges,81.4% of total billed charges,74.52,90,,,percent of total billed charges,90% of total billed charges,74.52,90,,,percent of total billed charges,90% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,62.1,75,,,percent of total billed charges,75% of total billed charges,70.38,85,,,percent of total billed charges,85% of total billed charges,31.46,77,
(RES) ASPERGILLUS FLAVUS,2197,CDM,300,RC,86606,HCPCS,outpatient,,,86.7,65.03,,78.03,90,,,percent of total billed charges,90% of total billed charges,80.63,93,,,percent of total billed charges,93% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,70.57,81.4,,,percent of total billed charges,81.4% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,65.03,75,,,percent of total billed charges,75% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,32.95,80.63,
(RES) ASPERGILLUS NIGER,2198,CDM,300,RC,86606,HCPCS,outpatient,,,86.7,65.03,,78.03,90,,,percent of total billed charges,90% of total billed charges,80.63,93,,,percent of total billed charges,93% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,70.57,81.4,,,percent of total billed charges,81.4% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,65.03,75,,,percent of total billed charges,75% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,32.95,80.63,
(RESULT) ASPERGILLUS FUMIGATUS,2199,CDM,300,RC,86606,HCPCS,outpatient,,,86.7,65.03,,78.03,90,,,percent of total billed charges,90% of total billed charges,80.63,93,,,percent of total billed charges,93% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,70.57,81.4,,,percent of total billed charges,81.4% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,65.03,75,,,percent of total billed charges,75% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,32.95,80.63,
"Listeria Antibody, CF, Serum",2200,CDM,300,RC,86609,HCPCS,outpatient,,,208.91,156.68,,188.02,90,,,percent of total billed charges,90% of total billed charges,194.29,93,,,percent of total billed charges,93% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,177.57,85,,,percent of total billed charges,85% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,170.05,81.4,,,percent of total billed charges,81.4% of total billed charges,188.02,90,,,percent of total billed charges,90% of total billed charges,188.02,90,,,percent of total billed charges,90% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,79.39,38,,,percent of total billed charges,38% of total billed charges,156.68,75,,,percent of total billed charges,75% of total billed charges,177.57,85,,,percent of total billed charges,85% of total billed charges,79.39,194.29,
(RES) ASPERGILLUS FUMIGATUS,2201,CDM,300,RC,86609,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
(RES) S. RECTIVIRGULA,2202,CDM,300,RC,86609,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
(RES) T. CANDIDUS,2203,CDM,300,RC,86609,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
(RES) T. SACCHARI,2204,CDM,300,RC,86609,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
(RES) T. VULGARIS,2205,CDM,300,RC,86609,HCPCS,outpatient,,,49.89,37.42,,44.9,90,,,percent of total billed charges,90% of total billed charges,46.4,93,,,percent of total billed charges,93% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,40.61,81.4,,,percent of total billed charges,81.4% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,44.9,90,,,percent of total billed charges,90% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,18.96,38,,,percent of total billed charges,38% of total billed charges,37.42,75,,,percent of total billed charges,75% of total billed charges,42.41,85,,,percent of total billed charges,85% of total billed charges,18.96,46.4,
"(RES) B. HENSELAE AB (IGG), SCREEN",2206,CDM,300,RC,86611,HCPCS,outpatient,,,56.1,42.08,,50.49,90,,,percent of total billed charges,90% of total billed charges,52.17,93,,,percent of total billed charges,93% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,45.67,81.4,,,percent of total billed charges,81.4% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,42.08,75,,,percent of total billed charges,75% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,52.17,
"(RES) B. HENSELAE AB (IGM), SCREEN",2207,CDM,300,RC,86611,HCPCS,outpatient,,,56.1,42.08,,50.49,90,,,percent of total billed charges,90% of total billed charges,52.17,93,,,percent of total billed charges,93% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,45.67,81.4,,,percent of total billed charges,81.4% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,42.08,75,,,percent of total billed charges,75% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,52.17,
"(RES) BLASTOMYCES ANTIBODY, IMMUNODIFFUSION",2208,CDM,300,RC,86612,HCPCS,outpatient,,,109.76,82.32,,98.78,90,,,percent of total billed charges,90% of total billed charges,102.08,93,,,percent of total billed charges,93% of total billed charges,41.71,38,,,percent of total billed charges,38% of total billed charges,41.71,38,,,percent of total billed charges,38% of total billed charges,93.3,85,,,percent of total billed charges,85% of total billed charges,41.71,38,,,percent of total billed charges,38% of total billed charges,89.34,81.4,,,percent of total billed charges,81.4% of total billed charges,98.78,90,,,percent of total billed charges,90% of total billed charges,98.78,90,,,percent of total billed charges,90% of total billed charges,41.71,38,,,percent of total billed charges,38% of total billed charges,41.71,38,,,percent of total billed charges,38% of total billed charges,41.71,38,,,percent of total billed charges,38% of total billed charges,82.32,75,,,percent of total billed charges,75% of total billed charges,93.3,85,,,percent of total billed charges,85% of total billed charges,41.71,102.08,
Bordetella Pertussis AB,2209,CDM,300,RC,86615,HCPCS,outpatient,,,275.36,206.52,,247.82,90,,,percent of total billed charges,90% of total billed charges,256.08,93,,,percent of total billed charges,93% of total billed charges,104.64,38,,,percent of total billed charges,38% of total billed charges,104.64,38,,,percent of total billed charges,38% of total billed charges,234.06,85,,,percent of total billed charges,85% of total billed charges,104.64,38,,,percent of total billed charges,38% of total billed charges,224.14,81.4,,,percent of total billed charges,81.4% of total billed charges,247.82,90,,,percent of total billed charges,90% of total billed charges,247.82,90,,,percent of total billed charges,90% of total billed charges,104.64,38,,,percent of total billed charges,38% of total billed charges,104.64,38,,,percent of total billed charges,38% of total billed charges,104.64,38,,,percent of total billed charges,38% of total billed charges,206.52,75,,,percent of total billed charges,75% of total billed charges,234.06,85,,,percent of total billed charges,85% of total billed charges,104.64,256.08,
"(RES) LYME DISEASE AB (IgG), BLOT",2210,CDM,300,RC,86617,HCPCS,outpatient,,,119.65,89.74,,107.69,90,,,percent of total billed charges,90% of total billed charges,111.27,93,,,percent of total billed charges,93% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,101.7,85,,,percent of total billed charges,85% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,97.4,81.4,,,percent of total billed charges,81.4% of total billed charges,107.69,90,,,percent of total billed charges,90% of total billed charges,107.69,90,,,percent of total billed charges,90% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,89.74,75,,,percent of total billed charges,75% of total billed charges,101.7,85,,,percent of total billed charges,85% of total billed charges,45.47,111.27,
"(RES) LYME DISEASE AB (IgM), BLOT",2211,CDM,300,RC,86617,HCPCS,outpatient,,,119.65,89.74,,107.69,90,,,percent of total billed charges,90% of total billed charges,111.27,93,,,percent of total billed charges,93% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,101.7,85,,,percent of total billed charges,85% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,97.4,81.4,,,percent of total billed charges,81.4% of total billed charges,107.69,90,,,percent of total billed charges,90% of total billed charges,107.69,90,,,percent of total billed charges,90% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,45.47,38,,,percent of total billed charges,38% of total billed charges,89.74,75,,,percent of total billed charges,75% of total billed charges,101.7,85,,,percent of total billed charges,85% of total billed charges,45.47,111.27,
"LYME DISEASE AB w Rflx Blot (IgG, IgM)",2212,CDM,300,RC,86618,HCPCS,outpatient,,,198.74,149.06,,178.87,90,,,percent of total billed charges,90% of total billed charges,184.83,93,,,percent of total billed charges,93% of total billed charges,75.52,38,,,percent of total billed charges,38% of total billed charges,75.52,38,,,percent of total billed charges,38% of total billed charges,168.93,85,,,percent of total billed charges,85% of total billed charges,75.52,38,,,percent of total billed charges,38% of total billed charges,161.77,81.4,,,percent of total billed charges,81.4% of total billed charges,178.87,90,,,percent of total billed charges,90% of total billed charges,178.87,90,,,percent of total billed charges,90% of total billed charges,75.52,38,,,percent of total billed charges,38% of total billed charges,75.52,38,,,percent of total billed charges,38% of total billed charges,75.52,38,,,percent of total billed charges,38% of total billed charges,149.06,75,,,percent of total billed charges,75% of total billed charges,168.93,85,,,percent of total billed charges,85% of total billed charges,75.52,184.83,
"(RES) Tick, Lyme AB Screen",2213,CDM,300,RC,86618,HCPCS,outpatient,,,126.08,94.56,,113.47,90,,,percent of total billed charges,90% of total billed charges,117.25,93,,,percent of total billed charges,93% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,102.63,81.4,,,percent of total billed charges,81.4% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,94.56,75,,,percent of total billed charges,75% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,117.25,
(RES) LYME AB SCREEN,2214,CDM,300,RC,86618,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BRUCELLA IGG,2215,CDM,300,RC,86622,HCPCS,outpatient,,,81.6,61.2,,73.44,90,,,percent of total billed charges,90% of total billed charges,75.89,93,,,percent of total billed charges,93% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,66.42,81.4,,,percent of total billed charges,81.4% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,61.2,75,,,percent of total billed charges,75% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,75.89,
(RES) BRUCELLA IGM,2216,CDM,300,RC,86622,HCPCS,outpatient,,,81.6,61.2,,73.44,90,,,percent of total billed charges,90% of total billed charges,75.89,93,,,percent of total billed charges,93% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,66.42,81.4,,,percent of total billed charges,81.4% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,61.2,75,,,percent of total billed charges,75% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,75.89,
"(RES) CANDIDA ANTIBODY, IMMUNODIFFUSION",2217,CDM,300,RC,86628,HCPCS,outpatient,,,86.29,64.72,,77.66,90,,,percent of total billed charges,90% of total billed charges,80.25,93,,,percent of total billed charges,93% of total billed charges,32.79,38,,,percent of total billed charges,38% of total billed charges,32.79,38,,,percent of total billed charges,38% of total billed charges,73.35,85,,,percent of total billed charges,85% of total billed charges,32.79,38,,,percent of total billed charges,38% of total billed charges,70.24,81.4,,,percent of total billed charges,81.4% of total billed charges,77.66,90,,,percent of total billed charges,90% of total billed charges,77.66,90,,,percent of total billed charges,90% of total billed charges,32.79,38,,,percent of total billed charges,38% of total billed charges,32.79,38,,,percent of total billed charges,38% of total billed charges,32.79,38,,,percent of total billed charges,38% of total billed charges,64.72,75,,,percent of total billed charges,75% of total billed charges,73.35,85,,,percent of total billed charges,85% of total billed charges,32.79,80.25,
"Candida albicans AB (IgA, IgG, IgM)",2218,CDM,300,RC,86628,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) C. albicans IgG,2219,CDM,300,RC,86628,HCPCS,outpatient,,,67.11,50.33,,60.4,90,,,percent of total billed charges,90% of total billed charges,62.41,93,,,percent of total billed charges,93% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,54.63,81.4,,,percent of total billed charges,81.4% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,50.33,75,,,percent of total billed charges,75% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,62.41,
(RES) C. albicans IgA,2220,CDM,300,RC,86628,HCPCS,outpatient,,,67.11,50.33,,60.4,90,,,percent of total billed charges,90% of total billed charges,62.41,93,,,percent of total billed charges,93% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,54.63,81.4,,,percent of total billed charges,81.4% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,50.33,75,,,percent of total billed charges,75% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,62.41,
(RES) C. albicans IgM,2221,CDM,300,RC,86628,HCPCS,outpatient,,,67.11,50.33,,60.4,90,,,percent of total billed charges,90% of total billed charges,62.41,93,,,percent of total billed charges,93% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,54.63,81.4,,,percent of total billed charges,81.4% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,60.4,90,,,percent of total billed charges,90% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,25.5,38,,,percent of total billed charges,38% of total billed charges,50.33,75,,,percent of total billed charges,75% of total billed charges,57.04,85,,,percent of total billed charges,85% of total billed charges,25.5,62.41,
(RES) AB TO F ANTIGEN (IgG),2222,CDM,300,RC,86635,HCPCS,outpatient,,,64.96,48.72,,58.46,90,,,percent of total billed charges,90% of total billed charges,60.41,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.22,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.88,81.4,,,percent of total billed charges,81.4% of total billed charges,58.46,90,,,percent of total billed charges,90% of total billed charges,58.46,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.72,75,,,percent of total billed charges,75% of total billed charges,55.22,85,,,percent of total billed charges,85% of total billed charges,24.68,60.41,
(RES) AB TO TP ANTIGEN (IgM),2223,CDM,300,RC,86635,HCPCS,outpatient,,,64.96,48.72,,58.46,90,,,percent of total billed charges,90% of total billed charges,60.41,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.22,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.88,81.4,,,percent of total billed charges,81.4% of total billed charges,58.46,90,,,percent of total billed charges,90% of total billed charges,58.46,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.72,75,,,percent of total billed charges,75% of total billed charges,55.22,85,,,percent of total billed charges,85% of total billed charges,24.68,60.41,
(RES) CF TITER,2224,CDM,300,RC,86635,HCPCS,outpatient,,,88.77,66.58,,79.89,90,,,percent of total billed charges,90% of total billed charges,82.56,93,,,percent of total billed charges,93% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,75.45,85,,,percent of total billed charges,85% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,72.26,81.4,,,percent of total billed charges,81.4% of total billed charges,79.89,90,,,percent of total billed charges,90% of total billed charges,79.89,90,,,percent of total billed charges,90% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,66.58,75,,,percent of total billed charges,75% of total billed charges,75.45,85,,,percent of total billed charges,85% of total billed charges,33.73,82.56,
Coccidio Antibody Complement Fixation,2225,CDM,300,RC,86635,HCPCS,outpatient,,,102.24,76.68,,92.02,90,,,percent of total billed charges,90% of total billed charges,95.08,93,,,percent of total billed charges,93% of total billed charges,38.85,38,,,percent of total billed charges,38% of total billed charges,38.85,38,,,percent of total billed charges,38% of total billed charges,86.9,85,,,percent of total billed charges,85% of total billed charges,38.85,38,,,percent of total billed charges,38% of total billed charges,83.22,81.4,,,percent of total billed charges,81.4% of total billed charges,92.02,90,,,percent of total billed charges,90% of total billed charges,92.02,90,,,percent of total billed charges,90% of total billed charges,38.85,38,,,percent of total billed charges,38% of total billed charges,38.85,38,,,percent of total billed charges,38% of total billed charges,38.85,38,,,percent of total billed charges,38% of total billed charges,76.68,75,,,percent of total billed charges,75% of total billed charges,86.9,85,,,percent of total billed charges,85% of total billed charges,38.85,95.08,
Coccidio Antibody Immunodiffusion,2226,CDM,300,RC,86635,HCPCS,outpatient,,,89.6,67.2,,80.64,90,,,percent of total billed charges,90% of total billed charges,83.33,93,,,percent of total billed charges,93% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,76.16,85,,,percent of total billed charges,85% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,72.93,81.4,,,percent of total billed charges,81.4% of total billed charges,80.64,90,,,percent of total billed charges,90% of total billed charges,80.64,90,,,percent of total billed charges,90% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,34.05,38,,,percent of total billed charges,38% of total billed charges,67.2,75,,,percent of total billed charges,75% of total billed charges,76.16,85,,,percent of total billed charges,85% of total billed charges,34.05,83.33,
"(RES) COCCIDIOIDES AB (IGG), IMMUNODIFFUSION",2227,CDM,300,RC,86635,HCPCS,outpatient,,,97.28,72.96,,87.55,90,,,percent of total billed charges,90% of total billed charges,90.47,93,,,percent of total billed charges,93% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,82.69,85,,,percent of total billed charges,85% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,79.19,81.4,,,percent of total billed charges,81.4% of total billed charges,87.55,90,,,percent of total billed charges,90% of total billed charges,87.55,90,,,percent of total billed charges,90% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,72.96,75,,,percent of total billed charges,75% of total billed charges,82.69,85,,,percent of total billed charges,85% of total billed charges,36.97,90.47,
"Coccidioides AB (IgG), Immuno, CSF",2228,CDM,300,RC,86635,HCPCS,outpatient,,,108.83,81.62,,97.95,90,,,percent of total billed charges,90% of total billed charges,101.21,93,,,percent of total billed charges,93% of total billed charges,41.36,38,,,percent of total billed charges,38% of total billed charges,41.36,38,,,percent of total billed charges,38% of total billed charges,92.51,85,,,percent of total billed charges,85% of total billed charges,41.36,38,,,percent of total billed charges,38% of total billed charges,88.59,81.4,,,percent of total billed charges,81.4% of total billed charges,97.95,90,,,percent of total billed charges,90% of total billed charges,97.95,90,,,percent of total billed charges,90% of total billed charges,41.36,38,,,percent of total billed charges,38% of total billed charges,41.36,38,,,percent of total billed charges,38% of total billed charges,41.36,38,,,percent of total billed charges,38% of total billed charges,81.62,75,,,percent of total billed charges,75% of total billed charges,92.51,85,,,percent of total billed charges,85% of total billed charges,41.36,101.21,
"Coccidioides AB, Complement Fix. Serum",2229,CDM,300,RC,86635,HCPCS,outpatient,,,87.33,65.5,,78.6,90,,,percent of total billed charges,90% of total billed charges,81.22,93,,,percent of total billed charges,93% of total billed charges,33.19,38,,,percent of total billed charges,38% of total billed charges,33.19,38,,,percent of total billed charges,38% of total billed charges,74.23,85,,,percent of total billed charges,85% of total billed charges,33.19,38,,,percent of total billed charges,38% of total billed charges,71.09,81.4,,,percent of total billed charges,81.4% of total billed charges,78.6,90,,,percent of total billed charges,90% of total billed charges,78.6,90,,,percent of total billed charges,90% of total billed charges,33.19,38,,,percent of total billed charges,38% of total billed charges,33.19,38,,,percent of total billed charges,38% of total billed charges,33.19,38,,,percent of total billed charges,38% of total billed charges,65.5,75,,,percent of total billed charges,75% of total billed charges,74.23,85,,,percent of total billed charges,85% of total billed charges,33.19,81.22,
(RES) Q FEVER IGG PHASE I SCR,2230,CDM,300,RC,86638,HCPCS,outpatient,,,51,38.25,,45.9,90,,,percent of total billed charges,90% of total billed charges,47.43,93,,,percent of total billed charges,93% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,41.51,81.4,,,percent of total billed charges,81.4% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,38.25,75,,,percent of total billed charges,75% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,47.43,
Q fever Phase II reflex titer,2231,CDM,300,RC,86638,HCPCS,outpatient,,,78.85,59.14,,70.97,90,,,percent of total billed charges,90% of total billed charges,73.33,93,,,percent of total billed charges,93% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,67.02,85,,,percent of total billed charges,85% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,64.18,81.4,,,percent of total billed charges,81.4% of total billed charges,70.97,90,,,percent of total billed charges,90% of total billed charges,70.97,90,,,percent of total billed charges,90% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,59.14,75,,,percent of total billed charges,75% of total billed charges,67.02,85,,,percent of total billed charges,85% of total billed charges,29.96,73.33,
(RES) Q FEVER IGG PHASE II SCR,2232,CDM,300,RC,86638,HCPCS,outpatient,,,51,38.25,,45.9,90,,,percent of total billed charges,90% of total billed charges,47.43,93,,,percent of total billed charges,93% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,41.51,81.4,,,percent of total billed charges,81.4% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,38.25,75,,,percent of total billed charges,75% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,47.43,
(RES) Q FEVER IGM PHASE I SCR,2233,CDM,300,RC,86638,HCPCS,outpatient,,,51,38.25,,45.9,90,,,percent of total billed charges,90% of total billed charges,47.43,93,,,percent of total billed charges,93% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,41.51,81.4,,,percent of total billed charges,81.4% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,38.25,75,,,percent of total billed charges,75% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,47.43,
(RES) Q FEVER IGM PHASE II SCR,2234,CDM,300,RC,86638,HCPCS,outpatient,,,51,38.25,,45.9,90,,,percent of total billed charges,90% of total billed charges,47.43,93,,,percent of total billed charges,93% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,41.51,81.4,,,percent of total billed charges,81.4% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,45.9,90,,,percent of total billed charges,90% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,19.38,38,,,percent of total billed charges,38% of total billed charges,38.25,75,,,percent of total billed charges,75% of total billed charges,43.35,85,,,percent of total billed charges,85% of total billed charges,19.38,47.43,
(RES) CYTOMEGALOVIRUS ANTIBODY (IGG),2235,CDM,300,RC,86644,HCPCS,outpatient,,,137.85,103.39,,124.07,90,,,percent of total billed charges,90% of total billed charges,128.2,93,,,percent of total billed charges,93% of total billed charges,52.38,38,,,percent of total billed charges,38% of total billed charges,52.38,38,,,percent of total billed charges,38% of total billed charges,117.17,85,,,percent of total billed charges,85% of total billed charges,52.38,38,,,percent of total billed charges,38% of total billed charges,112.21,81.4,,,percent of total billed charges,81.4% of total billed charges,124.07,90,,,percent of total billed charges,90% of total billed charges,124.07,90,,,percent of total billed charges,90% of total billed charges,52.38,38,,,percent of total billed charges,38% of total billed charges,52.38,38,,,percent of total billed charges,38% of total billed charges,52.38,38,,,percent of total billed charges,38% of total billed charges,103.39,75,,,percent of total billed charges,75% of total billed charges,117.17,85,,,percent of total billed charges,85% of total billed charges,52.38,128.2,
(RES) CYTOMEGALOVIRUS ANTIBODY (IGM),2236,CDM,300,RC,86645,HCPCS,outpatient,,,140.14,105.11,,126.13,90,,,percent of total billed charges,90% of total billed charges,130.33,93,,,percent of total billed charges,93% of total billed charges,53.25,38,,,percent of total billed charges,38% of total billed charges,53.25,38,,,percent of total billed charges,38% of total billed charges,119.12,85,,,percent of total billed charges,85% of total billed charges,53.25,38,,,percent of total billed charges,38% of total billed charges,114.07,81.4,,,percent of total billed charges,81.4% of total billed charges,126.13,90,,,percent of total billed charges,90% of total billed charges,126.13,90,,,percent of total billed charges,90% of total billed charges,53.25,38,,,percent of total billed charges,38% of total billed charges,53.25,38,,,percent of total billed charges,38% of total billed charges,53.25,38,,,percent of total billed charges,38% of total billed charges,105.11,75,,,percent of total billed charges,75% of total billed charges,119.12,85,,,percent of total billed charges,85% of total billed charges,53.25,130.33,
Cytomegalovirus AB IgM,2237,CDM,300,RC,86645,HCPCS,outpatient,,,133.7,100.28,,120.33,90,,,percent of total billed charges,90% of total billed charges,124.34,93,,,percent of total billed charges,93% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,113.65,85,,,percent of total billed charges,85% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,108.83,81.4,,,percent of total billed charges,81.4% of total billed charges,120.33,90,,,percent of total billed charges,90% of total billed charges,120.33,90,,,percent of total billed charges,90% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,50.81,38,,,percent of total billed charges,38% of total billed charges,100.28,75,,,percent of total billed charges,75% of total billed charges,113.65,85,,,percent of total billed charges,85% of total billed charges,50.81,124.34,
Diphteria,2238,CDM,300,RC,86648,HCPCS,outpatient,,,149.98,112.49,,134.98,90,,,percent of total billed charges,90% of total billed charges,139.48,93,,,percent of total billed charges,93% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,127.48,85,,,percent of total billed charges,85% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,122.08,81.4,,,percent of total billed charges,81.4% of total billed charges,134.98,90,,,percent of total billed charges,90% of total billed charges,134.98,90,,,percent of total billed charges,90% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,56.99,38,,,percent of total billed charges,38% of total billed charges,112.49,75,,,percent of total billed charges,75% of total billed charges,127.48,85,,,percent of total billed charges,85% of total billed charges,56.99,139.48,
(RES) DIPHTHERIA ANTITOXOID,2239,CDM,300,RC,86648,HCPCS,outpatient,,,156.96,117.72,,141.26,90,,,percent of total billed charges,90% of total billed charges,145.97,93,,,percent of total billed charges,93% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,127.77,81.4,,,percent of total billed charges,81.4% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,117.72,75,,,percent of total billed charges,75% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,145.97,
Meningoencephalitis Comprehensive Panel CSF,2240,CDM,300,RC,86658,HCPCS,outpatient,,,4262.55,3196.91,,3836.3,90,,,percent of total billed charges,90% of total billed charges,3964.17,93,,,percent of total billed charges,93% of total billed charges,1619.77,38,,,percent of total billed charges,38% of total billed charges,1619.77,38,,,percent of total billed charges,38% of total billed charges,3623.17,85,,,percent of total billed charges,85% of total billed charges,1619.77,38,,,percent of total billed charges,38% of total billed charges,3469.72,81.4,,,percent of total billed charges,81.4% of total billed charges,3836.3,90,,,percent of total billed charges,90% of total billed charges,3836.3,90,,,percent of total billed charges,90% of total billed charges,1619.77,38,,,percent of total billed charges,38% of total billed charges,1619.77,38,,,percent of total billed charges,38% of total billed charges,1619.77,38,,,percent of total billed charges,38% of total billed charges,3196.91,75,,,percent of total billed charges,75% of total billed charges,3623.17,85,,,percent of total billed charges,85% of total billed charges,1619.77,3964.17,
(RES) COXSACKIE A2 AB,2241,CDM,300,RC,86658,HCPCS,outpatient,,,39.88,29.91,,35.89,90,,,percent of total billed charges,90% of total billed charges,37.09,93,,,percent of total billed charges,93% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,32.46,81.4,,,percent of total billed charges,81.4% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,29.91,75,,,percent of total billed charges,75% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,37.09,
(RES) COXSACKIE A4 AB,2242,CDM,300,RC,86658,HCPCS,outpatient,,,39.88,29.91,,35.89,90,,,percent of total billed charges,90% of total billed charges,37.09,93,,,percent of total billed charges,93% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,32.46,81.4,,,percent of total billed charges,81.4% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,29.91,75,,,percent of total billed charges,75% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,37.09,
(RES) COXSACKIE A7 AB,2243,CDM,300,RC,86658,HCPCS,outpatient,,,39.88,29.91,,35.89,90,,,percent of total billed charges,90% of total billed charges,37.09,93,,,percent of total billed charges,93% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,32.46,81.4,,,percent of total billed charges,81.4% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,29.91,75,,,percent of total billed charges,75% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,37.09,
(RES) COXSACKIE A9 AB,2244,CDM,300,RC,86658,HCPCS,outpatient,,,39.88,29.91,,35.89,90,,,percent of total billed charges,90% of total billed charges,37.09,93,,,percent of total billed charges,93% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,32.46,81.4,,,percent of total billed charges,81.4% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,29.91,75,,,percent of total billed charges,75% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,37.09,
(RES) COXSACKIE A10 AB,2245,CDM,300,RC,86658,HCPCS,outpatient,,,39.88,29.91,,35.89,90,,,percent of total billed charges,90% of total billed charges,37.09,93,,,percent of total billed charges,93% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,32.46,81.4,,,percent of total billed charges,81.4% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,29.91,75,,,percent of total billed charges,75% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,37.09,
(RES) COXSACKIE A16 AB,2246,CDM,300,RC,86658,HCPCS,outpatient,,,39.88,29.91,,35.89,90,,,percent of total billed charges,90% of total billed charges,37.09,93,,,percent of total billed charges,93% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,32.46,81.4,,,percent of total billed charges,81.4% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,35.89,90,,,percent of total billed charges,90% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,15.15,38,,,percent of total billed charges,38% of total billed charges,29.91,75,,,percent of total billed charges,75% of total billed charges,33.9,85,,,percent of total billed charges,85% of total billed charges,15.15,37.09,
EBV Early AG IGG,2247,CDM,300,RC,86663,HCPCS,outpatient,,,147.63,110.72,,132.87,90,,,percent of total billed charges,90% of total billed charges,137.3,93,,,percent of total billed charges,93% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,125.49,85,,,percent of total billed charges,85% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,120.17,81.4,,,percent of total billed charges,81.4% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,110.72,75,,,percent of total billed charges,75% of total billed charges,125.49,85,,,percent of total billed charges,85% of total billed charges,56.1,137.3,
"EBV Nuclear Antigen AG/AB, IgG",2248,CDM,300,RC,86664,HCPCS,outpatient,,,129.91,97.43,,116.92,90,,,percent of total billed charges,90% of total billed charges,120.82,93,,,percent of total billed charges,93% of total billed charges,49.37,38,,,percent of total billed charges,38% of total billed charges,49.37,38,,,percent of total billed charges,38% of total billed charges,110.42,85,,,percent of total billed charges,85% of total billed charges,49.37,38,,,percent of total billed charges,38% of total billed charges,105.75,81.4,,,percent of total billed charges,81.4% of total billed charges,116.92,90,,,percent of total billed charges,90% of total billed charges,116.92,90,,,percent of total billed charges,90% of total billed charges,49.37,38,,,percent of total billed charges,38% of total billed charges,49.37,38,,,percent of total billed charges,38% of total billed charges,49.37,38,,,percent of total billed charges,38% of total billed charges,97.43,75,,,percent of total billed charges,75% of total billed charges,110.42,85,,,percent of total billed charges,85% of total billed charges,49.37,120.82,
(RES) EBV VIRAL CAPSID AG (VCA) AB (IGM),2249,CDM,300,RC,86664,HCPCS,outpatient,,,133.6,100.2,,120.24,90,,,percent of total billed charges,90% of total billed charges,124.25,93,,,percent of total billed charges,93% of total billed charges,50.77,38,,,percent of total billed charges,38% of total billed charges,50.77,38,,,percent of total billed charges,38% of total billed charges,113.56,85,,,percent of total billed charges,85% of total billed charges,50.77,38,,,percent of total billed charges,38% of total billed charges,108.75,81.4,,,percent of total billed charges,81.4% of total billed charges,120.24,90,,,percent of total billed charges,90% of total billed charges,120.24,90,,,percent of total billed charges,90% of total billed charges,50.77,38,,,percent of total billed charges,38% of total billed charges,50.77,38,,,percent of total billed charges,38% of total billed charges,50.77,38,,,percent of total billed charges,38% of total billed charges,100.2,75,,,percent of total billed charges,75% of total billed charges,113.56,85,,,percent of total billed charges,85% of total billed charges,50.77,124.25,
Epstein Barr viral capsid AG/AB IgM,2250,CDM,300,RC,86665,HCPCS,outpatient,,,136.9,102.68,,123.21,90,,,percent of total billed charges,90% of total billed charges,127.32,93,,,percent of total billed charges,93% of total billed charges,52.02,38,,,percent of total billed charges,38% of total billed charges,52.02,38,,,percent of total billed charges,38% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,52.02,38,,,percent of total billed charges,38% of total billed charges,111.44,81.4,,,percent of total billed charges,81.4% of total billed charges,123.21,90,,,percent of total billed charges,90% of total billed charges,123.21,90,,,percent of total billed charges,90% of total billed charges,52.02,38,,,percent of total billed charges,38% of total billed charges,52.02,38,,,percent of total billed charges,38% of total billed charges,52.02,38,,,percent of total billed charges,38% of total billed charges,102.68,75,,,percent of total billed charges,75% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,52.02,127.32,
(RES) EBV NUCLEAR AG (EBNA) AB (IGG),2251,CDM,300,RC,86665,HCPCS,outpatient,,,149.05,111.79,,134.15,90,,,percent of total billed charges,90% of total billed charges,138.62,93,,,percent of total billed charges,93% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,126.69,85,,,percent of total billed charges,85% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,121.33,81.4,,,percent of total billed charges,81.4% of total billed charges,134.15,90,,,percent of total billed charges,90% of total billed charges,134.15,90,,,percent of total billed charges,90% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,111.79,75,,,percent of total billed charges,75% of total billed charges,126.69,85,,,percent of total billed charges,85% of total billed charges,56.64,138.62,
(RES) EBV VIRAL CAPSID AG (VCA) AB (IGG),2252,CDM,300,RC,86665,HCPCS,outpatient,,,149.05,111.79,,134.15,90,,,percent of total billed charges,90% of total billed charges,138.62,93,,,percent of total billed charges,93% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,126.69,85,,,percent of total billed charges,85% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,121.33,81.4,,,percent of total billed charges,81.4% of total billed charges,134.15,90,,,percent of total billed charges,90% of total billed charges,134.15,90,,,percent of total billed charges,90% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,56.64,38,,,percent of total billed charges,38% of total billed charges,111.79,75,,,percent of total billed charges,75% of total billed charges,126.69,85,,,percent of total billed charges,85% of total billed charges,56.64,138.62,
Profile - Ehrlichia AB (IgG),2253,CDM,300,RC,86666,HCPCS,outpatient,,,121.44,91.08,,109.3,90,,,percent of total billed charges,90% of total billed charges,112.94,93,,,percent of total billed charges,93% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,103.22,85,,,percent of total billed charges,85% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,98.85,81.4,,,percent of total billed charges,81.4% of total billed charges,109.3,90,,,percent of total billed charges,90% of total billed charges,109.3,90,,,percent of total billed charges,90% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,46.15,38,,,percent of total billed charges,38% of total billed charges,91.08,75,,,percent of total billed charges,75% of total billed charges,103.22,85,,,percent of total billed charges,85% of total billed charges,46.15,112.94,
"(RES) Tick, E. Chaffeensis AB (IgM)",2254,CDM,300,RC,86666,HCPCS,outpatient,,,126.08,94.56,,113.47,90,,,percent of total billed charges,90% of total billed charges,117.25,93,,,percent of total billed charges,93% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,102.63,81.4,,,percent of total billed charges,81.4% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,94.56,75,,,percent of total billed charges,75% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,117.25,
(RES) E. CHAFFEENSIS AB IGG,2255,CDM,300,RC,86666,HCPCS,outpatient,,,76.5,57.38,,68.85,90,,,percent of total billed charges,90% of total billed charges,71.15,93,,,percent of total billed charges,93% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,65.03,85,,,percent of total billed charges,85% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,62.27,81.4,,,percent of total billed charges,81.4% of total billed charges,68.85,90,,,percent of total billed charges,90% of total billed charges,68.85,90,,,percent of total billed charges,90% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,57.38,75,,,percent of total billed charges,75% of total billed charges,65.03,85,,,percent of total billed charges,85% of total billed charges,29.07,71.15,
(RES) E. CHAFFEENSIS AB IGM,2256,CDM,300,RC,86666,HCPCS,outpatient,,,76.5,57.38,,68.85,90,,,percent of total billed charges,90% of total billed charges,71.15,93,,,percent of total billed charges,93% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,65.03,85,,,percent of total billed charges,85% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,62.27,81.4,,,percent of total billed charges,81.4% of total billed charges,68.85,90,,,percent of total billed charges,90% of total billed charges,68.85,90,,,percent of total billed charges,90% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,57.38,75,,,percent of total billed charges,75% of total billed charges,65.03,85,,,percent of total billed charges,85% of total billed charges,29.07,71.15,
Profile - Ehrlichia AB (IgM),2257,CDM,300,RC,86666,HCPCS,outpatient,,,138.01,103.51,,124.21,90,,,percent of total billed charges,90% of total billed charges,128.35,93,,,percent of total billed charges,93% of total billed charges,52.44,38,,,percent of total billed charges,38% of total billed charges,52.44,38,,,percent of total billed charges,38% of total billed charges,117.31,85,,,percent of total billed charges,85% of total billed charges,52.44,38,,,percent of total billed charges,38% of total billed charges,112.34,81.4,,,percent of total billed charges,81.4% of total billed charges,124.21,90,,,percent of total billed charges,90% of total billed charges,124.21,90,,,percent of total billed charges,90% of total billed charges,52.44,38,,,percent of total billed charges,38% of total billed charges,52.44,38,,,percent of total billed charges,38% of total billed charges,52.44,38,,,percent of total billed charges,38% of total billed charges,103.51,75,,,percent of total billed charges,75% of total billed charges,117.31,85,,,percent of total billed charges,85% of total billed charges,52.44,128.35,
(Result) Ehrlichia AB Interpretation,2258,CDM,300,RC,86666,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) Tick, A. Phagocytophilum AB (IgG)",2259,CDM,300,RC,86666,HCPCS,outpatient,,,126.08,94.56,,113.47,90,,,percent of total billed charges,90% of total billed charges,117.25,93,,,percent of total billed charges,93% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,102.63,81.4,,,percent of total billed charges,81.4% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,94.56,75,,,percent of total billed charges,75% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,117.25,
"(RES) Tick, A. Phagocytophilum AB (IgM)",2260,CDM,300,RC,86666,HCPCS,outpatient,,,126.08,94.56,,113.47,90,,,percent of total billed charges,90% of total billed charges,117.25,93,,,percent of total billed charges,93% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,102.63,81.4,,,percent of total billed charges,81.4% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,94.56,75,,,percent of total billed charges,75% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,117.25,
"(RES) Tick, E. Chaffeensis AB (IgG)",2261,CDM,300,RC,86666,HCPCS,outpatient,,,126.08,94.56,,113.47,90,,,percent of total billed charges,90% of total billed charges,117.25,93,,,percent of total billed charges,93% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,102.63,81.4,,,percent of total billed charges,81.4% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,94.56,75,,,percent of total billed charges,75% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,117.25,
H. Pylori in-house,2262,CDM,300,RC,86677,HCPCS,outpatient,,,165.21,123.91,,148.69,90,,,percent of total billed charges,90% of total billed charges,153.65,93,,,percent of total billed charges,93% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,134.48,81.4,,,percent of total billed charges,81.4% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,123.91,75,,,percent of total billed charges,75% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,153.65,
Clinic- H.pylori,2263,CDM,300,RC,86677,HCPCS,outpatient,,,165.21,123.91,,148.69,90,,,percent of total billed charges,90% of total billed charges,153.65,93,,,percent of total billed charges,93% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,134.48,81.4,,,percent of total billed charges,81.4% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,123.91,75,,,percent of total billed charges,75% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,153.65,
Helicobacter Pylori Antibodies,2264,CDM,300,RC,86677,HCPCS,outpatient,,,424.18,318.14,,381.76,90,,,percent of total billed charges,90% of total billed charges,394.49,93,,,percent of total billed charges,93% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,360.55,85,,,percent of total billed charges,85% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,345.28,81.4,,,percent of total billed charges,81.4% of total billed charges,381.76,90,,,percent of total billed charges,90% of total billed charges,381.76,90,,,percent of total billed charges,90% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,318.14,75,,,percent of total billed charges,75% of total billed charges,360.55,85,,,percent of total billed charges,85% of total billed charges,161.19,394.49,
Strongyloides  AB IGG,2265,CDM,300,RC,86682,HCPCS,outpatient,,,233.11,174.83,,209.8,90,,,percent of total billed charges,90% of total billed charges,216.79,93,,,percent of total billed charges,93% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,198.14,85,,,percent of total billed charges,85% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,189.75,81.4,,,percent of total billed charges,81.4% of total billed charges,209.8,90,,,percent of total billed charges,90% of total billed charges,209.8,90,,,percent of total billed charges,90% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,88.58,38,,,percent of total billed charges,38% of total billed charges,174.83,75,,,percent of total billed charges,75% of total billed charges,198.14,85,,,percent of total billed charges,85% of total billed charges,88.58,216.79,
Filaria AB IgG4,2266,CDM,300,RC,86682,HCPCS,outpatient,,,280.41,210.31,,252.37,90,,,percent of total billed charges,90% of total billed charges,260.78,93,,,percent of total billed charges,93% of total billed charges,106.56,38,,,percent of total billed charges,38% of total billed charges,106.56,38,,,percent of total billed charges,38% of total billed charges,238.35,85,,,percent of total billed charges,85% of total billed charges,106.56,38,,,percent of total billed charges,38% of total billed charges,228.25,81.4,,,percent of total billed charges,81.4% of total billed charges,252.37,90,,,percent of total billed charges,90% of total billed charges,252.37,90,,,percent of total billed charges,90% of total billed charges,106.56,38,,,percent of total billed charges,38% of total billed charges,106.56,38,,,percent of total billed charges,38% of total billed charges,106.56,38,,,percent of total billed charges,38% of total billed charges,210.31,75,,,percent of total billed charges,75% of total billed charges,238.35,85,,,percent of total billed charges,85% of total billed charges,106.56,260.78,
"Toxocara AB (IgG), ELISA",2267,CDM,300,RC,86682,HCPCS,outpatient,,,226.34,169.76,,203.71,90,,,percent of total billed charges,90% of total billed charges,210.5,93,,,percent of total billed charges,93% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,192.39,85,,,percent of total billed charges,85% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,184.24,81.4,,,percent of total billed charges,81.4% of total billed charges,203.71,90,,,percent of total billed charges,90% of total billed charges,203.71,90,,,percent of total billed charges,90% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,86.01,38,,,percent of total billed charges,38% of total billed charges,169.76,75,,,percent of total billed charges,75% of total billed charges,192.39,85,,,percent of total billed charges,85% of total billed charges,86.01,210.5,
Haemophilus influenzae B IgG,2268,CDM,300,RC,86684,HCPCS,outpatient,,,145.66,109.25,,131.09,90,,,percent of total billed charges,90% of total billed charges,135.46,93,,,percent of total billed charges,93% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,123.81,85,,,percent of total billed charges,85% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,118.57,81.4,,,percent of total billed charges,81.4% of total billed charges,131.09,90,,,percent of total billed charges,90% of total billed charges,131.09,90,,,percent of total billed charges,90% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,55.35,38,,,percent of total billed charges,38% of total billed charges,109.25,75,,,percent of total billed charges,75% of total billed charges,123.81,85,,,percent of total billed charges,85% of total billed charges,55.35,135.46,
"Hepatitis D Virus AB, Total",2269,CDM,300,RC,86692,HCPCS,outpatient,,,153.83,115.37,,138.45,90,,,percent of total billed charges,90% of total billed charges,143.06,93,,,percent of total billed charges,93% of total billed charges,58.46,38,,,percent of total billed charges,38% of total billed charges,58.46,38,,,percent of total billed charges,38% of total billed charges,130.76,85,,,percent of total billed charges,85% of total billed charges,58.46,38,,,percent of total billed charges,38% of total billed charges,125.22,81.4,,,percent of total billed charges,81.4% of total billed charges,138.45,90,,,percent of total billed charges,90% of total billed charges,138.45,90,,,percent of total billed charges,90% of total billed charges,58.46,38,,,percent of total billed charges,38% of total billed charges,58.46,38,,,percent of total billed charges,38% of total billed charges,58.46,38,,,percent of total billed charges,38% of total billed charges,115.37,75,,,percent of total billed charges,75% of total billed charges,130.76,85,,,percent of total billed charges,85% of total billed charges,58.46,143.06,
"Hepatitis D Virus AB, IgM, EIA",2270,CDM,300,RC,86692,HCPCS,outpatient,,,276.26,207.2,,248.63,90,,,percent of total billed charges,90% of total billed charges,256.92,93,,,percent of total billed charges,93% of total billed charges,104.98,38,,,percent of total billed charges,38% of total billed charges,104.98,38,,,percent of total billed charges,38% of total billed charges,234.82,85,,,percent of total billed charges,85% of total billed charges,104.98,38,,,percent of total billed charges,38% of total billed charges,224.88,81.4,,,percent of total billed charges,81.4% of total billed charges,248.63,90,,,percent of total billed charges,90% of total billed charges,248.63,90,,,percent of total billed charges,90% of total billed charges,104.98,38,,,percent of total billed charges,38% of total billed charges,104.98,38,,,percent of total billed charges,38% of total billed charges,104.98,38,,,percent of total billed charges,38% of total billed charges,207.2,75,,,percent of total billed charges,75% of total billed charges,234.82,85,,,percent of total billed charges,85% of total billed charges,104.98,256.92,
(Result) HSV 1 IGG,2271,CDM,300,RC,86695,HCPCS,outpatient,,,137.09,102.82,,123.38,90,,,percent of total billed charges,90% of total billed charges,127.49,93,,,percent of total billed charges,93% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,111.59,81.4,,,percent of total billed charges,81.4% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,102.82,75,,,percent of total billed charges,75% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,127.49,
"(RES) HSV 1 IGG, TYPE SPECIFIC AB",2272,CDM,300,RC,86695,HCPCS,outpatient,,,129.52,97.14,,116.57,90,,,percent of total billed charges,90% of total billed charges,120.45,93,,,percent of total billed charges,93% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,110.09,85,,,percent of total billed charges,85% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,105.43,81.4,,,percent of total billed charges,81.4% of total billed charges,116.57,90,,,percent of total billed charges,90% of total billed charges,116.57,90,,,percent of total billed charges,90% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,97.14,75,,,percent of total billed charges,75% of total billed charges,110.09,85,,,percent of total billed charges,85% of total billed charges,49.22,120.45,
HSV 1 IgM Titer,2273,CDM,300,RC,86695,HCPCS,outpatient,,,78.4,58.8,,70.56,90,,,percent of total billed charges,90% of total billed charges,72.91,93,,,percent of total billed charges,93% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,66.64,85,,,percent of total billed charges,85% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,63.82,81.4,,,percent of total billed charges,81.4% of total billed charges,70.56,90,,,percent of total billed charges,90% of total billed charges,70.56,90,,,percent of total billed charges,90% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,29.79,38,,,percent of total billed charges,38% of total billed charges,58.8,75,,,percent of total billed charges,75% of total billed charges,66.64,85,,,percent of total billed charges,85% of total billed charges,29.79,72.91,
(RES) HSV 1 IGM SCREEN,2274,CDM,300,RC,86695,HCPCS,outpatient,,,75,56.25,,67.5,90,,,percent of total billed charges,90% of total billed charges,69.75,93,,,percent of total billed charges,93% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,63.75,85,,,percent of total billed charges,85% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,61.05,81.4,,,percent of total billed charges,81.4% of total billed charges,67.5,90,,,percent of total billed charges,90% of total billed charges,67.5,90,,,percent of total billed charges,90% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,56.25,75,,,percent of total billed charges,75% of total billed charges,63.75,85,,,percent of total billed charges,85% of total billed charges,28.5,69.75,
(RES) HSV 1 IGM,2275,CDM,300,RC,86695,HCPCS,outpatient,,,75,56.25,,67.5,90,,,percent of total billed charges,90% of total billed charges,69.75,93,,,percent of total billed charges,93% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,63.75,85,,,percent of total billed charges,85% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,61.05,81.4,,,percent of total billed charges,81.4% of total billed charges,67.5,90,,,percent of total billed charges,90% of total billed charges,67.5,90,,,percent of total billed charges,90% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,28.5,38,,,percent of total billed charges,38% of total billed charges,56.25,75,,,percent of total billed charges,75% of total billed charges,63.75,85,,,percent of total billed charges,85% of total billed charges,28.5,69.75,
"(RES) HSV 2 IgG Inhibition, IA",2276,CDM,300,RC,86696,HCPCS,outpatient,,,354.53,265.9,,319.08,90,,,percent of total billed charges,90% of total billed charges,329.71,93,,,percent of total billed charges,93% of total billed charges,134.72,38,,,percent of total billed charges,38% of total billed charges,134.72,38,,,percent of total billed charges,38% of total billed charges,301.35,85,,,percent of total billed charges,85% of total billed charges,134.72,38,,,percent of total billed charges,38% of total billed charges,288.59,81.4,,,percent of total billed charges,81.4% of total billed charges,319.08,90,,,percent of total billed charges,90% of total billed charges,319.08,90,,,percent of total billed charges,90% of total billed charges,134.72,38,,,percent of total billed charges,38% of total billed charges,134.72,38,,,percent of total billed charges,38% of total billed charges,134.72,38,,,percent of total billed charges,38% of total billed charges,265.9,75,,,percent of total billed charges,75% of total billed charges,301.35,85,,,percent of total billed charges,85% of total billed charges,134.72,329.71,
"(RES) HSV 2 IGG, TYPE SPECIFIC AB",2277,CDM,300,RC,86696,HCPCS,outpatient,,,129.52,97.14,,116.57,90,,,percent of total billed charges,90% of total billed charges,120.45,93,,,percent of total billed charges,93% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,110.09,85,,,percent of total billed charges,85% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,105.43,81.4,,,percent of total billed charges,81.4% of total billed charges,116.57,90,,,percent of total billed charges,90% of total billed charges,116.57,90,,,percent of total billed charges,90% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,49.22,38,,,percent of total billed charges,38% of total billed charges,97.14,75,,,percent of total billed charges,75% of total billed charges,110.09,85,,,percent of total billed charges,85% of total billed charges,49.22,120.45,
(RES) HSV 2 IGM,2278,CDM,300,RC,86696,HCPCS,outpatient,,,125.38,94.04,,112.84,90,,,percent of total billed charges,90% of total billed charges,116.6,93,,,percent of total billed charges,93% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,102.06,81.4,,,percent of total billed charges,81.4% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,94.04,75,,,percent of total billed charges,75% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,116.6,
HSV 2 IgG inhibition,2279,CDM,300,RC,86696,HCPCS,outpatient,,,391.9,293.93,,352.71,90,,,percent of total billed charges,90% of total billed charges,364.47,93,,,percent of total billed charges,93% of total billed charges,148.92,38,,,percent of total billed charges,38% of total billed charges,148.92,38,,,percent of total billed charges,38% of total billed charges,333.12,85,,,percent of total billed charges,85% of total billed charges,148.92,38,,,percent of total billed charges,38% of total billed charges,319.01,81.4,,,percent of total billed charges,81.4% of total billed charges,352.71,90,,,percent of total billed charges,90% of total billed charges,352.71,90,,,percent of total billed charges,90% of total billed charges,148.92,38,,,percent of total billed charges,38% of total billed charges,148.92,38,,,percent of total billed charges,38% of total billed charges,148.92,38,,,percent of total billed charges,38% of total billed charges,293.93,75,,,percent of total billed charges,75% of total billed charges,333.12,85,,,percent of total billed charges,85% of total billed charges,148.92,364.47,
(RES) HSV 2 IGM SCREEN,2280,CDM,300,RC,86696,HCPCS,outpatient,,,125.38,94.04,,112.84,90,,,percent of total billed charges,90% of total billed charges,116.6,93,,,percent of total billed charges,93% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,102.06,81.4,,,percent of total billed charges,81.4% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,94.04,75,,,percent of total billed charges,75% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,116.6,
(Result) HSV 2 IGG,2281,CDM,300,RC,86696,HCPCS,outpatient,,,137.09,102.82,,123.38,90,,,percent of total billed charges,90% of total billed charges,127.49,93,,,percent of total billed charges,93% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,111.59,81.4,,,percent of total billed charges,81.4% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,102.82,75,,,percent of total billed charges,75% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,127.49,
(RES) H BAND,2282,CDM,300,RC,86698,HCPCS,outpatient,,,97.28,72.96,,87.55,90,,,percent of total billed charges,90% of total billed charges,90.47,93,,,percent of total billed charges,93% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,82.69,85,,,percent of total billed charges,85% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,79.19,81.4,,,percent of total billed charges,81.4% of total billed charges,87.55,90,,,percent of total billed charges,90% of total billed charges,87.55,90,,,percent of total billed charges,90% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,36.97,38,,,percent of total billed charges,38% of total billed charges,72.96,75,,,percent of total billed charges,75% of total billed charges,82.69,85,,,percent of total billed charges,85% of total billed charges,36.97,90.47,
(RES) HIV 1 ANTIBODY,2283,CDM,300,RC,86701,HCPCS,outpatient,,,97.42,73.07,,87.68,90,,,percent of total billed charges,90% of total billed charges,90.6,93,,,percent of total billed charges,93% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,82.81,85,,,percent of total billed charges,85% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,79.3,81.4,,,percent of total billed charges,81.4% of total billed charges,87.68,90,,,percent of total billed charges,90% of total billed charges,87.68,90,,,percent of total billed charges,90% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,73.07,75,,,percent of total billed charges,75% of total billed charges,82.81,85,,,percent of total billed charges,85% of total billed charges,37.02,90.6,
(RES) HIV 2 ANTIBODY,2284,CDM,300,RC,86702,HCPCS,outpatient,,,162.36,121.77,,146.12,90,,,percent of total billed charges,90% of total billed charges,150.99,93,,,percent of total billed charges,93% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,132.16,81.4,,,percent of total billed charges,81.4% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,121.77,75,,,percent of total billed charges,75% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,150.99,
HIV 1/2 AB EIA W/ REFLEXES,2285,CDM,300,RC,86703,HCPCS,outpatient,,,134.75,101.06,,121.28,90,,,percent of total billed charges,90% of total billed charges,125.32,93,,,percent of total billed charges,93% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,109.69,81.4,,,percent of total billed charges,81.4% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,101.06,75,,,percent of total billed charges,75% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,125.32,
Hepatitis B Core AB,2286,CDM,300,RC,86704,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
"Hepatitis B Core AB, Total w Rflx to IgM",2287,CDM,300,RC,86704,HCPCS,outpatient,,,104.68,78.51,,94.21,90,,,percent of total billed charges,90% of total billed charges,97.35,93,,,percent of total billed charges,93% of total billed charges,39.78,38,,,percent of total billed charges,38% of total billed charges,39.78,38,,,percent of total billed charges,38% of total billed charges,88.98,85,,,percent of total billed charges,85% of total billed charges,39.78,38,,,percent of total billed charges,38% of total billed charges,85.21,81.4,,,percent of total billed charges,81.4% of total billed charges,94.21,90,,,percent of total billed charges,90% of total billed charges,94.21,90,,,percent of total billed charges,90% of total billed charges,39.78,38,,,percent of total billed charges,38% of total billed charges,39.78,38,,,percent of total billed charges,38% of total billed charges,39.78,38,,,percent of total billed charges,38% of total billed charges,78.51,75,,,percent of total billed charges,75% of total billed charges,88.98,85,,,percent of total billed charges,85% of total billed charges,39.78,97.35,
Hepatitis B Core AB (IGM),2288,CDM,300,RC,86705,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,150.39,
HEP B SURFACE AB QUALITATIVE,2289,CDM,300,RC,86706,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Hepatitis BeAB,2290,CDM,300,RC,86707,HCPCS,outpatient,,,111.49,83.62,,100.34,90,,,percent of total billed charges,90% of total billed charges,103.69,93,,,percent of total billed charges,93% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,90.75,81.4,,,percent of total billed charges,81.4% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,83.62,75,,,percent of total billed charges,75% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,103.69,
"Hepatitis A AB, Total",2291,CDM,300,RC,86708,HCPCS,outpatient,,,125.38,94.04,,112.84,90,,,percent of total billed charges,90% of total billed charges,116.6,93,,,percent of total billed charges,93% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,102.06,81.4,,,percent of total billed charges,81.4% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,94.04,75,,,percent of total billed charges,75% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,116.6,
"Hepatitis A AB, Total w Rflx to IgM",2292,CDM,300,RC,86708,HCPCS,outpatient,,,116.98,87.74,,105.28,90,,,percent of total billed charges,90% of total billed charges,108.79,93,,,percent of total billed charges,93% of total billed charges,44.45,38,,,percent of total billed charges,38% of total billed charges,44.45,38,,,percent of total billed charges,38% of total billed charges,99.43,85,,,percent of total billed charges,85% of total billed charges,44.45,38,,,percent of total billed charges,38% of total billed charges,95.22,81.4,,,percent of total billed charges,81.4% of total billed charges,105.28,90,,,percent of total billed charges,90% of total billed charges,105.28,90,,,percent of total billed charges,90% of total billed charges,44.45,38,,,percent of total billed charges,38% of total billed charges,44.45,38,,,percent of total billed charges,38% of total billed charges,44.45,38,,,percent of total billed charges,38% of total billed charges,87.74,75,,,percent of total billed charges,75% of total billed charges,99.43,85,,,percent of total billed charges,85% of total billed charges,44.45,108.79,
Hepatitis A IGM,2293,CDM,300,RC,86709,HCPCS,outpatient,,,104.95,78.71,,94.46,90,,,percent of total billed charges,90% of total billed charges,97.6,93,,,percent of total billed charges,93% of total billed charges,39.88,38,,,percent of total billed charges,38% of total billed charges,39.88,38,,,percent of total billed charges,38% of total billed charges,89.21,85,,,percent of total billed charges,85% of total billed charges,39.88,38,,,percent of total billed charges,38% of total billed charges,85.43,81.4,,,percent of total billed charges,81.4% of total billed charges,94.46,90,,,percent of total billed charges,90% of total billed charges,94.46,90,,,percent of total billed charges,90% of total billed charges,39.88,38,,,percent of total billed charges,38% of total billed charges,39.88,38,,,percent of total billed charges,38% of total billed charges,39.88,38,,,percent of total billed charges,38% of total billed charges,78.71,75,,,percent of total billed charges,75% of total billed charges,89.21,85,,,percent of total billed charges,85% of total billed charges,39.88,97.6,
Haemophilus Influenza B,2294,CDM,300,RC,86710,HCPCS,outpatient,,,127.54,95.66,,114.79,90,,,percent of total billed charges,90% of total billed charges,118.61,93,,,percent of total billed charges,93% of total billed charges,48.47,38,,,percent of total billed charges,38% of total billed charges,48.47,38,,,percent of total billed charges,38% of total billed charges,108.41,85,,,percent of total billed charges,85% of total billed charges,48.47,38,,,percent of total billed charges,38% of total billed charges,103.82,81.4,,,percent of total billed charges,81.4% of total billed charges,114.79,90,,,percent of total billed charges,90% of total billed charges,114.79,90,,,percent of total billed charges,90% of total billed charges,48.47,38,,,percent of total billed charges,38% of total billed charges,48.47,38,,,percent of total billed charges,38% of total billed charges,48.47,38,,,percent of total billed charges,38% of total billed charges,95.66,75,,,percent of total billed charges,75% of total billed charges,108.41,85,,,percent of total billed charges,85% of total billed charges,48.47,118.61,
Leptospira Antibody,2295,CDM,300,RC,86720,HCPCS,outpatient,,,114.44,85.83,,103,90,,,percent of total billed charges,90% of total billed charges,106.43,93,,,percent of total billed charges,93% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,97.27,85,,,percent of total billed charges,85% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,93.15,81.4,,,percent of total billed charges,81.4% of total billed charges,103,90,,,percent of total billed charges,90% of total billed charges,103,90,,,percent of total billed charges,90% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,43.49,38,,,percent of total billed charges,38% of total billed charges,85.83,75,,,percent of total billed charges,75% of total billed charges,97.27,85,,,percent of total billed charges,85% of total billed charges,43.49,106.43,
Mumps Virus AB(IGG),2296,CDM,300,RC,86735,HCPCS,outpatient,,,152.37,114.28,,137.13,90,,,percent of total billed charges,90% of total billed charges,141.7,93,,,percent of total billed charges,93% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,129.51,85,,,percent of total billed charges,85% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,124.03,81.4,,,percent of total billed charges,81.4% of total billed charges,137.13,90,,,percent of total billed charges,90% of total billed charges,137.13,90,,,percent of total billed charges,90% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,114.28,75,,,percent of total billed charges,75% of total billed charges,129.51,85,,,percent of total billed charges,85% of total billed charges,57.9,141.7,
Mumps Virus AB (IgM),2297,CDM,300,RC,86735,HCPCS,outpatient,,,152.37,114.28,,137.13,90,,,percent of total billed charges,90% of total billed charges,141.7,93,,,percent of total billed charges,93% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,129.51,85,,,percent of total billed charges,85% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,124.03,81.4,,,percent of total billed charges,81.4% of total billed charges,137.13,90,,,percent of total billed charges,90% of total billed charges,137.13,90,,,percent of total billed charges,90% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,57.9,38,,,percent of total billed charges,38% of total billed charges,114.28,75,,,percent of total billed charges,75% of total billed charges,129.51,85,,,percent of total billed charges,85% of total billed charges,57.9,141.7,
(RES) MUMPS VIRUS ANTIBODY (IGG),2298,CDM,300,RC,86735,HCPCS,outpatient,,,124.22,93.17,,111.8,90,,,percent of total billed charges,90% of total billed charges,115.52,93,,,percent of total billed charges,93% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,105.59,85,,,percent of total billed charges,85% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,101.12,81.4,,,percent of total billed charges,81.4% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,93.17,75,,,percent of total billed charges,75% of total billed charges,105.59,85,,,percent of total billed charges,85% of total billed charges,47.2,115.52,
(RES) PARVOVIRUS B19 ANTIBODY (IGG),2299,CDM,300,RC,86747,HCPCS,outpatient,,,105.56,79.17,,95,90,,,percent of total billed charges,90% of total billed charges,98.17,93,,,percent of total billed charges,93% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,89.73,85,,,percent of total billed charges,85% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,85.93,81.4,,,percent of total billed charges,81.4% of total billed charges,95,90,,,percent of total billed charges,90% of total billed charges,95,90,,,percent of total billed charges,90% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,79.17,75,,,percent of total billed charges,75% of total billed charges,89.73,85,,,percent of total billed charges,85% of total billed charges,40.11,98.17,
(RES) PARVOVIRUS B19 ANTIBODY (IGM),2300,CDM,300,RC,86747,HCPCS,outpatient,,,105.56,79.17,,95,90,,,percent of total billed charges,90% of total billed charges,98.17,93,,,percent of total billed charges,93% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,89.73,85,,,percent of total billed charges,85% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,85.93,81.4,,,percent of total billed charges,81.4% of total billed charges,95,90,,,percent of total billed charges,90% of total billed charges,95,90,,,percent of total billed charges,90% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,40.11,38,,,percent of total billed charges,38% of total billed charges,79.17,75,,,percent of total billed charges,75% of total billed charges,89.73,85,,,percent of total billed charges,85% of total billed charges,40.11,98.17,
Profile - WA1 IgG Ab,2301,CDM,300,RC,86753,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,154.02,
"(RES) Tick, Babesia Duncani (WA1) AB (IgG)",2302,CDM,300,RC,86753,HCPCS,outpatient,,,126.08,94.56,,113.47,90,,,percent of total billed charges,90% of total billed charges,117.25,93,,,percent of total billed charges,93% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,102.63,81.4,,,percent of total billed charges,81.4% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,94.56,75,,,percent of total billed charges,75% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,117.25,
"(RES) Tick, Babesia Microti AB (IgG)",2303,CDM,300,RC,86753,HCPCS,outpatient,,,126.08,94.56,,113.47,90,,,percent of total billed charges,90% of total billed charges,117.25,93,,,percent of total billed charges,93% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,102.63,81.4,,,percent of total billed charges,81.4% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,94.56,75,,,percent of total billed charges,75% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,117.25,
"(RES) Tick, Babesia Microti AB (IgM)",2304,CDM,300,RC,86753,HCPCS,outpatient,,,126.08,94.56,,113.47,90,,,percent of total billed charges,90% of total billed charges,117.25,93,,,percent of total billed charges,93% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,102.63,81.4,,,percent of total billed charges,81.4% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,113.47,90,,,percent of total billed charges,90% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,47.91,38,,,percent of total billed charges,38% of total billed charges,94.56,75,,,percent of total billed charges,75% of total billed charges,107.17,85,,,percent of total billed charges,85% of total billed charges,47.91,117.25,
Entamoeba histolytica Antibody (IgG),2305,CDM,300,RC,86753,HCPCS,outpatient,,,282.51,211.88,,254.26,90,,,percent of total billed charges,90% of total billed charges,262.73,93,,,percent of total billed charges,93% of total billed charges,107.35,38,,,percent of total billed charges,38% of total billed charges,107.35,38,,,percent of total billed charges,38% of total billed charges,240.13,85,,,percent of total billed charges,85% of total billed charges,107.35,38,,,percent of total billed charges,38% of total billed charges,229.96,81.4,,,percent of total billed charges,81.4% of total billed charges,254.26,90,,,percent of total billed charges,90% of total billed charges,254.26,90,,,percent of total billed charges,90% of total billed charges,107.35,38,,,percent of total billed charges,38% of total billed charges,107.35,38,,,percent of total billed charges,38% of total billed charges,107.35,38,,,percent of total billed charges,38% of total billed charges,211.88,75,,,percent of total billed charges,75% of total billed charges,240.13,85,,,percent of total billed charges,85% of total billed charges,107.35,262.73,
(RES) RMSF IGG,2306,CDM,300,RC,86757,HCPCS,outpatient,,,76.5,57.38,,68.85,90,,,percent of total billed charges,90% of total billed charges,71.15,93,,,percent of total billed charges,93% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,65.03,85,,,percent of total billed charges,85% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,62.27,81.4,,,percent of total billed charges,81.4% of total billed charges,68.85,90,,,percent of total billed charges,90% of total billed charges,68.85,90,,,percent of total billed charges,90% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,57.38,75,,,percent of total billed charges,75% of total billed charges,65.03,85,,,percent of total billed charges,85% of total billed charges,29.07,71.15,
(RES) RMSF IGM,2307,CDM,300,RC,86757,HCPCS,outpatient,,,76.5,57.38,,68.85,90,,,percent of total billed charges,90% of total billed charges,71.15,93,,,percent of total billed charges,93% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,65.03,85,,,percent of total billed charges,85% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,62.27,81.4,,,percent of total billed charges,81.4% of total billed charges,68.85,90,,,percent of total billed charges,90% of total billed charges,68.85,90,,,percent of total billed charges,90% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,29.07,38,,,percent of total billed charges,38% of total billed charges,57.38,75,,,percent of total billed charges,75% of total billed charges,65.03,85,,,percent of total billed charges,85% of total billed charges,29.07,71.15,
(RES) RUBELLA ANTIBODY (IGG),2308,CDM,300,RC,86762,HCPCS,outpatient,,,123.65,92.74,,111.29,90,,,percent of total billed charges,90% of total billed charges,114.99,93,,,percent of total billed charges,93% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,105.1,85,,,percent of total billed charges,85% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,100.65,81.4,,,percent of total billed charges,81.4% of total billed charges,111.29,90,,,percent of total billed charges,90% of total billed charges,111.29,90,,,percent of total billed charges,90% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,46.99,38,,,percent of total billed charges,38% of total billed charges,92.74,75,,,percent of total billed charges,75% of total billed charges,105.1,85,,,percent of total billed charges,85% of total billed charges,46.99,114.99,
(RES) RUBELLA ANTIBODY (IGG) DIAGNOSTIC,2309,CDM,300,RC,86762,HCPCS,outpatient,,,161.3,120.98,,145.17,90,,,percent of total billed charges,90% of total billed charges,150.01,93,,,percent of total billed charges,93% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,137.11,85,,,percent of total billed charges,85% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,131.3,81.4,,,percent of total billed charges,81.4% of total billed charges,145.17,90,,,percent of total billed charges,90% of total billed charges,145.17,90,,,percent of total billed charges,90% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,120.98,75,,,percent of total billed charges,75% of total billed charges,137.11,85,,,percent of total billed charges,85% of total billed charges,61.29,150.01,
(RES) RUBELLA ANTIBODY (IGM),2310,CDM,300,RC,86762,HCPCS,outpatient,,,161.3,120.98,,145.17,90,,,percent of total billed charges,90% of total billed charges,150.01,93,,,percent of total billed charges,93% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,137.11,85,,,percent of total billed charges,85% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,131.3,81.4,,,percent of total billed charges,81.4% of total billed charges,145.17,90,,,percent of total billed charges,90% of total billed charges,145.17,90,,,percent of total billed charges,90% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,61.29,38,,,percent of total billed charges,38% of total billed charges,120.98,75,,,percent of total billed charges,75% of total billed charges,137.11,85,,,percent of total billed charges,85% of total billed charges,61.29,150.01,
"Rubella Antibody (IgG), Immune Status",2311,CDM,300,RC,86762,HCPCS,outpatient,,,82.11,61.58,,73.9,90,,,percent of total billed charges,90% of total billed charges,76.36,93,,,percent of total billed charges,93% of total billed charges,31.2,38,,,percent of total billed charges,38% of total billed charges,31.2,38,,,percent of total billed charges,38% of total billed charges,69.79,85,,,percent of total billed charges,85% of total billed charges,31.2,38,,,percent of total billed charges,38% of total billed charges,66.84,81.4,,,percent of total billed charges,81.4% of total billed charges,73.9,90,,,percent of total billed charges,90% of total billed charges,73.9,90,,,percent of total billed charges,90% of total billed charges,31.2,38,,,percent of total billed charges,38% of total billed charges,31.2,38,,,percent of total billed charges,38% of total billed charges,31.2,38,,,percent of total billed charges,38% of total billed charges,61.58,75,,,percent of total billed charges,75% of total billed charges,69.79,85,,,percent of total billed charges,85% of total billed charges,31.2,76.36,
Measles Antibody (IgM),2312,CDM,300,RC,86765,HCPCS,outpatient,,,140.96,105.72,,126.86,90,,,percent of total billed charges,90% of total billed charges,131.09,93,,,percent of total billed charges,93% of total billed charges,53.56,38,,,percent of total billed charges,38% of total billed charges,53.56,38,,,percent of total billed charges,38% of total billed charges,119.82,85,,,percent of total billed charges,85% of total billed charges,53.56,38,,,percent of total billed charges,38% of total billed charges,114.74,81.4,,,percent of total billed charges,81.4% of total billed charges,126.86,90,,,percent of total billed charges,90% of total billed charges,126.86,90,,,percent of total billed charges,90% of total billed charges,53.56,38,,,percent of total billed charges,38% of total billed charges,53.56,38,,,percent of total billed charges,38% of total billed charges,53.56,38,,,percent of total billed charges,38% of total billed charges,105.72,75,,,percent of total billed charges,75% of total billed charges,119.82,85,,,percent of total billed charges,85% of total billed charges,53.56,131.09,
Profile - Measles IgG ab,2313,CDM,300,RC,86765,HCPCS,outpatient,,,125.87,94.4,,113.28,90,,,percent of total billed charges,90% of total billed charges,117.06,93,,,percent of total billed charges,93% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,102.46,81.4,,,percent of total billed charges,81.4% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,94.4,75,,,percent of total billed charges,75% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,117.06,
Profile- Measles IGM,2314,CDM,300,RC,86765,HCPCS,outpatient,,,155.85,116.89,,140.27,90,,,percent of total billed charges,90% of total billed charges,144.94,93,,,percent of total billed charges,93% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,126.86,81.4,,,percent of total billed charges,81.4% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,140.27,90,,,percent of total billed charges,90% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,59.22,38,,,percent of total billed charges,38% of total billed charges,116.89,75,,,percent of total billed charges,75% of total billed charges,132.47,85,,,percent of total billed charges,85% of total billed charges,59.22,144.94,
(RES) MEASLES ANTIBODY (IGG),2315,CDM,300,RC,86765,HCPCS,outpatient,,,125.87,94.4,,113.28,90,,,percent of total billed charges,90% of total billed charges,117.06,93,,,percent of total billed charges,93% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,102.46,81.4,,,percent of total billed charges,81.4% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,94.4,75,,,percent of total billed charges,75% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,117.06,
Salmonella Brucella Panel,2316,CDM,300,RC,86768,HCPCS,outpatient,,,329.27,246.95,,296.34,90,,,percent of total billed charges,90% of total billed charges,306.22,93,,,percent of total billed charges,93% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,279.88,85,,,percent of total billed charges,85% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,268.03,81.4,,,percent of total billed charges,81.4% of total billed charges,296.34,90,,,percent of total billed charges,90% of total billed charges,296.34,90,,,percent of total billed charges,90% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,246.95,75,,,percent of total billed charges,75% of total billed charges,279.88,85,,,percent of total billed charges,85% of total billed charges,125.12,306.22,
SARS-CoV-2 Serology Antibody (IgG),2317,CDM,300,RC,86769,HCPCS,outpatient,,,70.36,52.77,,63.32,90,,,percent of total billed charges,90% of total billed charges,65.43,93,,,percent of total billed charges,93% of total billed charges,26.74,38,,,percent of total billed charges,38% of total billed charges,26.74,38,,,percent of total billed charges,38% of total billed charges,59.81,85,,,percent of total billed charges,85% of total billed charges,26.74,38,,,percent of total billed charges,38% of total billed charges,57.27,81.4,,,percent of total billed charges,81.4% of total billed charges,63.32,90,,,percent of total billed charges,90% of total billed charges,63.32,90,,,percent of total billed charges,90% of total billed charges,26.74,38,,,percent of total billed charges,38% of total billed charges,26.74,38,,,percent of total billed charges,38% of total billed charges,26.74,38,,,percent of total billed charges,38% of total billed charges,52.77,75,,,percent of total billed charges,75% of total billed charges,59.81,85,,,percent of total billed charges,85% of total billed charges,26.74,65.43,
"SARS-CoV-2 Antibody (IgG), Nucleocapsid, Qual",2318,CDM,300,RC,86769,HCPCS,outpatient,,,140.72,105.54,,126.65,90,,,percent of total billed charges,90% of total billed charges,130.87,93,,,percent of total billed charges,93% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,119.61,85,,,percent of total billed charges,85% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,114.55,81.4,,,percent of total billed charges,81.4% of total billed charges,126.65,90,,,percent of total billed charges,90% of total billed charges,126.65,90,,,percent of total billed charges,90% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,105.54,75,,,percent of total billed charges,75% of total billed charges,119.61,85,,,percent of total billed charges,85% of total billed charges,53.47,130.87,
"SARS-CoV-2 Serology AB (IgG, IgM), Immunoassay",2319,CDM,300,RC,86769,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"SARS-CoV-2 Antibody (IgG), Spike, Semi-Quant",2320,CDM,300,RC,86769,HCPCS,outpatient,,,140.72,105.54,,126.65,90,,,percent of total billed charges,90% of total billed charges,130.87,93,,,percent of total billed charges,93% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,119.61,85,,,percent of total billed charges,85% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,114.55,81.4,,,percent of total billed charges,81.4% of total billed charges,126.65,90,,,percent of total billed charges,90% of total billed charges,126.65,90,,,percent of total billed charges,90% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,105.54,75,,,percent of total billed charges,75% of total billed charges,119.61,85,,,percent of total billed charges,85% of total billed charges,53.47,130.87,
"SARS-CoV-2 Total Antibody, Spike, Semi-Quant",2321,CDM,300,RC,86769,HCPCS,outpatient,,,140.72,105.54,,126.65,90,,,percent of total billed charges,90% of total billed charges,130.87,93,,,percent of total billed charges,93% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,119.61,85,,,percent of total billed charges,85% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,114.55,81.4,,,percent of total billed charges,81.4% of total billed charges,126.65,90,,,percent of total billed charges,90% of total billed charges,126.65,90,,,percent of total billed charges,90% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,53.47,38,,,percent of total billed charges,38% of total billed charges,105.54,75,,,percent of total billed charges,75% of total billed charges,119.61,85,,,percent of total billed charges,85% of total billed charges,53.47,130.87,
(RES) SARS CoV 2 IgM,2322,CDM,300,RC,86769,HCPCS,outpatient,,,68.98,51.74,,62.08,90,,,percent of total billed charges,90% of total billed charges,64.15,93,,,percent of total billed charges,93% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,58.63,85,,,percent of total billed charges,85% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,56.15,81.4,,,percent of total billed charges,81.4% of total billed charges,62.08,90,,,percent of total billed charges,90% of total billed charges,62.08,90,,,percent of total billed charges,90% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,51.74,75,,,percent of total billed charges,75% of total billed charges,58.63,85,,,percent of total billed charges,85% of total billed charges,26.21,64.15,
(RES) SARS CoV 2 AB IgG,2323,CDM,300,RC,86769,HCPCS,outpatient,,,68.98,51.74,,62.08,90,,,percent of total billed charges,90% of total billed charges,64.15,93,,,percent of total billed charges,93% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,58.63,85,,,percent of total billed charges,85% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,56.15,81.4,,,percent of total billed charges,81.4% of total billed charges,62.08,90,,,percent of total billed charges,90% of total billed charges,62.08,90,,,percent of total billed charges,90% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,26.21,38,,,percent of total billed charges,38% of total billed charges,51.74,75,,,percent of total billed charges,75% of total billed charges,58.63,85,,,percent of total billed charges,85% of total billed charges,26.21,64.15,
Tetanus,2324,CDM,300,RC,86774,HCPCS,outpatient,,,151.15,113.36,,136.04,90,,,percent of total billed charges,90% of total billed charges,140.57,93,,,percent of total billed charges,93% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,123.04,81.4,,,percent of total billed charges,81.4% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,113.36,75,,,percent of total billed charges,75% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,140.57,
(RES) TETANUS ANTITOXOID,2325,CDM,300,RC,86774,HCPCS,outpatient,,,156.96,117.72,,141.26,90,,,percent of total billed charges,90% of total billed charges,145.97,93,,,percent of total billed charges,93% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,127.77,81.4,,,percent of total billed charges,81.4% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,141.26,90,,,percent of total billed charges,90% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,59.64,38,,,percent of total billed charges,38% of total billed charges,117.72,75,,,percent of total billed charges,75% of total billed charges,133.42,85,,,percent of total billed charges,85% of total billed charges,59.64,145.97,
Toxoplasma AB (IgG),2326,CDM,300,RC,86777,HCPCS,outpatient,,,137.58,103.19,,123.82,90,,,percent of total billed charges,90% of total billed charges,127.95,93,,,percent of total billed charges,93% of total billed charges,52.28,38,,,percent of total billed charges,38% of total billed charges,52.28,38,,,percent of total billed charges,38% of total billed charges,116.94,85,,,percent of total billed charges,85% of total billed charges,52.28,38,,,percent of total billed charges,38% of total billed charges,111.99,81.4,,,percent of total billed charges,81.4% of total billed charges,123.82,90,,,percent of total billed charges,90% of total billed charges,123.82,90,,,percent of total billed charges,90% of total billed charges,52.28,38,,,percent of total billed charges,38% of total billed charges,52.28,38,,,percent of total billed charges,38% of total billed charges,52.28,38,,,percent of total billed charges,38% of total billed charges,103.19,75,,,percent of total billed charges,75% of total billed charges,116.94,85,,,percent of total billed charges,85% of total billed charges,52.28,127.95,
Toxoplasma Antibody (IgM),2327,CDM,300,RC,86778,HCPCS,outpatient,,,181.57,136.18,,163.41,90,,,percent of total billed charges,90% of total billed charges,168.86,93,,,percent of total billed charges,93% of total billed charges,69,38,,,percent of total billed charges,38% of total billed charges,69,38,,,percent of total billed charges,38% of total billed charges,154.33,85,,,percent of total billed charges,85% of total billed charges,69,38,,,percent of total billed charges,38% of total billed charges,147.8,81.4,,,percent of total billed charges,81.4% of total billed charges,163.41,90,,,percent of total billed charges,90% of total billed charges,163.41,90,,,percent of total billed charges,90% of total billed charges,69,38,,,percent of total billed charges,38% of total billed charges,69,38,,,percent of total billed charges,38% of total billed charges,69,38,,,percent of total billed charges,38% of total billed charges,136.18,75,,,percent of total billed charges,75% of total billed charges,154.33,85,,,percent of total billed charges,85% of total billed charges,69,168.86,
"FTA-ABS, Serum",2328,CDM,300,RC,86780,HCPCS,outpatient,,,116,87,,104.4,90,,,percent of total billed charges,90% of total billed charges,107.88,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.42,81.4,,,percent of total billed charges,81.4% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87,75,,,percent of total billed charges,75% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,107.88,
"Treponema pallidum Antibody, Particle Agglutination",2329,CDM,300,RC,86780,HCPCS,outpatient,,,176.17,132.13,,158.55,90,,,percent of total billed charges,90% of total billed charges,163.84,93,,,percent of total billed charges,93% of total billed charges,66.94,38,,,percent of total billed charges,38% of total billed charges,66.94,38,,,percent of total billed charges,38% of total billed charges,149.74,85,,,percent of total billed charges,85% of total billed charges,66.94,38,,,percent of total billed charges,38% of total billed charges,143.4,81.4,,,percent of total billed charges,81.4% of total billed charges,158.55,90,,,percent of total billed charges,90% of total billed charges,158.55,90,,,percent of total billed charges,90% of total billed charges,66.94,38,,,percent of total billed charges,38% of total billed charges,66.94,38,,,percent of total billed charges,38% of total billed charges,66.94,38,,,percent of total billed charges,38% of total billed charges,132.13,75,,,percent of total billed charges,75% of total billed charges,149.74,85,,,percent of total billed charges,85% of total billed charges,66.94,163.84,
Syphilis AB Cascading Reflx,2330,CDM,300,RC,86780,HCPCS,outpatient,,,99.48,74.61,,89.53,90,,,percent of total billed charges,90% of total billed charges,92.52,93,,,percent of total billed charges,93% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,84.56,85,,,percent of total billed charges,85% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,80.98,81.4,,,percent of total billed charges,81.4% of total billed charges,89.53,90,,,percent of total billed charges,90% of total billed charges,89.53,90,,,percent of total billed charges,90% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,37.8,38,,,percent of total billed charges,38% of total billed charges,74.61,75,,,percent of total billed charges,75% of total billed charges,84.56,85,,,percent of total billed charges,85% of total billed charges,37.8,92.52,
Treponema pallidum IgG  IFA,2331,CDM,300,RC,86780,HCPCS,outpatient,,,94.2,70.65,,84.78,90,,,percent of total billed charges,90% of total billed charges,87.61,93,,,percent of total billed charges,93% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,76.68,81.4,,,percent of total billed charges,81.4% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,70.65,75,,,percent of total billed charges,75% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,35.8,87.61,
Treponema pallidum IgM  IFA,2332,CDM,300,RC,86780,HCPCS,outpatient,,,94.2,70.65,,84.78,90,,,percent of total billed charges,90% of total billed charges,87.61,93,,,percent of total billed charges,93% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,76.68,81.4,,,percent of total billed charges,81.4% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,35.8,38,,,percent of total billed charges,38% of total billed charges,70.65,75,,,percent of total billed charges,75% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,35.8,87.61,
Trichinella AB (IgG) ELISA,2333,CDM,300,RC,86784,HCPCS,outpatient,,,201.49,151.12,,181.34,90,,,percent of total billed charges,90% of total billed charges,187.39,93,,,percent of total billed charges,93% of total billed charges,76.57,38,,,percent of total billed charges,38% of total billed charges,76.57,38,,,percent of total billed charges,38% of total billed charges,171.27,85,,,percent of total billed charges,85% of total billed charges,76.57,38,,,percent of total billed charges,38% of total billed charges,164.01,81.4,,,percent of total billed charges,81.4% of total billed charges,181.34,90,,,percent of total billed charges,90% of total billed charges,181.34,90,,,percent of total billed charges,90% of total billed charges,76.57,38,,,percent of total billed charges,38% of total billed charges,76.57,38,,,percent of total billed charges,38% of total billed charges,76.57,38,,,percent of total billed charges,38% of total billed charges,151.12,75,,,percent of total billed charges,75% of total billed charges,171.27,85,,,percent of total billed charges,85% of total billed charges,76.57,187.39,
Varicella zoster AB (Immunity),2334,CDM,300,RC,86787,HCPCS,outpatient,,,176.65,132.49,,158.99,90,,,percent of total billed charges,90% of total billed charges,164.28,93,,,percent of total billed charges,93% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,150.15,85,,,percent of total billed charges,85% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,143.79,81.4,,,percent of total billed charges,81.4% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,132.49,75,,,percent of total billed charges,75% of total billed charges,150.15,85,,,percent of total billed charges,85% of total billed charges,67.13,164.28,
(RES) VZV AB (IGG),2335,CDM,300,RC,86787,HCPCS,outpatient,,,148.39,111.29,,133.55,90,,,percent of total billed charges,90% of total billed charges,138,93,,,percent of total billed charges,93% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,126.13,85,,,percent of total billed charges,85% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,120.79,81.4,,,percent of total billed charges,81.4% of total billed charges,133.55,90,,,percent of total billed charges,90% of total billed charges,133.55,90,,,percent of total billed charges,90% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,111.29,75,,,percent of total billed charges,75% of total billed charges,126.13,85,,,percent of total billed charges,85% of total billed charges,56.39,138,
(RES) VZV AB (IGM),2336,CDM,300,RC,86787,HCPCS,outpatient,,,148.39,111.29,,133.55,90,,,percent of total billed charges,90% of total billed charges,138,93,,,percent of total billed charges,93% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,126.13,85,,,percent of total billed charges,85% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,120.79,81.4,,,percent of total billed charges,81.4% of total billed charges,133.55,90,,,percent of total billed charges,90% of total billed charges,133.55,90,,,percent of total billed charges,90% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,56.39,38,,,percent of total billed charges,38% of total billed charges,111.29,75,,,percent of total billed charges,75% of total billed charges,126.13,85,,,percent of total billed charges,85% of total billed charges,56.39,138,
"(RES) WEST NILE VIRUS ANTIBODY (IGM), SERUM",2337,CDM,300,RC,86788,HCPCS,outpatient,,,85.35,64.01,,76.82,90,,,percent of total billed charges,90% of total billed charges,79.38,93,,,percent of total billed charges,93% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,72.55,85,,,percent of total billed charges,85% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,69.47,81.4,,,percent of total billed charges,81.4% of total billed charges,76.82,90,,,percent of total billed charges,90% of total billed charges,76.82,90,,,percent of total billed charges,90% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,64.01,75,,,percent of total billed charges,75% of total billed charges,72.55,85,,,percent of total billed charges,85% of total billed charges,32.43,79.38,
"West Nile IgM, CSF",2338,CDM,300,RC,86788,HCPCS,outpatient,,,88.44,66.33,,79.6,90,,,percent of total billed charges,90% of total billed charges,82.25,93,,,percent of total billed charges,93% of total billed charges,33.61,38,,,percent of total billed charges,38% of total billed charges,33.61,38,,,percent of total billed charges,38% of total billed charges,75.17,85,,,percent of total billed charges,85% of total billed charges,33.61,38,,,percent of total billed charges,38% of total billed charges,71.99,81.4,,,percent of total billed charges,81.4% of total billed charges,79.6,90,,,percent of total billed charges,90% of total billed charges,79.6,90,,,percent of total billed charges,90% of total billed charges,33.61,38,,,percent of total billed charges,38% of total billed charges,33.61,38,,,percent of total billed charges,38% of total billed charges,33.61,38,,,percent of total billed charges,38% of total billed charges,66.33,75,,,percent of total billed charges,75% of total billed charges,75.17,85,,,percent of total billed charges,85% of total billed charges,33.61,82.25,
"(RES) WEST NILE VIRUS ANTIBODY (IGG), CSF",2339,CDM,300,RC,86788,HCPCS,outpatient,,,83.68,62.76,,75.31,90,,,percent of total billed charges,90% of total billed charges,77.82,93,,,percent of total billed charges,93% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,71.13,85,,,percent of total billed charges,85% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,68.12,81.4,,,percent of total billed charges,81.4% of total billed charges,75.31,90,,,percent of total billed charges,90% of total billed charges,75.31,90,,,percent of total billed charges,90% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,62.76,75,,,percent of total billed charges,75% of total billed charges,71.13,85,,,percent of total billed charges,85% of total billed charges,31.8,77.82,
"(RES)WEST NILE VIRUS ANTIBODY (IGG), SERUM",2340,CDM,300,RC,86789,HCPCS,outpatient,,,85.35,64.01,,76.82,90,,,percent of total billed charges,90% of total billed charges,79.38,93,,,percent of total billed charges,93% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,72.55,85,,,percent of total billed charges,85% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,69.47,81.4,,,percent of total billed charges,81.4% of total billed charges,76.82,90,,,percent of total billed charges,90% of total billed charges,76.82,90,,,percent of total billed charges,90% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,32.43,38,,,percent of total billed charges,38% of total billed charges,64.01,75,,,percent of total billed charges,75% of total billed charges,72.55,85,,,percent of total billed charges,85% of total billed charges,32.43,79.38,
"(RES) WEST NILE VIRUS ANTIBODY (IGM), CSF",2341,CDM,300,RC,86789,HCPCS,outpatient,,,83.68,62.76,,75.31,90,,,percent of total billed charges,90% of total billed charges,77.82,93,,,percent of total billed charges,93% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,71.13,85,,,percent of total billed charges,85% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,68.12,81.4,,,percent of total billed charges,81.4% of total billed charges,75.31,90,,,percent of total billed charges,90% of total billed charges,75.31,90,,,percent of total billed charges,90% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,31.8,38,,,percent of total billed charges,38% of total billed charges,62.76,75,,,percent of total billed charges,75% of total billed charges,71.13,85,,,percent of total billed charges,85% of total billed charges,31.8,77.82,
"HTLV-I/II AB, w/reflex",2342,CDM,300,RC,86790,HCPCS,outpatient,,,168.92,126.69,,152.03,90,,,percent of total billed charges,90% of total billed charges,157.1,93,,,percent of total billed charges,93% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,137.5,81.4,,,percent of total billed charges,81.4% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,126.69,75,,,percent of total billed charges,75% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,157.1,
Dengue Fever Antibody (IgM),2343,CDM,300,RC,86790,HCPCS,outpatient,,,131.81,98.86,,118.63,90,,,percent of total billed charges,90% of total billed charges,122.58,93,,,percent of total billed charges,93% of total billed charges,50.09,38,,,percent of total billed charges,38% of total billed charges,50.09,38,,,percent of total billed charges,38% of total billed charges,112.04,85,,,percent of total billed charges,85% of total billed charges,50.09,38,,,percent of total billed charges,38% of total billed charges,107.29,81.4,,,percent of total billed charges,81.4% of total billed charges,118.63,90,,,percent of total billed charges,90% of total billed charges,118.63,90,,,percent of total billed charges,90% of total billed charges,50.09,38,,,percent of total billed charges,38% of total billed charges,50.09,38,,,percent of total billed charges,38% of total billed charges,50.09,38,,,percent of total billed charges,38% of total billed charges,98.86,75,,,percent of total billed charges,75% of total billed charges,112.04,85,,,percent of total billed charges,85% of total billed charges,50.09,122.58,
HTLV 1/2 w/ Western Blot,2344,CDM,300,RC,86790,HCPCS,outpatient,,,234.06,175.55,,210.65,90,,,percent of total billed charges,90% of total billed charges,217.68,93,,,percent of total billed charges,93% of total billed charges,88.94,38,,,percent of total billed charges,38% of total billed charges,88.94,38,,,percent of total billed charges,38% of total billed charges,198.95,85,,,percent of total billed charges,85% of total billed charges,88.94,38,,,percent of total billed charges,38% of total billed charges,190.52,81.4,,,percent of total billed charges,81.4% of total billed charges,210.65,90,,,percent of total billed charges,90% of total billed charges,210.65,90,,,percent of total billed charges,90% of total billed charges,88.94,38,,,percent of total billed charges,38% of total billed charges,88.94,38,,,percent of total billed charges,38% of total billed charges,88.94,38,,,percent of total billed charges,38% of total billed charges,175.55,75,,,percent of total billed charges,75% of total billed charges,198.95,85,,,percent of total billed charges,85% of total billed charges,88.94,217.68,
"(RES) COLORADO TICK FEVR AB,IgM",2345,CDM,300,RC,86790,HCPCS,outpatient,,,81.6,61.2,,73.44,90,,,percent of total billed charges,90% of total billed charges,75.89,93,,,percent of total billed charges,93% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,66.42,81.4,,,percent of total billed charges,81.4% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,61.2,75,,,percent of total billed charges,75% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,75.89,
(RES) HEV IGG,2346,CDM,300,RC,86790,HCPCS,outpatient,,,109.1,81.83,,98.19,90,,,percent of total billed charges,90% of total billed charges,101.46,93,,,percent of total billed charges,93% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,92.74,85,,,percent of total billed charges,85% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,88.81,81.4,,,percent of total billed charges,81.4% of total billed charges,98.19,90,,,percent of total billed charges,90% of total billed charges,98.19,90,,,percent of total billed charges,90% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,81.83,75,,,percent of total billed charges,75% of total billed charges,92.74,85,,,percent of total billed charges,85% of total billed charges,41.46,101.46,
(RES) HEV IGM,2347,CDM,300,RC,86790,HCPCS,outpatient,,,109.1,81.83,,98.19,90,,,percent of total billed charges,90% of total billed charges,101.46,93,,,percent of total billed charges,93% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,92.74,85,,,percent of total billed charges,85% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,88.81,81.4,,,percent of total billed charges,81.4% of total billed charges,98.19,90,,,percent of total billed charges,90% of total billed charges,98.19,90,,,percent of total billed charges,90% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,41.46,38,,,percent of total billed charges,38% of total billed charges,81.83,75,,,percent of total billed charges,75% of total billed charges,92.74,85,,,percent of total billed charges,85% of total billed charges,41.46,101.46,
(RES) HANTAVIRUS IGM,2348,CDM,300,RC,86790,HCPCS,outpatient,,,127.73,95.8,,114.96,90,,,percent of total billed charges,90% of total billed charges,118.79,93,,,percent of total billed charges,93% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,108.57,85,,,percent of total billed charges,85% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,103.97,81.4,,,percent of total billed charges,81.4% of total billed charges,114.96,90,,,percent of total billed charges,90% of total billed charges,114.96,90,,,percent of total billed charges,90% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,95.8,75,,,percent of total billed charges,75% of total billed charges,108.57,85,,,percent of total billed charges,85% of total billed charges,48.54,118.79,
Dengue Fever AB IgG,2349,CDM,300,RC,86790,HCPCS,outpatient,,,114.69,86.02,,103.22,90,,,percent of total billed charges,90% of total billed charges,106.66,93,,,percent of total billed charges,93% of total billed charges,43.58,38,,,percent of total billed charges,38% of total billed charges,43.58,38,,,percent of total billed charges,38% of total billed charges,97.49,85,,,percent of total billed charges,85% of total billed charges,43.58,38,,,percent of total billed charges,38% of total billed charges,93.36,81.4,,,percent of total billed charges,81.4% of total billed charges,103.22,90,,,percent of total billed charges,90% of total billed charges,103.22,90,,,percent of total billed charges,90% of total billed charges,43.58,38,,,percent of total billed charges,38% of total billed charges,43.58,38,,,percent of total billed charges,38% of total billed charges,43.58,38,,,percent of total billed charges,38% of total billed charges,86.02,75,,,percent of total billed charges,75% of total billed charges,97.49,85,,,percent of total billed charges,85% of total billed charges,43.58,106.66,
(RES) CHIKUNGUNYA IGG SCREEN,2350,CDM,300,RC,86790,HCPCS,outpatient,,,145.35,109.01,,130.82,90,,,percent of total billed charges,90% of total billed charges,135.18,93,,,percent of total billed charges,93% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,123.55,85,,,percent of total billed charges,85% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,118.31,81.4,,,percent of total billed charges,81.4% of total billed charges,130.82,90,,,percent of total billed charges,90% of total billed charges,130.82,90,,,percent of total billed charges,90% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,109.01,75,,,percent of total billed charges,75% of total billed charges,123.55,85,,,percent of total billed charges,85% of total billed charges,55.23,135.18,
(RES) CHIKUNGUNYA IGM SCREEN,2351,CDM,300,RC,86790,HCPCS,outpatient,,,145.35,109.01,,130.82,90,,,percent of total billed charges,90% of total billed charges,135.18,93,,,percent of total billed charges,93% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,123.55,85,,,percent of total billed charges,85% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,118.31,81.4,,,percent of total billed charges,81.4% of total billed charges,130.82,90,,,percent of total billed charges,90% of total billed charges,130.82,90,,,percent of total billed charges,90% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,55.23,38,,,percent of total billed charges,38% of total billed charges,109.01,75,,,percent of total billed charges,75% of total billed charges,123.55,85,,,percent of total billed charges,85% of total billed charges,55.23,135.18,
(RES) HANTAVIRUS IGG,2352,CDM,300,RC,86790,HCPCS,outpatient,,,127.73,95.8,,114.96,90,,,percent of total billed charges,90% of total billed charges,118.79,93,,,percent of total billed charges,93% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,108.57,85,,,percent of total billed charges,85% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,103.97,81.4,,,percent of total billed charges,81.4% of total billed charges,114.96,90,,,percent of total billed charges,90% of total billed charges,114.96,90,,,percent of total billed charges,90% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,48.54,38,,,percent of total billed charges,38% of total billed charges,95.8,75,,,percent of total billed charges,75% of total billed charges,108.57,85,,,percent of total billed charges,85% of total billed charges,48.54,118.79,
"(RES) COLORADO TICK FEVR AB,IgG",2353,CDM,300,RC,86790,HCPCS,outpatient,,,81.6,61.2,,73.44,90,,,percent of total billed charges,90% of total billed charges,75.89,93,,,percent of total billed charges,93% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,66.42,81.4,,,percent of total billed charges,81.4% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,31.01,38,,,percent of total billed charges,38% of total billed charges,61.2,75,,,percent of total billed charges,75% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,31.01,75.89,
"Donor, HTLV I/II Ab screen",2354,CDM,300,RC,86790,HCPCS,outpatient,,,186.6,139.95,,167.94,90,,,percent of total billed charges,90% of total billed charges,173.54,93,,,percent of total billed charges,93% of total billed charges,70.91,38,,,percent of total billed charges,38% of total billed charges,70.91,38,,,percent of total billed charges,38% of total billed charges,158.61,85,,,percent of total billed charges,85% of total billed charges,70.91,38,,,percent of total billed charges,38% of total billed charges,151.89,81.4,,,percent of total billed charges,81.4% of total billed charges,167.94,90,,,percent of total billed charges,90% of total billed charges,167.94,90,,,percent of total billed charges,90% of total billed charges,70.91,38,,,percent of total billed charges,38% of total billed charges,70.91,38,,,percent of total billed charges,38% of total billed charges,70.91,38,,,percent of total billed charges,38% of total billed charges,139.95,75,,,percent of total billed charges,75% of total billed charges,158.61,85,,,percent of total billed charges,85% of total billed charges,70.91,173.54,
THYROGLOBULIN ANTIBODY-ATA,2355,CDM,300,RC,86800,HCPCS,outpatient,,,57.41,43.06,,51.67,90,,,percent of total billed charges,90% of total billed charges,53.39,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.73,81.4,,,percent of total billed charges,81.4% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.06,75,,,percent of total billed charges,75% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,53.39,
(RES) THYROGLOBULIN ANTIBODIES,2356,CDM,300,RC,86800,HCPCS,outpatient,,,57.41,43.06,,51.67,90,,,percent of total billed charges,90% of total billed charges,53.39,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.73,81.4,,,percent of total billed charges,81.4% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.06,75,,,percent of total billed charges,75% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,53.39,
Thyroid Cancer (thyroglobulin) monitor,2357,CDM,300,RC,86800,HCPCS,outpatient,,,128.79,96.59,,115.91,90,,,percent of total billed charges,90% of total billed charges,119.77,93,,,percent of total billed charges,93% of total billed charges,48.94,38,,,percent of total billed charges,38% of total billed charges,48.94,38,,,percent of total billed charges,38% of total billed charges,109.47,85,,,percent of total billed charges,85% of total billed charges,48.94,38,,,percent of total billed charges,38% of total billed charges,104.84,81.4,,,percent of total billed charges,81.4% of total billed charges,115.91,90,,,percent of total billed charges,90% of total billed charges,115.91,90,,,percent of total billed charges,90% of total billed charges,48.94,38,,,percent of total billed charges,38% of total billed charges,48.94,38,,,percent of total billed charges,38% of total billed charges,48.94,38,,,percent of total billed charges,38% of total billed charges,96.59,75,,,percent of total billed charges,75% of total billed charges,109.47,85,,,percent of total billed charges,85% of total billed charges,48.94,119.77,
(RES) THYROGLOBULIN AB,2358,CDM,300,RC,86800,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
Hepatitis C ab,2359,CDM,300,RC,86803,HCPCS,outpatient,,,166.39,124.79,,149.75,90,,,percent of total billed charges,90% of total billed charges,154.74,93,,,percent of total billed charges,93% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,141.43,85,,,percent of total billed charges,85% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,135.44,81.4,,,percent of total billed charges,81.4% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,124.79,75,,,percent of total billed charges,75% of total billed charges,141.43,85,,,percent of total billed charges,85% of total billed charges,63.23,154.74,
"Hepatitis C AB w reflex to HCV RNA to Genotype, LiPA",2360,CDM,300,RC,86803,HCPCS,outpatient,,,153.99,115.49,,138.59,90,,,percent of total billed charges,90% of total billed charges,143.21,93,,,percent of total billed charges,93% of total billed charges,58.52,38,,,percent of total billed charges,38% of total billed charges,58.52,38,,,percent of total billed charges,38% of total billed charges,130.89,85,,,percent of total billed charges,85% of total billed charges,58.52,38,,,percent of total billed charges,38% of total billed charges,125.35,81.4,,,percent of total billed charges,81.4% of total billed charges,138.59,90,,,percent of total billed charges,90% of total billed charges,138.59,90,,,percent of total billed charges,90% of total billed charges,58.52,38,,,percent of total billed charges,38% of total billed charges,58.52,38,,,percent of total billed charges,38% of total billed charges,58.52,38,,,percent of total billed charges,38% of total billed charges,115.49,75,,,percent of total billed charges,75% of total billed charges,130.89,85,,,percent of total billed charges,85% of total billed charges,58.52,143.21,
HLA-B27 Antigen,2361,CDM,300,RC,86812,HCPCS,outpatient,,,213.26,159.95,,191.93,90,,,percent of total billed charges,90% of total billed charges,198.33,93,,,percent of total billed charges,93% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,181.27,85,,,percent of total billed charges,85% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,173.59,81.4,,,percent of total billed charges,81.4% of total billed charges,191.93,90,,,percent of total billed charges,90% of total billed charges,191.93,90,,,percent of total billed charges,90% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,159.95,75,,,percent of total billed charges,75% of total billed charges,181.27,85,,,percent of total billed charges,85% of total billed charges,81.04,198.33,
Antibody Screen,2362,CDM,300,RC,86850,HCPCS,outpatient,,,91.4,68.55,,82.26,90,,,percent of total billed charges,90% of total billed charges,85,93,,,percent of total billed charges,93% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,77.69,85,,,percent of total billed charges,85% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,74.4,81.4,,,percent of total billed charges,81.4% of total billed charges,82.26,90,,,percent of total billed charges,90% of total billed charges,82.26,90,,,percent of total billed charges,90% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,68.55,75,,,percent of total billed charges,75% of total billed charges,77.69,85,,,percent of total billed charges,85% of total billed charges,34.73,85,
Antibody Screen (Vitalant),2363,CDM,300,RC,86850,HCPCS,outpatient,,,159.18,119.39,,143.26,90,,,percent of total billed charges,90% of total billed charges,148.04,93,,,percent of total billed charges,93% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,135.3,85,,,percent of total billed charges,85% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,129.57,81.4,,,percent of total billed charges,81.4% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,119.39,75,,,percent of total billed charges,75% of total billed charges,135.3,85,,,percent of total billed charges,85% of total billed charges,60.49,148.04,
Elution (Vitalant),2364,CDM,300,RC,86860,HCPCS,outpatient,,,147.9,110.93,,133.11,90,,,percent of total billed charges,90% of total billed charges,137.55,93,,,percent of total billed charges,93% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,125.72,85,,,percent of total billed charges,85% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,120.39,81.4,,,percent of total billed charges,81.4% of total billed charges,133.11,90,,,percent of total billed charges,90% of total billed charges,133.11,90,,,percent of total billed charges,90% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,56.2,38,,,percent of total billed charges,38% of total billed charges,110.93,75,,,percent of total billed charges,75% of total billed charges,125.72,85,,,percent of total billed charges,85% of total billed charges,56.2,137.55,
ref AB ID Panel,2365,CDM,300,RC,86870,HCPCS,outpatient,,,175.77,131.83,,158.19,90,,,percent of total billed charges,90% of total billed charges,163.47,93,,,percent of total billed charges,93% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,143.08,81.4,,,percent of total billed charges,81.4% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,131.83,75,,,percent of total billed charges,75% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,163.47,
Ref BB Antibody titer,2366,CDM,300,RC,86870,HCPCS,outpatient,,,37.88,28.41,,34.09,90,,,percent of total billed charges,90% of total billed charges,35.23,93,,,percent of total billed charges,93% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,30.83,81.4,,,percent of total billed charges,81.4% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,28.41,75,,,percent of total billed charges,75% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,35.23,
Antibody ID Panel (Vitalant),2367,CDM,300,RC,86870,HCPCS,outpatient,,,204,153,,183.6,90,,,percent of total billed charges,90% of total billed charges,189.72,93,,,percent of total billed charges,93% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,173.4,85,,,percent of total billed charges,85% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,166.06,81.4,,,percent of total billed charges,81.4% of total billed charges,183.6,90,,,percent of total billed charges,90% of total billed charges,183.6,90,,,percent of total billed charges,90% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,153,75,,,percent of total billed charges,75% of total billed charges,173.4,85,,,percent of total billed charges,85% of total billed charges,77.52,189.72,
Antibody ID Panel (SLVRMC),2368,CDM,300,RC,86870,HCPCS,outpatient,,,204,153,,183.6,90,,,percent of total billed charges,90% of total billed charges,189.72,93,,,percent of total billed charges,93% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,173.4,85,,,percent of total billed charges,85% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,166.06,81.4,,,percent of total billed charges,81.4% of total billed charges,183.6,90,,,percent of total billed charges,90% of total billed charges,183.6,90,,,percent of total billed charges,90% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,153,75,,,percent of total billed charges,75% of total billed charges,173.4,85,,,percent of total billed charges,85% of total billed charges,77.52,189.72,
DIRECT COOMBS TEST,2369,CDM,300,RC,86880,HCPCS,outpatient,,,26.96,20.22,,24.26,90,,,percent of total billed charges,90% of total billed charges,25.07,93,,,percent of total billed charges,93% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,21.95,81.4,,,percent of total billed charges,81.4% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,20.22,75,,,percent of total billed charges,75% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,25.07,
Ref-Anti IgG,2370,CDM,300,RC,86880,HCPCS,outpatient,,,54.12,40.59,,48.71,90,,,percent of total billed charges,90% of total billed charges,50.33,93,,,percent of total billed charges,93% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,44.05,81.4,,,percent of total billed charges,81.4% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,40.59,75,,,percent of total billed charges,75% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,50.33,
Direct Antiglobulin Test (DAT) SLVRMC,2371,CDM,300,RC,86880,HCPCS,outpatient,,,56.1,42.08,,50.49,90,,,percent of total billed charges,90% of total billed charges,52.17,93,,,percent of total billed charges,93% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,45.67,81.4,,,percent of total billed charges,81.4% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,50.49,90,,,percent of total billed charges,90% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,21.32,38,,,percent of total billed charges,38% of total billed charges,42.08,75,,,percent of total billed charges,75% of total billed charges,47.69,85,,,percent of total billed charges,85% of total billed charges,21.32,52.17,
Direct Antiglobulin Test Polyspecific (Vitalant),2372,CDM,300,RC,86880,HCPCS,outpatient,,,47.76,35.82,,42.98,90,,,percent of total billed charges,90% of total billed charges,44.42,93,,,percent of total billed charges,93% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,40.6,85,,,percent of total billed charges,85% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,38.88,81.4,,,percent of total billed charges,81.4% of total billed charges,42.98,90,,,percent of total billed charges,90% of total billed charges,42.98,90,,,percent of total billed charges,90% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,35.82,75,,,percent of total billed charges,75% of total billed charges,40.6,85,,,percent of total billed charges,85% of total billed charges,18.15,44.42,
Direct Antiglobulin Test (DAT),2373,CDM,300,RC,86880,HCPCS,outpatient,,,52,39,,46.8,90,,,percent of total billed charges,90% of total billed charges,48.36,93,,,percent of total billed charges,93% of total billed charges,19.76,38,,,percent of total billed charges,38% of total billed charges,19.76,38,,,percent of total billed charges,38% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,19.76,38,,,percent of total billed charges,38% of total billed charges,42.33,81.4,,,percent of total billed charges,81.4% of total billed charges,46.8,90,,,percent of total billed charges,90% of total billed charges,46.8,90,,,percent of total billed charges,90% of total billed charges,19.76,38,,,percent of total billed charges,38% of total billed charges,19.76,38,,,percent of total billed charges,38% of total billed charges,19.76,38,,,percent of total billed charges,38% of total billed charges,39,75,,,percent of total billed charges,75% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,19.76,48.36,
Direct Antiglobulin Test C3 (Vitalant),2374,CDM,300,RC,86880,HCPCS,outpatient,,,47.76,35.82,,42.98,90,,,percent of total billed charges,90% of total billed charges,44.42,93,,,percent of total billed charges,93% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,40.6,85,,,percent of total billed charges,85% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,38.88,81.4,,,percent of total billed charges,81.4% of total billed charges,42.98,90,,,percent of total billed charges,90% of total billed charges,42.98,90,,,percent of total billed charges,90% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,18.15,38,,,percent of total billed charges,38% of total billed charges,35.82,75,,,percent of total billed charges,75% of total billed charges,40.6,85,,,percent of total billed charges,85% of total billed charges,18.15,44.42,
(RES) Blood Type ABO,2376,CDM,300,RC,86900,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
(RES) Blood Type Rh,2377,CDM,300,RC,86901,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Antigen Typing - Donor Unit (Vitalant),2378,CDM,300,RC,86902,HCPCS,outpatient,,,149.82,112.37,,134.84,90,,,percent of total billed charges,90% of total billed charges,139.33,93,,,percent of total billed charges,93% of total billed charges,56.93,38,,,percent of total billed charges,38% of total billed charges,56.93,38,,,percent of total billed charges,38% of total billed charges,127.35,85,,,percent of total billed charges,85% of total billed charges,56.93,38,,,percent of total billed charges,38% of total billed charges,121.95,81.4,,,percent of total billed charges,81.4% of total billed charges,134.84,90,,,percent of total billed charges,90% of total billed charges,134.84,90,,,percent of total billed charges,90% of total billed charges,56.93,38,,,percent of total billed charges,38% of total billed charges,56.93,38,,,percent of total billed charges,38% of total billed charges,56.93,38,,,percent of total billed charges,38% of total billed charges,112.37,75,,,percent of total billed charges,75% of total billed charges,127.35,85,,,percent of total billed charges,85% of total billed charges,56.93,139.33,
Ref antigen typing,2379,CDM,300,RC,86905,HCPCS,outpatient,,,48.72,36.54,,43.85,90,,,percent of total billed charges,90% of total billed charges,45.31,93,,,percent of total billed charges,93% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,39.66,81.4,,,percent of total billed charges,81.4% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,36.54,75,,,percent of total billed charges,75% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,45.31,
"Antigen Typing, Patient (Vitalant)",2380,CDM,300,RC,86905,HCPCS,outpatient,,,106.12,79.59,,95.51,90,,,percent of total billed charges,90% of total billed charges,98.69,93,,,percent of total billed charges,93% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,86.38,81.4,,,percent of total billed charges,81.4% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,79.59,75,,,percent of total billed charges,75% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,98.69,
Rhphenotype(Bonfils),2381,CDM,300,RC,86906,HCPCS,outpatient,,,175.77,131.83,,158.19,90,,,percent of total billed charges,90% of total billed charges,163.47,93,,,percent of total billed charges,93% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,143.08,81.4,,,percent of total billed charges,81.4% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,131.83,75,,,percent of total billed charges,75% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,163.47,
(Result) Crossmatch - IS,2382,CDM,300,RC,86920,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
(result) Crossmatch IS #2,2383,CDM,300,RC,86920,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
YY - Crossmatch - Incubation,2384,CDM,300,RC,86921,HCPCS,outpatient,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
(RESULT) Crossmatch - AHG,2385,CDM,300,RC,86922,HCPCS,outpatient,,,57.41,43.06,,51.67,90,,,percent of total billed charges,90% of total billed charges,53.39,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.73,81.4,,,percent of total billed charges,81.4% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.06,75,,,percent of total billed charges,75% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,53.39,
Crossmatch AHG,2386,CDM,300,RC,86922,HCPCS,outpatient,,,68.48,51.36,,61.63,90,,,percent of total billed charges,90% of total billed charges,63.69,93,,,percent of total billed charges,93% of total billed charges,26.02,38,,,percent of total billed charges,38% of total billed charges,26.02,38,,,percent of total billed charges,38% of total billed charges,58.21,85,,,percent of total billed charges,85% of total billed charges,26.02,38,,,percent of total billed charges,38% of total billed charges,55.74,81.4,,,percent of total billed charges,81.4% of total billed charges,61.63,90,,,percent of total billed charges,90% of total billed charges,61.63,90,,,percent of total billed charges,90% of total billed charges,26.02,38,,,percent of total billed charges,38% of total billed charges,26.02,38,,,percent of total billed charges,38% of total billed charges,26.02,38,,,percent of total billed charges,38% of total billed charges,51.36,75,,,percent of total billed charges,75% of total billed charges,58.21,85,,,percent of total billed charges,85% of total billed charges,26.02,63.69,
Myco culture concen,2387,CDM,300,RC,87015,HCPCS,outpatient,,,220.81,165.61,,198.73,90,,,percent of total billed charges,90% of total billed charges,205.35,93,,,percent of total billed charges,93% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,187.69,85,,,percent of total billed charges,85% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,179.74,81.4,,,percent of total billed charges,81.4% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,165.61,75,,,percent of total billed charges,75% of total billed charges,187.69,85,,,percent of total billed charges,85% of total billed charges,83.91,205.35,
Blood Culture,2388,CDM,300,RC,87040,HCPCS,outpatient,,,103.12,77.34,,92.81,90,,,percent of total billed charges,90% of total billed charges,95.9,93,,,percent of total billed charges,93% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,83.94,81.4,,,percent of total billed charges,81.4% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,77.34,75,,,percent of total billed charges,75% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,95.9,
Stool Culture-Sal/Shig,2389,CDM,300,RC,87045,HCPCS,outpatient,,,59.68,44.76,,53.71,90,,,percent of total billed charges,90% of total billed charges,55.5,93,,,percent of total billed charges,93% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,50.73,85,,,percent of total billed charges,85% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,48.58,81.4,,,percent of total billed charges,81.4% of total billed charges,53.71,90,,,percent of total billed charges,90% of total billed charges,53.71,90,,,percent of total billed charges,90% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,44.76,75,,,percent of total billed charges,75% of total billed charges,50.73,85,,,percent of total billed charges,85% of total billed charges,22.68,55.5,
"(RES) SALMONELLA AND SHIG, CULTURE",2390,CDM,300,RC,87045,HCPCS,outpatient,,,59.68,44.76,,53.71,90,,,percent of total billed charges,90% of total billed charges,55.5,93,,,percent of total billed charges,93% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,50.73,85,,,percent of total billed charges,85% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,48.58,81.4,,,percent of total billed charges,81.4% of total billed charges,53.71,90,,,percent of total billed charges,90% of total billed charges,53.71,90,,,percent of total billed charges,90% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,44.76,75,,,percent of total billed charges,75% of total billed charges,50.73,85,,,percent of total billed charges,85% of total billed charges,22.68,55.5,
Profile - Stool Culture-Campylobacter,2391,CDM,300,RC,87046,HCPCS,outpatient,,,49.55,37.16,,44.6,90,,,percent of total billed charges,90% of total billed charges,46.08,93,,,percent of total billed charges,93% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,42.12,85,,,percent of total billed charges,85% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,40.33,81.4,,,percent of total billed charges,81.4% of total billed charges,44.6,90,,,percent of total billed charges,90% of total billed charges,44.6,90,,,percent of total billed charges,90% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,37.16,75,,,percent of total billed charges,75% of total billed charges,42.12,85,,,percent of total billed charges,85% of total billed charges,18.83,46.08,
"(RES) CAMPYLOBACTER, CULTURE",2392,CDM,300,RC,87046,HCPCS,outpatient,,,49.55,37.16,,44.6,90,,,percent of total billed charges,90% of total billed charges,46.08,93,,,percent of total billed charges,93% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,42.12,85,,,percent of total billed charges,85% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,40.33,81.4,,,percent of total billed charges,81.4% of total billed charges,44.6,90,,,percent of total billed charges,90% of total billed charges,44.6,90,,,percent of total billed charges,90% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,18.83,38,,,percent of total billed charges,38% of total billed charges,37.16,75,,,percent of total billed charges,75% of total billed charges,42.12,85,,,percent of total billed charges,85% of total billed charges,18.83,46.08,
"Culture, other: specify source",2393,CDM,300,RC,87070,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
Culture  Sputum,2394,CDM,300,RC,87070,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
Culture CSF,2395,CDM,300,RC,87070,HCPCS,outpatient,,,135.15,101.36,,121.64,90,,,percent of total billed charges,90% of total billed charges,125.69,93,,,percent of total billed charges,93% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,114.88,85,,,percent of total billed charges,85% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,110.01,81.4,,,percent of total billed charges,81.4% of total billed charges,121.64,90,,,percent of total billed charges,90% of total billed charges,121.64,90,,,percent of total billed charges,90% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,101.36,75,,,percent of total billed charges,75% of total billed charges,114.88,85,,,percent of total billed charges,85% of total billed charges,51.36,125.69,
"Culture,Ear",2396,CDM,300,RC,87070,HCPCS,outpatient,,,118.24,88.68,,106.42,90,,,percent of total billed charges,90% of total billed charges,109.96,93,,,percent of total billed charges,93% of total billed charges,44.93,38,,,percent of total billed charges,38% of total billed charges,44.93,38,,,percent of total billed charges,38% of total billed charges,100.5,85,,,percent of total billed charges,85% of total billed charges,44.93,38,,,percent of total billed charges,38% of total billed charges,96.25,81.4,,,percent of total billed charges,81.4% of total billed charges,106.42,90,,,percent of total billed charges,90% of total billed charges,106.42,90,,,percent of total billed charges,90% of total billed charges,44.93,38,,,percent of total billed charges,38% of total billed charges,44.93,38,,,percent of total billed charges,38% of total billed charges,44.93,38,,,percent of total billed charges,38% of total billed charges,88.68,75,,,percent of total billed charges,75% of total billed charges,100.5,85,,,percent of total billed charges,85% of total billed charges,44.93,109.96,
"Culture,EYE",2397,CDM,300,RC,87070,HCPCS,outpatient,,,123.87,92.9,,111.48,90,,,percent of total billed charges,90% of total billed charges,115.2,93,,,percent of total billed charges,93% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,105.29,85,,,percent of total billed charges,85% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,100.83,81.4,,,percent of total billed charges,81.4% of total billed charges,111.48,90,,,percent of total billed charges,90% of total billed charges,111.48,90,,,percent of total billed charges,90% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,47.07,38,,,percent of total billed charges,38% of total billed charges,92.9,75,,,percent of total billed charges,75% of total billed charges,105.29,85,,,percent of total billed charges,85% of total billed charges,47.07,115.2,
Culture Urogenital (Alamosa),2398,CDM,300,RC,87070,HCPCS,outpatient,,,143.59,107.69,,129.23,90,,,percent of total billed charges,90% of total billed charges,133.54,93,,,percent of total billed charges,93% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,122.05,85,,,percent of total billed charges,85% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,116.88,81.4,,,percent of total billed charges,81.4% of total billed charges,129.23,90,,,percent of total billed charges,90% of total billed charges,129.23,90,,,percent of total billed charges,90% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,107.69,75,,,percent of total billed charges,75% of total billed charges,122.05,85,,,percent of total billed charges,85% of total billed charges,54.56,133.54,
"(RES) CULTURE, AEROBIC BACTERIA",2399,CDM,300,RC,87070,HCPCS,outpatient,,,106.12,79.59,,95.51,90,,,percent of total billed charges,90% of total billed charges,98.69,93,,,percent of total billed charges,93% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,86.38,81.4,,,percent of total billed charges,81.4% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,79.59,75,,,percent of total billed charges,75% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,98.69,
(Result) Gram Stain Smear,2400,CDM,300,RC,87070,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Sputum Culture,2401,CDM,300,RC,87070,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Culture Wound,2402,CDM,300,RC,87070,HCPCS,outpatient,,,104.42,78.32,,93.98,90,,,percent of total billed charges,90% of total billed charges,97.11,93,,,percent of total billed charges,93% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,85,81.4,,,percent of total billed charges,81.4% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,78.32,75,,,percent of total billed charges,75% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,97.11,
Culture Vaginal/GU - alamosa,2403,CDM,300,RC,87070,HCPCS,outpatient,,,143.59,107.69,,129.23,90,,,percent of total billed charges,90% of total billed charges,133.54,93,,,percent of total billed charges,93% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,122.05,85,,,percent of total billed charges,85% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,116.88,81.4,,,percent of total billed charges,81.4% of total billed charges,129.23,90,,,percent of total billed charges,90% of total billed charges,129.23,90,,,percent of total billed charges,90% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,107.69,75,,,percent of total billed charges,75% of total billed charges,122.05,85,,,percent of total billed charges,85% of total billed charges,54.56,133.54,
"CULTURE, BODY FLUID",2404,CDM,300,RC,87070,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
Culture Bone,2405,CDM,300,RC,87070,HCPCS,outpatient,,,84.46,63.35,,76.01,90,,,percent of total billed charges,90% of total billed charges,78.55,93,,,percent of total billed charges,93% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,68.75,81.4,,,percent of total billed charges,81.4% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,63.35,75,,,percent of total billed charges,75% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,78.55,
Culture  -Anaerobic,2406,CDM,300,RC,87073,HCPCS,outpatient,,,73.83,55.37,,66.45,90,,,percent of total billed charges,90% of total billed charges,68.66,93,,,percent of total billed charges,93% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,62.76,85,,,percent of total billed charges,85% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,60.1,81.4,,,percent of total billed charges,81.4% of total billed charges,66.45,90,,,percent of total billed charges,90% of total billed charges,66.45,90,,,percent of total billed charges,90% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,55.37,75,,,percent of total billed charges,75% of total billed charges,62.76,85,,,percent of total billed charges,85% of total billed charges,28.06,68.66,
"(RES) BACTERIAL IDENTIFICATION, ANAEROBIC",2407,CDM,300,RC,87075,HCPCS,outpatient,,,106.12,79.59,,95.51,90,,,percent of total billed charges,90% of total billed charges,98.69,93,,,percent of total billed charges,93% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,86.38,81.4,,,percent of total billed charges,81.4% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,79.59,75,,,percent of total billed charges,75% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,98.69,
Anaerobic Bacteria Identification and Susceptibility,2408,CDM,300,RC,87076,HCPCS,outpatient,,,139.34,104.51,,125.41,90,,,percent of total billed charges,90% of total billed charges,129.59,93,,,percent of total billed charges,93% of total billed charges,52.95,38,,,percent of total billed charges,38% of total billed charges,52.95,38,,,percent of total billed charges,38% of total billed charges,118.44,85,,,percent of total billed charges,85% of total billed charges,52.95,38,,,percent of total billed charges,38% of total billed charges,113.42,81.4,,,percent of total billed charges,81.4% of total billed charges,125.41,90,,,percent of total billed charges,90% of total billed charges,125.41,90,,,percent of total billed charges,90% of total billed charges,52.95,38,,,percent of total billed charges,38% of total billed charges,52.95,38,,,percent of total billed charges,38% of total billed charges,52.95,38,,,percent of total billed charges,38% of total billed charges,104.51,75,,,percent of total billed charges,75% of total billed charges,118.44,85,,,percent of total billed charges,85% of total billed charges,52.95,129.59,
Clo Test,2409,CDM,300,RC,87077,HCPCS,outpatient,,,28.71,21.53,,25.84,90,,,percent of total billed charges,90% of total billed charges,26.7,93,,,percent of total billed charges,93% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,24.4,85,,,percent of total billed charges,85% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,23.37,81.4,,,percent of total billed charges,81.4% of total billed charges,25.84,90,,,percent of total billed charges,90% of total billed charges,25.84,90,,,percent of total billed charges,90% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,10.91,38,,,percent of total billed charges,38% of total billed charges,21.53,75,,,percent of total billed charges,75% of total billed charges,24.4,85,,,percent of total billed charges,85% of total billed charges,10.91,26.7,
Non-Urine ID,2410,CDM,300,RC,87077,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Urine ID,2411,CDM,300,RC,87077,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Non-Urine ID - ALAMOSA,2412,CDM,300,RC,87077,HCPCS,outpatient,,,71.93,53.95,,64.74,90,,,percent of total billed charges,90% of total billed charges,66.89,93,,,percent of total billed charges,93% of total billed charges,27.33,38,,,percent of total billed charges,38% of total billed charges,27.33,38,,,percent of total billed charges,38% of total billed charges,61.14,85,,,percent of total billed charges,85% of total billed charges,27.33,38,,,percent of total billed charges,38% of total billed charges,58.55,81.4,,,percent of total billed charges,81.4% of total billed charges,64.74,90,,,percent of total billed charges,90% of total billed charges,64.74,90,,,percent of total billed charges,90% of total billed charges,27.33,38,,,percent of total billed charges,38% of total billed charges,27.33,38,,,percent of total billed charges,38% of total billed charges,27.33,38,,,percent of total billed charges,38% of total billed charges,53.95,75,,,percent of total billed charges,75% of total billed charges,61.14,85,,,percent of total billed charges,85% of total billed charges,27.33,66.89,
(RES) AEROBIC BACTERIUM ID,2413,CDM,300,RC,87077,HCPCS,outpatient,,,58.75,44.06,,52.88,90,,,percent of total billed charges,90% of total billed charges,54.64,93,,,percent of total billed charges,93% of total billed charges,22.33,38,,,percent of total billed charges,38% of total billed charges,22.33,38,,,percent of total billed charges,38% of total billed charges,49.94,85,,,percent of total billed charges,85% of total billed charges,22.33,38,,,percent of total billed charges,38% of total billed charges,47.82,81.4,,,percent of total billed charges,81.4% of total billed charges,52.88,90,,,percent of total billed charges,90% of total billed charges,52.88,90,,,percent of total billed charges,90% of total billed charges,22.33,38,,,percent of total billed charges,38% of total billed charges,22.33,38,,,percent of total billed charges,38% of total billed charges,22.33,38,,,percent of total billed charges,38% of total billed charges,44.06,75,,,percent of total billed charges,75% of total billed charges,49.94,85,,,percent of total billed charges,85% of total billed charges,22.33,54.64,
Culture Throat,2414,CDM,300,RC,87081,HCPCS,outpatient,,,74.67,56,,67.2,90,,,percent of total billed charges,90% of total billed charges,69.44,93,,,percent of total billed charges,93% of total billed charges,28.37,38,,,percent of total billed charges,38% of total billed charges,28.37,38,,,percent of total billed charges,38% of total billed charges,63.47,85,,,percent of total billed charges,85% of total billed charges,28.37,38,,,percent of total billed charges,38% of total billed charges,60.78,81.4,,,percent of total billed charges,81.4% of total billed charges,67.2,90,,,percent of total billed charges,90% of total billed charges,67.2,90,,,percent of total billed charges,90% of total billed charges,28.37,38,,,percent of total billed charges,38% of total billed charges,28.37,38,,,percent of total billed charges,38% of total billed charges,28.37,38,,,percent of total billed charges,38% of total billed charges,56,75,,,percent of total billed charges,75% of total billed charges,63.47,85,,,percent of total billed charges,85% of total billed charges,28.37,69.44,
Culture Throat for RST FU,2415,CDM,300,RC,87081,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
YY - Group B Strep - Culture,2416,CDM,300,RC,87081,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
Tularemia (Francisella tularensis) screen,2417,CDM,300,RC,87081,HCPCS,outpatient,,,53.39,40.04,,48.05,90,,,percent of total billed charges,90% of total billed charges,49.65,93,,,percent of total billed charges,93% of total billed charges,20.29,38,,,percent of total billed charges,38% of total billed charges,20.29,38,,,percent of total billed charges,38% of total billed charges,45.38,85,,,percent of total billed charges,85% of total billed charges,20.29,38,,,percent of total billed charges,38% of total billed charges,43.46,81.4,,,percent of total billed charges,81.4% of total billed charges,48.05,90,,,percent of total billed charges,90% of total billed charges,48.05,90,,,percent of total billed charges,90% of total billed charges,20.29,38,,,percent of total billed charges,38% of total billed charges,20.29,38,,,percent of total billed charges,38% of total billed charges,20.29,38,,,percent of total billed charges,38% of total billed charges,40.04,75,,,percent of total billed charges,75% of total billed charges,45.38,85,,,percent of total billed charges,85% of total billed charges,20.29,49.65,
Culture -screen for MRSA,2418,CDM,300,RC,87081,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
Culture Urine,2419,CDM,300,RC,87088,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
"(RES) Culture, Fungus",2420,CDM,300,RC,87101,HCPCS,outpatient,,,102.72,77.04,,92.45,90,,,percent of total billed charges,90% of total billed charges,95.53,93,,,percent of total billed charges,93% of total billed charges,39.03,38,,,percent of total billed charges,38% of total billed charges,39.03,38,,,percent of total billed charges,38% of total billed charges,87.31,85,,,percent of total billed charges,85% of total billed charges,39.03,38,,,percent of total billed charges,38% of total billed charges,83.61,81.4,,,percent of total billed charges,81.4% of total billed charges,92.45,90,,,percent of total billed charges,90% of total billed charges,92.45,90,,,percent of total billed charges,90% of total billed charges,39.03,38,,,percent of total billed charges,38% of total billed charges,39.03,38,,,percent of total billed charges,38% of total billed charges,39.03,38,,,percent of total billed charges,38% of total billed charges,77.04,75,,,percent of total billed charges,75% of total billed charges,87.31,85,,,percent of total billed charges,85% of total billed charges,39.03,95.53,
Culture Fungus,2421,CDM,300,RC,87102,HCPCS,outpatient,,,193.34,145.01,,174.01,90,,,percent of total billed charges,90% of total billed charges,179.81,93,,,percent of total billed charges,93% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,164.34,85,,,percent of total billed charges,85% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,157.38,81.4,,,percent of total billed charges,81.4% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,145.01,75,,,percent of total billed charges,75% of total billed charges,164.34,85,,,percent of total billed charges,85% of total billed charges,73.47,179.81,
(Lab) Specimen Source,2422,CDM,300,RC,87102,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Fungal Preliminary 1,2423,CDM,300,RC,87102,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Fungal Preliminary 2,2424,CDM,300,RC,87102,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(Result) Fungus Culture, Misc",2425,CDM,300,RC,87102,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Culture, Yeast w Limited Susceptibility",2426,CDM,300,RC,87102,HCPCS,outpatient,,,158.84,119.13,,142.96,90,,,percent of total billed charges,90% of total billed charges,147.72,93,,,percent of total billed charges,93% of total billed charges,60.36,38,,,percent of total billed charges,38% of total billed charges,60.36,38,,,percent of total billed charges,38% of total billed charges,135.01,85,,,percent of total billed charges,85% of total billed charges,60.36,38,,,percent of total billed charges,38% of total billed charges,129.3,81.4,,,percent of total billed charges,81.4% of total billed charges,142.96,90,,,percent of total billed charges,90% of total billed charges,142.96,90,,,percent of total billed charges,90% of total billed charges,60.36,38,,,percent of total billed charges,38% of total billed charges,60.36,38,,,percent of total billed charges,38% of total billed charges,60.36,38,,,percent of total billed charges,38% of total billed charges,119.13,75,,,percent of total billed charges,75% of total billed charges,135.01,85,,,percent of total billed charges,85% of total billed charges,60.36,147.72,
(RES) FUNGAL CULTURE,2427,CDM,300,RC,87102,HCPCS,outpatient,,,102.37,76.78,,92.13,90,,,percent of total billed charges,90% of total billed charges,95.2,93,,,percent of total billed charges,93% of total billed charges,38.9,38,,,percent of total billed charges,38% of total billed charges,38.9,38,,,percent of total billed charges,38% of total billed charges,87.01,85,,,percent of total billed charges,85% of total billed charges,38.9,38,,,percent of total billed charges,38% of total billed charges,83.33,81.4,,,percent of total billed charges,81.4% of total billed charges,92.13,90,,,percent of total billed charges,90% of total billed charges,92.13,90,,,percent of total billed charges,90% of total billed charges,38.9,38,,,percent of total billed charges,38% of total billed charges,38.9,38,,,percent of total billed charges,38% of total billed charges,38.9,38,,,percent of total billed charges,38% of total billed charges,76.78,75,,,percent of total billed charges,75% of total billed charges,87.01,85,,,percent of total billed charges,85% of total billed charges,38.9,95.2,
Fungal Isolate Identification,2428,CDM,300,RC,87106,HCPCS,outpatient,,,92,69,,82.8,90,,,percent of total billed charges,90% of total billed charges,85.56,93,,,percent of total billed charges,93% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,78.2,85,,,percent of total billed charges,85% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,74.89,81.4,,,percent of total billed charges,81.4% of total billed charges,82.8,90,,,percent of total billed charges,90% of total billed charges,82.8,90,,,percent of total billed charges,90% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,34.96,38,,,percent of total billed charges,38% of total billed charges,69,75,,,percent of total billed charges,75% of total billed charges,78.2,85,,,percent of total billed charges,85% of total billed charges,34.96,85.56,
Profile - Chlamydia Culture,2429,CDM,300,RC,87110,HCPCS,outpatient,,,114.86,86.15,,103.37,90,,,percent of total billed charges,90% of total billed charges,106.82,93,,,percent of total billed charges,93% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,97.63,85,,,percent of total billed charges,85% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,93.5,81.4,,,percent of total billed charges,81.4% of total billed charges,103.37,90,,,percent of total billed charges,90% of total billed charges,103.37,90,,,percent of total billed charges,90% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,86.15,75,,,percent of total billed charges,75% of total billed charges,97.63,85,,,percent of total billed charges,85% of total billed charges,43.65,106.82,
Culture Mycobacteria,2430,CDM,300,RC,87116,HCPCS,outpatient,,,154.57,115.93,,139.11,90,,,percent of total billed charges,90% of total billed charges,143.75,93,,,percent of total billed charges,93% of total billed charges,58.74,38,,,percent of total billed charges,38% of total billed charges,58.74,38,,,percent of total billed charges,38% of total billed charges,131.38,85,,,percent of total billed charges,85% of total billed charges,58.74,38,,,percent of total billed charges,38% of total billed charges,125.82,81.4,,,percent of total billed charges,81.4% of total billed charges,139.11,90,,,percent of total billed charges,90% of total billed charges,139.11,90,,,percent of total billed charges,90% of total billed charges,58.74,38,,,percent of total billed charges,38% of total billed charges,58.74,38,,,percent of total billed charges,38% of total billed charges,58.74,38,,,percent of total billed charges,38% of total billed charges,115.93,75,,,percent of total billed charges,75% of total billed charges,131.38,85,,,percent of total billed charges,85% of total billed charges,58.74,143.75,
"Mycobacterium, Blood Culture",2431,CDM,300,RC,87116,HCPCS,outpatient,,,117.17,87.88,,105.45,90,,,percent of total billed charges,90% of total billed charges,108.97,93,,,percent of total billed charges,93% of total billed charges,44.52,38,,,percent of total billed charges,38% of total billed charges,44.52,38,,,percent of total billed charges,38% of total billed charges,99.59,85,,,percent of total billed charges,85% of total billed charges,44.52,38,,,percent of total billed charges,38% of total billed charges,95.38,81.4,,,percent of total billed charges,81.4% of total billed charges,105.45,90,,,percent of total billed charges,90% of total billed charges,105.45,90,,,percent of total billed charges,90% of total billed charges,44.52,38,,,percent of total billed charges,38% of total billed charges,44.52,38,,,percent of total billed charges,38% of total billed charges,44.52,38,,,percent of total billed charges,38% of total billed charges,87.88,75,,,percent of total billed charges,75% of total billed charges,99.59,85,,,percent of total billed charges,85% of total billed charges,44.52,108.97,
Profile - Culture typing (HSV),2432,CDM,300,RC,87140,HCPCS,outpatient,,,86.15,64.61,,77.54,90,,,percent of total billed charges,90% of total billed charges,80.12,93,,,percent of total billed charges,93% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,73.23,85,,,percent of total billed charges,85% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,70.13,81.4,,,percent of total billed charges,81.4% of total billed charges,77.54,90,,,percent of total billed charges,90% of total billed charges,77.54,90,,,percent of total billed charges,90% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,64.61,75,,,percent of total billed charges,75% of total billed charges,73.23,85,,,percent of total billed charges,85% of total billed charges,32.74,80.12,
"Bacterial Identification, Anaerobic",2433,CDM,300,RC,87143,HCPCS,outpatient,,,58.51,43.88,,52.66,90,,,percent of total billed charges,90% of total billed charges,54.41,93,,,percent of total billed charges,93% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,47.63,81.4,,,percent of total billed charges,81.4% of total billed charges,52.66,90,,,percent of total billed charges,90% of total billed charges,52.66,90,,,percent of total billed charges,90% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,22.23,38,,,percent of total billed charges,38% of total billed charges,43.88,75,,,percent of total billed charges,75% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,22.23,54.41,
STREPTEX - Alamosa,2434,CDM,300,RC,87147,HCPCS,outpatient,,,33.65,25.24,,30.29,90,,,percent of total billed charges,90% of total billed charges,31.29,93,,,percent of total billed charges,93% of total billed charges,12.79,38,,,percent of total billed charges,38% of total billed charges,12.79,38,,,percent of total billed charges,38% of total billed charges,28.6,85,,,percent of total billed charges,85% of total billed charges,12.79,38,,,percent of total billed charges,38% of total billed charges,27.39,81.4,,,percent of total billed charges,81.4% of total billed charges,30.29,90,,,percent of total billed charges,90% of total billed charges,30.29,90,,,percent of total billed charges,90% of total billed charges,12.79,38,,,percent of total billed charges,38% of total billed charges,12.79,38,,,percent of total billed charges,38% of total billed charges,12.79,38,,,percent of total billed charges,38% of total billed charges,25.24,75,,,percent of total billed charges,75% of total billed charges,28.6,85,,,percent of total billed charges,85% of total billed charges,12.79,31.29,
Pinworm Exam,2435,CDM,300,RC,87172,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,51.34,
(RES) Ova & Parasites (1),2436,CDM,300,RC,87177,HCPCS,outpatient,,,28.15,21.11,,25.34,90,,,percent of total billed charges,90% of total billed charges,26.18,93,,,percent of total billed charges,93% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,23.93,85,,,percent of total billed charges,85% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,22.91,81.4,,,percent of total billed charges,81.4% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,21.11,75,,,percent of total billed charges,75% of total billed charges,23.93,85,,,percent of total billed charges,85% of total billed charges,10.7,26.18,
DONOTUSEOva and Parasite,2437,CDM,300,RC,87177,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Ova and Parasite,2438,CDM,300,RC,87177,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MIC(anerobic) each antibiotic,2439,CDM,300,RC,87181,HCPCS,outpatient,,,61.83,46.37,,55.65,90,,,percent of total billed charges,90% of total billed charges,57.5,93,,,percent of total billed charges,93% of total billed charges,23.5,38,,,percent of total billed charges,38% of total billed charges,23.5,38,,,percent of total billed charges,38% of total billed charges,52.56,85,,,percent of total billed charges,85% of total billed charges,23.5,38,,,percent of total billed charges,38% of total billed charges,50.33,81.4,,,percent of total billed charges,81.4% of total billed charges,55.65,90,,,percent of total billed charges,90% of total billed charges,55.65,90,,,percent of total billed charges,90% of total billed charges,23.5,38,,,percent of total billed charges,38% of total billed charges,23.5,38,,,percent of total billed charges,38% of total billed charges,23.5,38,,,percent of total billed charges,38% of total billed charges,46.37,75,,,percent of total billed charges,75% of total billed charges,52.56,85,,,percent of total billed charges,85% of total billed charges,23.5,57.5,
Betalactamase  ALAMOSA,2440,CDM,300,RC,87185,HCPCS,outpatient,,,63.81,47.86,,57.43,90,,,percent of total billed charges,90% of total billed charges,59.34,93,,,percent of total billed charges,93% of total billed charges,24.25,38,,,percent of total billed charges,38% of total billed charges,24.25,38,,,percent of total billed charges,38% of total billed charges,54.24,85,,,percent of total billed charges,85% of total billed charges,24.25,38,,,percent of total billed charges,38% of total billed charges,51.94,81.4,,,percent of total billed charges,81.4% of total billed charges,57.43,90,,,percent of total billed charges,90% of total billed charges,57.43,90,,,percent of total billed charges,90% of total billed charges,24.25,38,,,percent of total billed charges,38% of total billed charges,24.25,38,,,percent of total billed charges,38% of total billed charges,24.25,38,,,percent of total billed charges,38% of total billed charges,47.86,75,,,percent of total billed charges,75% of total billed charges,54.24,85,,,percent of total billed charges,85% of total billed charges,24.25,59.34,
Sensitivity (MIC),2441,CDM,300,RC,87186,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
SENSITIVITY - ALamosa,2442,CDM,300,RC,87186,HCPCS,outpatient,,,91.66,68.75,,82.49,90,,,percent of total billed charges,90% of total billed charges,85.24,93,,,percent of total billed charges,93% of total billed charges,34.83,38,,,percent of total billed charges,38% of total billed charges,34.83,38,,,percent of total billed charges,38% of total billed charges,77.91,85,,,percent of total billed charges,85% of total billed charges,34.83,38,,,percent of total billed charges,38% of total billed charges,74.61,81.4,,,percent of total billed charges,81.4% of total billed charges,82.49,90,,,percent of total billed charges,90% of total billed charges,82.49,90,,,percent of total billed charges,90% of total billed charges,34.83,38,,,percent of total billed charges,38% of total billed charges,34.83,38,,,percent of total billed charges,38% of total billed charges,34.83,38,,,percent of total billed charges,38% of total billed charges,68.75,75,,,percent of total billed charges,75% of total billed charges,77.91,85,,,percent of total billed charges,85% of total billed charges,34.83,85.24,
"Susceptibility, Yeast, Comprehensive",2443,CDM,300,RC,87186,HCPCS,outpatient,,,676.53,507.4,,608.88,90,,,percent of total billed charges,90% of total billed charges,629.17,93,,,percent of total billed charges,93% of total billed charges,257.08,38,,,percent of total billed charges,38% of total billed charges,257.08,38,,,percent of total billed charges,38% of total billed charges,575.05,85,,,percent of total billed charges,85% of total billed charges,257.08,38,,,percent of total billed charges,38% of total billed charges,550.7,81.4,,,percent of total billed charges,81.4% of total billed charges,608.88,90,,,percent of total billed charges,90% of total billed charges,608.88,90,,,percent of total billed charges,90% of total billed charges,257.08,38,,,percent of total billed charges,38% of total billed charges,257.08,38,,,percent of total billed charges,38% of total billed charges,257.08,38,,,percent of total billed charges,38% of total billed charges,507.4,75,,,percent of total billed charges,75% of total billed charges,575.05,85,,,percent of total billed charges,85% of total billed charges,257.08,629.17,
(RES) AEROBIC SENSITIVITY,2444,CDM,300,RC,87186,HCPCS,outpatient,,,116.73,87.55,,105.06,90,,,percent of total billed charges,90% of total billed charges,108.56,93,,,percent of total billed charges,93% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,99.22,85,,,percent of total billed charges,85% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,95.02,81.4,,,percent of total billed charges,81.4% of total billed charges,105.06,90,,,percent of total billed charges,90% of total billed charges,105.06,90,,,percent of total billed charges,90% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,44.36,38,,,percent of total billed charges,38% of total billed charges,87.55,75,,,percent of total billed charges,75% of total billed charges,99.22,85,,,percent of total billed charges,85% of total billed charges,44.36,108.56,
Quest send out ID/MIC,2445,CDM,300,RC,87186,HCPCS,outpatient,,,236.69,177.52,,213.02,90,,,percent of total billed charges,90% of total billed charges,220.12,93,,,percent of total billed charges,93% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,201.19,85,,,percent of total billed charges,85% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,192.67,81.4,,,percent of total billed charges,81.4% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,177.52,75,,,percent of total billed charges,75% of total billed charges,201.19,85,,,percent of total billed charges,85% of total billed charges,89.94,220.12,
Gram Stain,2446,CDM,300,RC,87205,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Gram Stain - Alamosa,2447,CDM,300,RC,87205,HCPCS,outpatient,,,92.82,69.62,,83.54,90,,,percent of total billed charges,90% of total billed charges,86.32,93,,,percent of total billed charges,93% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,78.9,85,,,percent of total billed charges,85% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,75.56,81.4,,,percent of total billed charges,81.4% of total billed charges,83.54,90,,,percent of total billed charges,90% of total billed charges,83.54,90,,,percent of total billed charges,90% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,69.62,75,,,percent of total billed charges,75% of total billed charges,78.9,85,,,percent of total billed charges,85% of total billed charges,35.27,86.32,
(RES) GRAM STAIN,2448,CDM,300,RC,87205,HCPCS,outpatient,,,76.63,57.47,,68.97,90,,,percent of total billed charges,90% of total billed charges,71.27,93,,,percent of total billed charges,93% of total billed charges,29.12,38,,,percent of total billed charges,38% of total billed charges,29.12,38,,,percent of total billed charges,38% of total billed charges,65.14,85,,,percent of total billed charges,85% of total billed charges,29.12,38,,,percent of total billed charges,38% of total billed charges,62.38,81.4,,,percent of total billed charges,81.4% of total billed charges,68.97,90,,,percent of total billed charges,90% of total billed charges,68.97,90,,,percent of total billed charges,90% of total billed charges,29.12,38,,,percent of total billed charges,38% of total billed charges,29.12,38,,,percent of total billed charges,38% of total billed charges,29.12,38,,,percent of total billed charges,38% of total billed charges,57.47,75,,,percent of total billed charges,75% of total billed charges,65.14,85,,,percent of total billed charges,85% of total billed charges,29.12,71.27,
Acid-Fast  Bacilli stain,2449,CDM,300,RC,87206,HCPCS,outpatient,,,97.63,73.22,,87.87,90,,,percent of total billed charges,90% of total billed charges,90.8,93,,,percent of total billed charges,93% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,82.99,85,,,percent of total billed charges,85% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,79.47,81.4,,,percent of total billed charges,81.4% of total billed charges,87.87,90,,,percent of total billed charges,90% of total billed charges,87.87,90,,,percent of total billed charges,90% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,73.22,75,,,percent of total billed charges,75% of total billed charges,82.99,85,,,percent of total billed charges,85% of total billed charges,37.1,90.8,
"Fluorescent fast stain, fungi",2450,CDM,300,RC,87206,HCPCS,outpatient,,,97.63,73.22,,87.87,90,,,percent of total billed charges,90% of total billed charges,90.8,93,,,percent of total billed charges,93% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,82.99,85,,,percent of total billed charges,85% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,79.47,81.4,,,percent of total billed charges,81.4% of total billed charges,87.87,90,,,percent of total billed charges,90% of total billed charges,87.87,90,,,percent of total billed charges,90% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,37.1,38,,,percent of total billed charges,38% of total billed charges,73.22,75,,,percent of total billed charges,75% of total billed charges,82.99,85,,,percent of total billed charges,85% of total billed charges,37.1,90.8,
(RES) FUNGAL STAIN,2451,CDM,300,RC,87206,HCPCS,outpatient,,,75.74,56.81,,68.17,90,,,percent of total billed charges,90% of total billed charges,70.44,93,,,percent of total billed charges,93% of total billed charges,28.78,38,,,percent of total billed charges,38% of total billed charges,28.78,38,,,percent of total billed charges,38% of total billed charges,64.38,85,,,percent of total billed charges,85% of total billed charges,28.78,38,,,percent of total billed charges,38% of total billed charges,61.65,81.4,,,percent of total billed charges,81.4% of total billed charges,68.17,90,,,percent of total billed charges,90% of total billed charges,68.17,90,,,percent of total billed charges,90% of total billed charges,28.78,38,,,percent of total billed charges,38% of total billed charges,28.78,38,,,percent of total billed charges,38% of total billed charges,28.78,38,,,percent of total billed charges,38% of total billed charges,56.81,75,,,percent of total billed charges,75% of total billed charges,64.38,85,,,percent of total billed charges,85% of total billed charges,28.78,70.44,
CYCLOSPORA,2452,CDM,300,RC,87207,HCPCS,outpatient,,,182.8,137.1,,164.52,90,,,percent of total billed charges,90% of total billed charges,170,93,,,percent of total billed charges,93% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,148.8,81.4,,,percent of total billed charges,81.4% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,137.1,75,,,percent of total billed charges,75% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,170,
Malaria Bebesia and other blood parasites,2453,CDM,300,RC,87207,HCPCS,outpatient,,,189.21,141.91,,170.29,90,,,percent of total billed charges,90% of total billed charges,175.97,93,,,percent of total billed charges,93% of total billed charges,71.9,38,,,percent of total billed charges,38% of total billed charges,71.9,38,,,percent of total billed charges,38% of total billed charges,160.83,85,,,percent of total billed charges,85% of total billed charges,71.9,38,,,percent of total billed charges,38% of total billed charges,154.02,81.4,,,percent of total billed charges,81.4% of total billed charges,170.29,90,,,percent of total billed charges,90% of total billed charges,170.29,90,,,percent of total billed charges,90% of total billed charges,71.9,38,,,percent of total billed charges,38% of total billed charges,71.9,38,,,percent of total billed charges,38% of total billed charges,71.9,38,,,percent of total billed charges,38% of total billed charges,141.91,75,,,percent of total billed charges,75% of total billed charges,160.83,85,,,percent of total billed charges,85% of total billed charges,71.9,175.97,
Microsporidia Exam,2454,CDM,300,RC,87207,HCPCS,outpatient,,,105,78.75,,94.5,90,,,percent of total billed charges,90% of total billed charges,97.65,93,,,percent of total billed charges,93% of total billed charges,39.9,38,,,percent of total billed charges,38% of total billed charges,39.9,38,,,percent of total billed charges,38% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,39.9,38,,,percent of total billed charges,38% of total billed charges,85.47,81.4,,,percent of total billed charges,81.4% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,39.9,38,,,percent of total billed charges,38% of total billed charges,39.9,38,,,percent of total billed charges,38% of total billed charges,39.9,38,,,percent of total billed charges,38% of total billed charges,78.75,75,,,percent of total billed charges,75% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,39.9,97.65,
(RES) Ova & Parasites (2),2455,CDM,300,RC,87209,HCPCS,outpatient,,,58.59,43.94,,52.73,90,,,percent of total billed charges,90% of total billed charges,54.49,93,,,percent of total billed charges,93% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,47.69,81.4,,,percent of total billed charges,81.4% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,43.94,75,,,percent of total billed charges,75% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,54.49,
Wet Prep / KOH,2456,CDM,300,RC,87210,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
Clinic Wet prep/KOH,2457,CDM,300,RC,87210,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
(RES) Fungal Smear,2458,CDM,300,RC,87220,HCPCS,outpatient,,,86.7,65.03,,78.03,90,,,percent of total billed charges,90% of total billed charges,80.63,93,,,percent of total billed charges,93% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,70.57,81.4,,,percent of total billed charges,81.4% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,32.95,38,,,percent of total billed charges,38% of total billed charges,65.03,75,,,percent of total billed charges,75% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,32.95,80.63,
C. Diff cytotoxin AB neutral,2459,CDM,300,RC,87230,HCPCS,outpatient,,,287.72,215.79,,258.95,90,,,percent of total billed charges,90% of total billed charges,267.58,93,,,percent of total billed charges,93% of total billed charges,109.33,38,,,percent of total billed charges,38% of total billed charges,109.33,38,,,percent of total billed charges,38% of total billed charges,244.56,85,,,percent of total billed charges,85% of total billed charges,109.33,38,,,percent of total billed charges,38% of total billed charges,234.2,81.4,,,percent of total billed charges,81.4% of total billed charges,258.95,90,,,percent of total billed charges,90% of total billed charges,258.95,90,,,percent of total billed charges,90% of total billed charges,109.33,38,,,percent of total billed charges,38% of total billed charges,109.33,38,,,percent of total billed charges,38% of total billed charges,109.33,38,,,percent of total billed charges,38% of total billed charges,215.79,75,,,percent of total billed charges,75% of total billed charges,244.56,85,,,percent of total billed charges,85% of total billed charges,109.33,267.58,
"Culture, Virus",2460,CDM,300,RC,87252,HCPCS,outpatient,,,299.97,224.98,,269.97,90,,,percent of total billed charges,90% of total billed charges,278.97,93,,,percent of total billed charges,93% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,254.97,85,,,percent of total billed charges,85% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,244.18,81.4,,,percent of total billed charges,81.4% of total billed charges,269.97,90,,,percent of total billed charges,90% of total billed charges,269.97,90,,,percent of total billed charges,90% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,224.98,75,,,percent of total billed charges,75% of total billed charges,254.97,85,,,percent of total billed charges,85% of total billed charges,113.99,278.97,
Varicella zoster Rapid culture,2461,CDM,300,RC,87254,HCPCS,outpatient,,,185.81,139.36,,167.23,90,,,percent of total billed charges,90% of total billed charges,172.8,93,,,percent of total billed charges,93% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,157.94,85,,,percent of total billed charges,85% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,151.25,81.4,,,percent of total billed charges,81.4% of total billed charges,167.23,90,,,percent of total billed charges,90% of total billed charges,167.23,90,,,percent of total billed charges,90% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,139.36,75,,,percent of total billed charges,75% of total billed charges,157.94,85,,,percent of total billed charges,85% of total billed charges,70.61,172.8,
Culture Herpes Simplex Virus (HSV),2462,CDM,300,RC,87255,HCPCS,outpatient,,,116.01,87.01,,104.41,90,,,percent of total billed charges,90% of total billed charges,107.89,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.43,81.4,,,percent of total billed charges,81.4% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,104.41,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87.01,75,,,percent of total billed charges,75% of total billed charges,98.61,85,,,percent of total billed charges,85% of total billed charges,44.08,107.89,
"Pneumocystis jirovecii, DFA",2463,CDM,300,RC,87281,HCPCS,outpatient,,,160.97,120.73,,144.87,90,,,percent of total billed charges,90% of total billed charges,149.7,93,,,percent of total billed charges,93% of total billed charges,61.17,38,,,percent of total billed charges,38% of total billed charges,61.17,38,,,percent of total billed charges,38% of total billed charges,136.82,85,,,percent of total billed charges,85% of total billed charges,61.17,38,,,percent of total billed charges,38% of total billed charges,131.03,81.4,,,percent of total billed charges,81.4% of total billed charges,144.87,90,,,percent of total billed charges,90% of total billed charges,144.87,90,,,percent of total billed charges,90% of total billed charges,61.17,38,,,percent of total billed charges,38% of total billed charges,61.17,38,,,percent of total billed charges,38% of total billed charges,61.17,38,,,percent of total billed charges,38% of total billed charges,120.73,75,,,percent of total billed charges,75% of total billed charges,136.82,85,,,percent of total billed charges,85% of total billed charges,61.17,149.7,
"Aspergillus Antigen, EIA, Serum",2464,CDM,300,RC,87305,HCPCS,outpatient,,,178.56,133.92,,160.7,90,,,percent of total billed charges,90% of total billed charges,166.06,93,,,percent of total billed charges,93% of total billed charges,67.85,38,,,percent of total billed charges,38% of total billed charges,67.85,38,,,percent of total billed charges,38% of total billed charges,151.78,85,,,percent of total billed charges,85% of total billed charges,67.85,38,,,percent of total billed charges,38% of total billed charges,145.35,81.4,,,percent of total billed charges,81.4% of total billed charges,160.7,90,,,percent of total billed charges,90% of total billed charges,160.7,90,,,percent of total billed charges,90% of total billed charges,67.85,38,,,percent of total billed charges,38% of total billed charges,67.85,38,,,percent of total billed charges,38% of total billed charges,67.85,38,,,percent of total billed charges,38% of total billed charges,133.92,75,,,percent of total billed charges,75% of total billed charges,151.78,85,,,percent of total billed charges,85% of total billed charges,67.85,166.06,
"C. DIFFICILE TOXIN A,B",2465,CDM,300,RC,87324,HCPCS,outpatient,,,151.54,113.66,,136.39,90,,,percent of total billed charges,90% of total billed charges,140.93,93,,,percent of total billed charges,93% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,128.81,85,,,percent of total billed charges,85% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,123.35,81.4,,,percent of total billed charges,81.4% of total billed charges,136.39,90,,,percent of total billed charges,90% of total billed charges,136.39,90,,,percent of total billed charges,90% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,113.66,75,,,percent of total billed charges,75% of total billed charges,128.81,85,,,percent of total billed charges,85% of total billed charges,57.59,140.93,
(RES) C. Diff Toxin B (reflex),2466,CDM,300,RC,87324,HCPCS,outpatient,,,151.54,113.66,,136.39,90,,,percent of total billed charges,90% of total billed charges,140.93,93,,,percent of total billed charges,93% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,128.81,85,,,percent of total billed charges,85% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,123.35,81.4,,,percent of total billed charges,81.4% of total billed charges,136.39,90,,,percent of total billed charges,90% of total billed charges,136.39,90,,,percent of total billed charges,90% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,57.59,38,,,percent of total billed charges,38% of total billed charges,113.66,75,,,percent of total billed charges,75% of total billed charges,128.81,85,,,percent of total billed charges,85% of total billed charges,57.59,140.93,
Cryptosporidium AG,2467,CDM,300,RC,87328,HCPCS,outpatient,,,141.79,106.34,,127.61,90,,,percent of total billed charges,90% of total billed charges,131.86,93,,,percent of total billed charges,93% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,115.42,81.4,,,percent of total billed charges,81.4% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,106.34,75,,,percent of total billed charges,75% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,131.86,
Profile - Giardia ag,2468,CDM,300,RC,87329,HCPCS,outpatient,,,59.68,44.76,,53.71,90,,,percent of total billed charges,90% of total billed charges,55.5,93,,,percent of total billed charges,93% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,50.73,85,,,percent of total billed charges,85% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,48.58,81.4,,,percent of total billed charges,81.4% of total billed charges,53.71,90,,,percent of total billed charges,90% of total billed charges,53.71,90,,,percent of total billed charges,90% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,22.68,38,,,percent of total billed charges,38% of total billed charges,44.76,75,,,percent of total billed charges,75% of total billed charges,50.73,85,,,percent of total billed charges,85% of total billed charges,22.68,55.5,
"Giardia Antigen, EIA, Stool",2469,CDM,300,RC,87329,HCPCS,outpatient,,,103.07,77.3,,92.76,90,,,percent of total billed charges,90% of total billed charges,95.86,93,,,percent of total billed charges,93% of total billed charges,39.17,38,,,percent of total billed charges,38% of total billed charges,39.17,38,,,percent of total billed charges,38% of total billed charges,87.61,85,,,percent of total billed charges,85% of total billed charges,39.17,38,,,percent of total billed charges,38% of total billed charges,83.9,81.4,,,percent of total billed charges,81.4% of total billed charges,92.76,90,,,percent of total billed charges,90% of total billed charges,92.76,90,,,percent of total billed charges,90% of total billed charges,39.17,38,,,percent of total billed charges,38% of total billed charges,39.17,38,,,percent of total billed charges,38% of total billed charges,39.17,38,,,percent of total billed charges,38% of total billed charges,77.3,75,,,percent of total billed charges,75% of total billed charges,87.61,85,,,percent of total billed charges,85% of total billed charges,39.17,95.86,
"H.  Pylori Quest, Stool",2470,CDM,300,RC,87338,HCPCS,outpatient,,,423.87,317.9,,381.48,90,,,percent of total billed charges,90% of total billed charges,394.2,93,,,percent of total billed charges,93% of total billed charges,161.07,38,,,percent of total billed charges,38% of total billed charges,161.07,38,,,percent of total billed charges,38% of total billed charges,360.29,85,,,percent of total billed charges,85% of total billed charges,161.07,38,,,percent of total billed charges,38% of total billed charges,345.03,81.4,,,percent of total billed charges,81.4% of total billed charges,381.48,90,,,percent of total billed charges,90% of total billed charges,381.48,90,,,percent of total billed charges,90% of total billed charges,161.07,38,,,percent of total billed charges,38% of total billed charges,161.07,38,,,percent of total billed charges,38% of total billed charges,161.07,38,,,percent of total billed charges,38% of total billed charges,317.9,75,,,percent of total billed charges,75% of total billed charges,360.29,85,,,percent of total billed charges,85% of total billed charges,161.07,394.2,
HEPATITIS B SURFACE ANTIGEN,2471,CDM,300,RC,87340,HCPCS,outpatient,,,89.06,66.8,,80.15,90,,,percent of total billed charges,90% of total billed charges,82.83,93,,,percent of total billed charges,93% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,75.7,85,,,percent of total billed charges,85% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,72.49,81.4,,,percent of total billed charges,81.4% of total billed charges,80.15,90,,,percent of total billed charges,90% of total billed charges,80.15,90,,,percent of total billed charges,90% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,66.8,75,,,percent of total billed charges,75% of total billed charges,75.7,85,,,percent of total billed charges,85% of total billed charges,33.84,82.83,
Hepatitis BeAg,2472,CDM,300,RC,87350,HCPCS,outpatient,,,111.49,83.62,,100.34,90,,,percent of total billed charges,90% of total billed charges,103.69,93,,,percent of total billed charges,93% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,90.75,81.4,,,percent of total billed charges,81.4% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,100.34,90,,,percent of total billed charges,90% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,42.37,38,,,percent of total billed charges,38% of total billed charges,83.62,75,,,percent of total billed charges,75% of total billed charges,94.77,85,,,percent of total billed charges,85% of total billed charges,42.37,103.69,
Histooplasma galac AG-urine,2473,CDM,300,RC,87385,HCPCS,outpatient,,,171.16,128.37,,154.04,90,,,percent of total billed charges,90% of total billed charges,159.18,93,,,percent of total billed charges,93% of total billed charges,65.04,38,,,percent of total billed charges,38% of total billed charges,65.04,38,,,percent of total billed charges,38% of total billed charges,145.49,85,,,percent of total billed charges,85% of total billed charges,65.04,38,,,percent of total billed charges,38% of total billed charges,139.32,81.4,,,percent of total billed charges,81.4% of total billed charges,154.04,90,,,percent of total billed charges,90% of total billed charges,154.04,90,,,percent of total billed charges,90% of total billed charges,65.04,38,,,percent of total billed charges,38% of total billed charges,65.04,38,,,percent of total billed charges,38% of total billed charges,65.04,38,,,percent of total billed charges,38% of total billed charges,128.37,75,,,percent of total billed charges,75% of total billed charges,145.49,85,,,percent of total billed charges,85% of total billed charges,65.04,159.18,
Veritor  RSV,2474,CDM,300,RC,87420,HCPCS,outpatient,,,37.45,28.09,,33.71,90,,,percent of total billed charges,90% of total billed charges,34.83,93,,,percent of total billed charges,93% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,31.83,85,,,percent of total billed charges,85% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,30.48,81.4,,,percent of total billed charges,81.4% of total billed charges,33.71,90,,,percent of total billed charges,90% of total billed charges,33.71,90,,,percent of total billed charges,90% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,28.09,75,,,percent of total billed charges,75% of total billed charges,31.83,85,,,percent of total billed charges,85% of total billed charges,14.23,34.83,
Veritor  RSV,2475,CDM,300,RC,87420,HCPCS,outpatient,,,37.45,28.09,,33.71,90,,,percent of total billed charges,90% of total billed charges,34.83,93,,,percent of total billed charges,93% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,31.83,85,,,percent of total billed charges,85% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,30.48,81.4,,,percent of total billed charges,81.4% of total billed charges,33.71,90,,,percent of total billed charges,90% of total billed charges,33.71,90,,,percent of total billed charges,90% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,14.23,38,,,percent of total billed charges,38% of total billed charges,28.09,75,,,percent of total billed charges,75% of total billed charges,31.83,85,,,percent of total billed charges,85% of total billed charges,14.23,34.83,
Rotavirus Antigen detection,2476,CDM,300,RC,87425,HCPCS,outpatient,,,203.84,152.88,,183.46,90,,,percent of total billed charges,90% of total billed charges,189.57,93,,,percent of total billed charges,93% of total billed charges,77.46,38,,,percent of total billed charges,38% of total billed charges,77.46,38,,,percent of total billed charges,38% of total billed charges,173.26,85,,,percent of total billed charges,85% of total billed charges,77.46,38,,,percent of total billed charges,38% of total billed charges,165.93,81.4,,,percent of total billed charges,81.4% of total billed charges,183.46,90,,,percent of total billed charges,90% of total billed charges,183.46,90,,,percent of total billed charges,90% of total billed charges,77.46,38,,,percent of total billed charges,38% of total billed charges,77.46,38,,,percent of total billed charges,38% of total billed charges,77.46,38,,,percent of total billed charges,38% of total billed charges,152.88,75,,,percent of total billed charges,75% of total billed charges,173.26,85,,,percent of total billed charges,85% of total billed charges,77.46,189.57,
Profile - Stool Culture-Shiga Toxin RFL,2477,CDM,300,RC,87427,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
(RES) SHIGA W/RFL TO E.COLI O157 CULTURE,2478,CDM,300,RC,87427,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
"Veritor Flu A,B, Covid",2479,CDM,300,RC,87428,HCPCS,outpatient,,,156.06,117.05,,140.45,90,,,percent of total billed charges,90% of total billed charges,145.14,93,,,percent of total billed charges,93% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,156.06,,,,other,Not reimbursable per contract,59.3,38,,,percent of total billed charges,38% of total billed charges,127.03,81.4,,,percent of total billed charges,81.4% of total billed charges,140.45,90,,,percent of total billed charges,90% of total billed charges,140.45,90,,,percent of total billed charges,90% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,117.05,75,,,percent of total billed charges,75% of total billed charges,132.65,85,,,percent of total billed charges,85% of total billed charges,59.3,156.06,
"Veritor Flu A,B, Covid",2480,CDM,300,RC,87428,HCPCS,outpatient,,,156.06,117.05,,140.45,90,,,percent of total billed charges,90% of total billed charges,145.14,93,,,percent of total billed charges,93% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,156.06,,,,other,Not reimbursable per contract,59.3,38,,,percent of total billed charges,38% of total billed charges,127.03,81.4,,,percent of total billed charges,81.4% of total billed charges,140.45,90,,,percent of total billed charges,90% of total billed charges,140.45,90,,,percent of total billed charges,90% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,59.3,38,,,percent of total billed charges,38% of total billed charges,117.05,75,,,percent of total billed charges,75% of total billed charges,132.65,85,,,percent of total billed charges,85% of total billed charges,59.3,156.06,
Clinic Rapid Strep,2481,CDM,300,RC,87430,HCPCS,outpatient,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
Legionella AG  EIA Urine,2482,CDM,300,RC,87449,HCPCS,outpatient,,,214.65,160.99,,193.19,90,,,percent of total billed charges,90% of total billed charges,199.62,93,,,percent of total billed charges,93% of total billed charges,81.57,38,,,percent of total billed charges,38% of total billed charges,81.57,38,,,percent of total billed charges,38% of total billed charges,182.45,85,,,percent of total billed charges,85% of total billed charges,81.57,38,,,percent of total billed charges,38% of total billed charges,174.73,81.4,,,percent of total billed charges,81.4% of total billed charges,193.19,90,,,percent of total billed charges,90% of total billed charges,193.19,90,,,percent of total billed charges,90% of total billed charges,81.57,38,,,percent of total billed charges,38% of total billed charges,81.57,38,,,percent of total billed charges,38% of total billed charges,81.57,38,,,percent of total billed charges,38% of total billed charges,160.99,75,,,percent of total billed charges,75% of total billed charges,182.45,85,,,percent of total billed charges,85% of total billed charges,81.57,199.62,
Campylobacter antigen EIA,2483,CDM,300,RC,87449,HCPCS,outpatient,,,156.62,117.47,,140.96,90,,,percent of total billed charges,90% of total billed charges,145.66,93,,,percent of total billed charges,93% of total billed charges,59.52,38,,,percent of total billed charges,38% of total billed charges,59.52,38,,,percent of total billed charges,38% of total billed charges,133.13,85,,,percent of total billed charges,85% of total billed charges,59.52,38,,,percent of total billed charges,38% of total billed charges,127.49,81.4,,,percent of total billed charges,81.4% of total billed charges,140.96,90,,,percent of total billed charges,90% of total billed charges,140.96,90,,,percent of total billed charges,90% of total billed charges,59.52,38,,,percent of total billed charges,38% of total billed charges,59.52,38,,,percent of total billed charges,38% of total billed charges,59.52,38,,,percent of total billed charges,38% of total billed charges,117.47,75,,,percent of total billed charges,75% of total billed charges,133.13,85,,,percent of total billed charges,85% of total billed charges,59.52,145.66,
Fungitell (1-3)-B-D-Glucan,2484,CDM,300,RC,87449,HCPCS,outpatient,,,477.54,358.16,,429.79,90,,,percent of total billed charges,90% of total billed charges,444.11,93,,,percent of total billed charges,93% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,405.91,85,,,percent of total billed charges,85% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,388.72,81.4,,,percent of total billed charges,81.4% of total billed charges,429.79,90,,,percent of total billed charges,90% of total billed charges,429.79,90,,,percent of total billed charges,90% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,358.16,75,,,percent of total billed charges,75% of total billed charges,405.91,85,,,percent of total billed charges,85% of total billed charges,181.47,444.11,
(RES) CANDIDA SPECIES,2485,CDM,300,RC,87481,HCPCS,outpatient,,,159.18,119.39,,143.26,90,,,percent of total billed charges,90% of total billed charges,148.04,93,,,percent of total billed charges,93% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,135.3,85,,,percent of total billed charges,85% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,129.57,81.4,,,percent of total billed charges,81.4% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,119.39,75,,,percent of total billed charges,75% of total billed charges,135.3,85,,,percent of total billed charges,85% of total billed charges,60.49,148.04,
(RES) CANDIDA GLABRATA,2486,CDM,300,RC,87481,HCPCS,outpatient,,,159.18,119.39,,143.26,90,,,percent of total billed charges,90% of total billed charges,148.04,93,,,percent of total billed charges,93% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,135.3,85,,,percent of total billed charges,85% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,129.57,81.4,,,percent of total billed charges,81.4% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,143.26,90,,,percent of total billed charges,90% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,60.49,38,,,percent of total billed charges,38% of total billed charges,119.39,75,,,percent of total billed charges,75% of total billed charges,135.3,85,,,percent of total billed charges,85% of total billed charges,60.49,148.04,
(RES) Candida Spp.,2487,CDM,300,RC,87481,HCPCS,outpatient,,,35.7,26.78,,32.13,90,,,percent of total billed charges,90% of total billed charges,33.2,93,,,percent of total billed charges,93% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,29.06,81.4,,,percent of total billed charges,81.4% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,26.78,75,,,percent of total billed charges,75% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,33.2,
(RES) Candida glabrata/krusei,2488,CDM,300,RC,87481,HCPCS,outpatient,,,35.7,26.78,,32.13,90,,,percent of total billed charges,90% of total billed charges,33.2,93,,,percent of total billed charges,93% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,29.06,81.4,,,percent of total billed charges,81.4% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,26.78,75,,,percent of total billed charges,75% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,33.2,
"(RES) C. ALBICANS, DNA",2489,CDM,300,RC,87481,HCPCS,outpatient,,,109.3,81.98,,98.37,90,,,percent of total billed charges,90% of total billed charges,101.65,93,,,percent of total billed charges,93% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,88.97,81.4,,,percent of total billed charges,81.4% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,81.98,75,,,percent of total billed charges,75% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,101.65,
"(RES) C. GLABRATA, DNA",2490,CDM,300,RC,87481,HCPCS,outpatient,,,109.3,81.98,,98.37,90,,,percent of total billed charges,90% of total billed charges,101.65,93,,,percent of total billed charges,93% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,88.97,81.4,,,percent of total billed charges,81.4% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,81.98,75,,,percent of total billed charges,75% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,101.65,
"(RES) C. TROPICALIS, DNA",2491,CDM,300,RC,87481,HCPCS,outpatient,,,109.3,81.98,,98.37,90,,,percent of total billed charges,90% of total billed charges,101.65,93,,,percent of total billed charges,93% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,88.97,81.4,,,percent of total billed charges,81.4% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,81.98,75,,,percent of total billed charges,75% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,101.65,
"(RES) C. PARAPSILOSIS, DNA",2492,CDM,300,RC,87481,HCPCS,outpatient,,,109.3,81.98,,98.37,90,,,percent of total billed charges,90% of total billed charges,101.65,93,,,percent of total billed charges,93% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,88.97,81.4,,,percent of total billed charges,81.4% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,81.98,75,,,percent of total billed charges,75% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,101.65,
*Respiratory Panel -Chlamy,2493,CDM,300,RC,87486,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
Resp panel Chlamydophila pneumo,2494,CDM,300,RC,87486,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
"C. TRACHOMATIS RNA, TMA(OLD not working)",2495,CDM,300,RC,87491,HCPCS,outpatient,,,103.12,77.34,,92.81,90,,,percent of total billed charges,90% of total billed charges,95.9,93,,,percent of total billed charges,93% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,83.94,81.4,,,percent of total billed charges,81.4% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,77.34,75,,,percent of total billed charges,75% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,95.9,
Profile - Chlamydia RNA,2496,CDM,300,RC,87491,HCPCS,outpatient,,,103.12,77.34,,92.81,90,,,percent of total billed charges,90% of total billed charges,95.9,93,,,percent of total billed charges,93% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,83.94,81.4,,,percent of total billed charges,81.4% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,77.34,75,,,percent of total billed charges,75% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,95.9,
"(RES) CHLAMYDIA TRACHOMATIS RNA, TMA, UROGENITAL",2497,CDM,300,RC,87491,HCPCS,outpatient,,,103.12,77.34,,92.81,90,,,percent of total billed charges,90% of total billed charges,95.9,93,,,percent of total billed charges,93% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,83.94,81.4,,,percent of total billed charges,81.4% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,77.34,75,,,percent of total billed charges,75% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,95.9,
Chlamydia Trach. RNA (Rectal),2498,CDM,300,RC,87491,HCPCS,outpatient,,,114.82,86.12,,103.34,90,,,percent of total billed charges,90% of total billed charges,106.78,93,,,percent of total billed charges,93% of total billed charges,43.63,38,,,percent of total billed charges,38% of total billed charges,43.63,38,,,percent of total billed charges,38% of total billed charges,97.6,85,,,percent of total billed charges,85% of total billed charges,43.63,38,,,percent of total billed charges,38% of total billed charges,93.46,81.4,,,percent of total billed charges,81.4% of total billed charges,103.34,90,,,percent of total billed charges,90% of total billed charges,103.34,90,,,percent of total billed charges,90% of total billed charges,43.63,38,,,percent of total billed charges,38% of total billed charges,43.63,38,,,percent of total billed charges,38% of total billed charges,43.63,38,,,percent of total billed charges,38% of total billed charges,86.12,75,,,percent of total billed charges,75% of total billed charges,97.6,85,,,percent of total billed charges,85% of total billed charges,43.63,106.78,
PRO1 Chlamydia Trachomatis,2499,CDM,300,RC,87491,HCPCS,outpatient,,,81.18,60.89,,73.06,90,,,percent of total billed charges,90% of total billed charges,75.5,93,,,percent of total billed charges,93% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,69,85,,,percent of total billed charges,85% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,66.08,81.4,,,percent of total billed charges,81.4% of total billed charges,73.06,90,,,percent of total billed charges,90% of total billed charges,73.06,90,,,percent of total billed charges,90% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,60.89,75,,,percent of total billed charges,75% of total billed charges,69,85,,,percent of total billed charges,85% of total billed charges,30.85,75.5,
Reflex C. Diff Charge,2500,CDM,300,RC,87493,HCPCS,outpatient,,,162.87,122.15,,146.58,90,,,percent of total billed charges,90% of total billed charges,151.47,93,,,percent of total billed charges,93% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,132.58,81.4,,,percent of total billed charges,81.4% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,122.15,75,,,percent of total billed charges,75% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,151.47,
"C Diff Toxin B, Qual. RT PCR",2501,CDM,300,RC,87493,HCPCS,outpatient,,,168.86,126.65,,151.97,90,,,percent of total billed charges,90% of total billed charges,157.04,93,,,percent of total billed charges,93% of total billed charges,64.17,38,,,percent of total billed charges,38% of total billed charges,64.17,38,,,percent of total billed charges,38% of total billed charges,143.53,85,,,percent of total billed charges,85% of total billed charges,64.17,38,,,percent of total billed charges,38% of total billed charges,137.45,81.4,,,percent of total billed charges,81.4% of total billed charges,151.97,90,,,percent of total billed charges,90% of total billed charges,151.97,90,,,percent of total billed charges,90% of total billed charges,64.17,38,,,percent of total billed charges,38% of total billed charges,64.17,38,,,percent of total billed charges,38% of total billed charges,64.17,38,,,percent of total billed charges,38% of total billed charges,126.65,75,,,percent of total billed charges,75% of total billed charges,143.53,85,,,percent of total billed charges,85% of total billed charges,64.17,157.04,
Toxigenic C. diff PCR,2502,CDM,300,RC,87493,HCPCS,outpatient,,,83.23,62.42,,74.91,90,,,percent of total billed charges,90% of total billed charges,77.4,93,,,percent of total billed charges,93% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,70.75,85,,,percent of total billed charges,85% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,67.75,81.4,,,percent of total billed charges,81.4% of total billed charges,74.91,90,,,percent of total billed charges,90% of total billed charges,74.91,90,,,percent of total billed charges,90% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,62.42,75,,,percent of total billed charges,75% of total billed charges,70.75,85,,,percent of total billed charges,85% of total billed charges,31.63,77.4,
027-NAP1-B1,2503,CDM,300,RC,87493,HCPCS,outpatient,,,83.23,62.42,,74.91,90,,,percent of total billed charges,90% of total billed charges,77.4,93,,,percent of total billed charges,93% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,70.75,85,,,percent of total billed charges,85% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,67.75,81.4,,,percent of total billed charges,81.4% of total billed charges,74.91,90,,,percent of total billed charges,90% of total billed charges,74.91,90,,,percent of total billed charges,90% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,31.63,38,,,percent of total billed charges,38% of total billed charges,62.42,75,,,percent of total billed charges,75% of total billed charges,70.75,85,,,percent of total billed charges,85% of total billed charges,31.63,77.4,
CMV DNA Qualitative,2504,CDM,300,RC,87496,HCPCS,outpatient,,,389.03,291.77,,350.13,90,,,percent of total billed charges,90% of total billed charges,361.8,93,,,percent of total billed charges,93% of total billed charges,147.83,38,,,percent of total billed charges,38% of total billed charges,147.83,38,,,percent of total billed charges,38% of total billed charges,330.68,85,,,percent of total billed charges,85% of total billed charges,147.83,38,,,percent of total billed charges,38% of total billed charges,316.67,81.4,,,percent of total billed charges,81.4% of total billed charges,350.13,90,,,percent of total billed charges,90% of total billed charges,350.13,90,,,percent of total billed charges,90% of total billed charges,147.83,38,,,percent of total billed charges,38% of total billed charges,147.83,38,,,percent of total billed charges,38% of total billed charges,147.83,38,,,percent of total billed charges,38% of total billed charges,291.77,75,,,percent of total billed charges,75% of total billed charges,330.68,85,,,percent of total billed charges,85% of total billed charges,147.83,361.8,
CMV DNA QUALITATIVE RT PCR,2505,CDM,300,RC,87496,HCPCS,outpatient,,,397.24,297.93,,357.52,90,,,percent of total billed charges,90% of total billed charges,369.43,93,,,percent of total billed charges,93% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,337.65,85,,,percent of total billed charges,85% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,323.35,81.4,,,percent of total billed charges,81.4% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,297.93,75,,,percent of total billed charges,75% of total billed charges,337.65,85,,,percent of total billed charges,85% of total billed charges,150.95,369.43,
*CSF Panel-CMV,2506,CDM,300,RC,87496,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
CSF PCR CMV,2507,CDM,300,RC,87496,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
Meningitis PCR-CMV,2508,CDM,300,RC,87496,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
CMV DNA QNT RT-PCR,2509,CDM,300,RC,87497,HCPCS,outpatient,,,508.54,381.41,,457.69,90,,,percent of total billed charges,90% of total billed charges,472.94,93,,,percent of total billed charges,93% of total billed charges,193.25,38,,,percent of total billed charges,38% of total billed charges,193.25,38,,,percent of total billed charges,38% of total billed charges,432.26,85,,,percent of total billed charges,85% of total billed charges,193.25,38,,,percent of total billed charges,38% of total billed charges,413.95,81.4,,,percent of total billed charges,81.4% of total billed charges,457.69,90,,,percent of total billed charges,90% of total billed charges,457.69,90,,,percent of total billed charges,90% of total billed charges,193.25,38,,,percent of total billed charges,38% of total billed charges,193.25,38,,,percent of total billed charges,38% of total billed charges,193.25,38,,,percent of total billed charges,38% of total billed charges,381.41,75,,,percent of total billed charges,75% of total billed charges,432.26,85,,,percent of total billed charges,85% of total billed charges,193.25,472.94,
(Result) CMV DNA Quantitative,2510,CDM,300,RC,87497,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SOURCE (RESULT),2511,CDM,300,RC,87497,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Post Transplant, CMV DNA, RT-PCR, Plasma",2512,CDM,300,RC,87497,HCPCS,outpatient,,,472.59,354.44,,425.33,90,,,percent of total billed charges,90% of total billed charges,439.51,93,,,percent of total billed charges,93% of total billed charges,179.58,38,,,percent of total billed charges,38% of total billed charges,179.58,38,,,percent of total billed charges,38% of total billed charges,401.7,85,,,percent of total billed charges,85% of total billed charges,179.58,38,,,percent of total billed charges,38% of total billed charges,384.69,81.4,,,percent of total billed charges,81.4% of total billed charges,425.33,90,,,percent of total billed charges,90% of total billed charges,425.33,90,,,percent of total billed charges,90% of total billed charges,179.58,38,,,percent of total billed charges,38% of total billed charges,179.58,38,,,percent of total billed charges,38% of total billed charges,179.58,38,,,percent of total billed charges,38% of total billed charges,354.44,75,,,percent of total billed charges,75% of total billed charges,401.7,85,,,percent of total billed charges,85% of total billed charges,179.58,439.51,
Enterovirus/Parachovirus RNA QL,2513,CDM,300,RC,87498,HCPCS,outpatient,,,467.54,350.66,,420.79,90,,,percent of total billed charges,90% of total billed charges,434.81,93,,,percent of total billed charges,93% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,397.41,85,,,percent of total billed charges,85% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,380.58,81.4,,,percent of total billed charges,81.4% of total billed charges,420.79,90,,,percent of total billed charges,90% of total billed charges,420.79,90,,,percent of total billed charges,90% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,350.66,75,,,percent of total billed charges,75% of total billed charges,397.41,85,,,percent of total billed charges,85% of total billed charges,177.67,434.81,
*CSF Panel-Entero virus,2514,CDM,300,RC,87498,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
CSF PCR Enterovirus,2515,CDM,300,RC,87498,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
Meningitis PCR-enterovirus,2516,CDM,300,RC,87498,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
"Influenza A and B Confirmation, RT-PCR",2517,CDM,300,RC,87502,HCPCS,outpatient,,,387.87,290.9,,349.08,90,,,percent of total billed charges,90% of total billed charges,360.72,93,,,percent of total billed charges,93% of total billed charges,147.39,38,,,percent of total billed charges,38% of total billed charges,147.39,38,,,percent of total billed charges,38% of total billed charges,329.69,85,,,percent of total billed charges,85% of total billed charges,147.39,38,,,percent of total billed charges,38% of total billed charges,315.73,81.4,,,percent of total billed charges,81.4% of total billed charges,349.08,90,,,percent of total billed charges,90% of total billed charges,349.08,90,,,percent of total billed charges,90% of total billed charges,147.39,38,,,percent of total billed charges,38% of total billed charges,147.39,38,,,percent of total billed charges,38% of total billed charges,147.39,38,,,percent of total billed charges,38% of total billed charges,290.9,75,,,percent of total billed charges,75% of total billed charges,329.69,85,,,percent of total billed charges,85% of total billed charges,147.39,360.72,
"Influenza A B RNA, PCR - Source",2518,CDM,300,RC,87502,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Influenza A RNA, PCR",2519,CDM,300,RC,87502,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Influenza A/B - Molecular,2520,CDM,300,RC,87502,HCPCS,outpatient,,,99.76,74.82,,89.78,90,,,percent of total billed charges,90% of total billed charges,92.78,93,,,percent of total billed charges,93% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,84.8,85,,,percent of total billed charges,85% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,81.2,81.4,,,percent of total billed charges,81.4% of total billed charges,89.78,90,,,percent of total billed charges,90% of total billed charges,89.78,90,,,percent of total billed charges,90% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,74.82,75,,,percent of total billed charges,75% of total billed charges,84.8,85,,,percent of total billed charges,85% of total billed charges,37.91,92.78,
Influenza A/B - Molecular,2521,CDM,300,RC,87502,HCPCS,outpatient,,,99.76,74.82,,89.78,90,,,percent of total billed charges,90% of total billed charges,92.78,93,,,percent of total billed charges,93% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,84.8,85,,,percent of total billed charges,85% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,81.2,81.4,,,percent of total billed charges,81.4% of total billed charges,89.78,90,,,percent of total billed charges,90% of total billed charges,89.78,90,,,percent of total billed charges,90% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,37.91,38,,,percent of total billed charges,38% of total billed charges,74.82,75,,,percent of total billed charges,75% of total billed charges,84.8,85,,,percent of total billed charges,85% of total billed charges,37.91,92.78,
"Influenza B RNA, PCR",2522,CDM,300,RC,87502,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Stool GI PCR Panel (6-11 targets),2523,CDM,300,RC,87505,HCPCS,outpatient,,,357,267.75,,321.3,90,,,percent of total billed charges,90% of total billed charges,332.01,93,,,percent of total billed charges,93% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,303.45,85,,,percent of total billed charges,85% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,290.6,81.4,,,percent of total billed charges,81.4% of total billed charges,321.3,90,,,percent of total billed charges,90% of total billed charges,321.3,90,,,percent of total billed charges,90% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,267.75,75,,,percent of total billed charges,75% of total billed charges,303.45,85,,,percent of total billed charges,85% of total billed charges,135.66,332.01,
(RES) LACTOBACILLUS SPECIES,2524,CDM,300,RC,87512,HCPCS,outpatient,,,109.3,81.98,,98.37,90,,,percent of total billed charges,90% of total billed charges,101.65,93,,,percent of total billed charges,93% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,88.97,81.4,,,percent of total billed charges,81.4% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,81.98,75,,,percent of total billed charges,75% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,101.65,
Hep B DNA Quant PCR,2525,CDM,300,RC,87517,HCPCS,outpatient,,,502.92,377.19,,452.63,90,,,percent of total billed charges,90% of total billed charges,467.72,93,,,percent of total billed charges,93% of total billed charges,191.11,38,,,percent of total billed charges,38% of total billed charges,191.11,38,,,percent of total billed charges,38% of total billed charges,427.48,85,,,percent of total billed charges,85% of total billed charges,191.11,38,,,percent of total billed charges,38% of total billed charges,409.38,81.4,,,percent of total billed charges,81.4% of total billed charges,452.63,90,,,percent of total billed charges,90% of total billed charges,452.63,90,,,percent of total billed charges,90% of total billed charges,191.11,38,,,percent of total billed charges,38% of total billed charges,191.11,38,,,percent of total billed charges,38% of total billed charges,191.11,38,,,percent of total billed charges,38% of total billed charges,377.19,75,,,percent of total billed charges,75% of total billed charges,427.48,85,,,percent of total billed charges,85% of total billed charges,191.11,467.72,
"Hep B Virus DNA, QT w Reflex to Genotype",2526,CDM,300,RC,87517,HCPCS,outpatient,,,477.54,358.16,,429.79,90,,,percent of total billed charges,90% of total billed charges,444.11,93,,,percent of total billed charges,93% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,405.91,85,,,percent of total billed charges,85% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,388.72,81.4,,,percent of total billed charges,81.4% of total billed charges,429.79,90,,,percent of total billed charges,90% of total billed charges,429.79,90,,,percent of total billed charges,90% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,181.47,38,,,percent of total billed charges,38% of total billed charges,358.16,75,,,percent of total billed charges,75% of total billed charges,405.91,85,,,percent of total billed charges,85% of total billed charges,181.47,444.11,
Hepatitis C Viral RNA Qual TMA,2527,CDM,300,RC,87521,HCPCS,outpatient,,,344.6,258.45,,310.14,90,,,percent of total billed charges,90% of total billed charges,320.48,93,,,percent of total billed charges,93% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,280.5,81.4,,,percent of total billed charges,81.4% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,258.45,75,,,percent of total billed charges,75% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,130.95,320.48,
"Hepatitis C RNA, Quant PCR",2528,CDM,300,RC,87522,HCPCS,outpatient,,,636.93,477.7,,573.24,90,,,percent of total billed charges,90% of total billed charges,592.34,93,,,percent of total billed charges,93% of total billed charges,242.03,38,,,percent of total billed charges,38% of total billed charges,242.03,38,,,percent of total billed charges,38% of total billed charges,541.39,85,,,percent of total billed charges,85% of total billed charges,242.03,38,,,percent of total billed charges,38% of total billed charges,518.46,81.4,,,percent of total billed charges,81.4% of total billed charges,573.24,90,,,percent of total billed charges,90% of total billed charges,573.24,90,,,percent of total billed charges,90% of total billed charges,242.03,38,,,percent of total billed charges,38% of total billed charges,242.03,38,,,percent of total billed charges,38% of total billed charges,242.03,38,,,percent of total billed charges,38% of total billed charges,477.7,75,,,percent of total billed charges,75% of total billed charges,541.39,85,,,percent of total billed charges,85% of total billed charges,242.03,592.34,
"Hepatitis C RNA, DNA Probe QNT",2529,CDM,300,RC,87522,HCPCS,outpatient,,,643.51,482.63,,579.16,90,,,percent of total billed charges,90% of total billed charges,598.46,93,,,percent of total billed charges,93% of total billed charges,244.53,38,,,percent of total billed charges,38% of total billed charges,244.53,38,,,percent of total billed charges,38% of total billed charges,546.98,85,,,percent of total billed charges,85% of total billed charges,244.53,38,,,percent of total billed charges,38% of total billed charges,523.82,81.4,,,percent of total billed charges,81.4% of total billed charges,579.16,90,,,percent of total billed charges,90% of total billed charges,579.16,90,,,percent of total billed charges,90% of total billed charges,244.53,38,,,percent of total billed charges,38% of total billed charges,244.53,38,,,percent of total billed charges,38% of total billed charges,244.53,38,,,percent of total billed charges,38% of total billed charges,482.63,75,,,percent of total billed charges,75% of total billed charges,546.98,85,,,percent of total billed charges,85% of total billed charges,244.53,598.46,
"Hepatitis C Viral RNA QN, w Reflx to Genotype, LiPA",2530,CDM,300,RC,87522,HCPCS,outpatient,,,611.82,458.87,,550.64,90,,,percent of total billed charges,90% of total billed charges,568.99,93,,,percent of total billed charges,93% of total billed charges,232.49,38,,,percent of total billed charges,38% of total billed charges,232.49,38,,,percent of total billed charges,38% of total billed charges,520.05,85,,,percent of total billed charges,85% of total billed charges,232.49,38,,,percent of total billed charges,38% of total billed charges,498.02,81.4,,,percent of total billed charges,81.4% of total billed charges,550.64,90,,,percent of total billed charges,90% of total billed charges,550.64,90,,,percent of total billed charges,90% of total billed charges,232.49,38,,,percent of total billed charges,38% of total billed charges,232.49,38,,,percent of total billed charges,38% of total billed charges,232.49,38,,,percent of total billed charges,38% of total billed charges,458.87,75,,,percent of total billed charges,75% of total billed charges,520.05,85,,,percent of total billed charges,85% of total billed charges,232.49,568.99,
*CSF Panel-HSV 1,2531,CDM,300,RC,87529,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
*CSF Panel-HSV 2,2532,CDM,300,RC,87529,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
(RES) HSV 1 DNA,2533,CDM,300,RC,87529,HCPCS,outpatient,,,216.48,162.36,,194.83,90,,,percent of total billed charges,90% of total billed charges,201.33,93,,,percent of total billed charges,93% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,184.01,85,,,percent of total billed charges,85% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,176.21,81.4,,,percent of total billed charges,81.4% of total billed charges,194.83,90,,,percent of total billed charges,90% of total billed charges,194.83,90,,,percent of total billed charges,90% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,162.36,75,,,percent of total billed charges,75% of total billed charges,184.01,85,,,percent of total billed charges,85% of total billed charges,82.26,201.33,
(RES) HSV 2 DNA,2534,CDM,300,RC,87529,HCPCS,outpatient,,,216.48,162.36,,194.83,90,,,percent of total billed charges,90% of total billed charges,201.33,93,,,percent of total billed charges,93% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,184.01,85,,,percent of total billed charges,85% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,176.21,81.4,,,percent of total billed charges,81.4% of total billed charges,194.83,90,,,percent of total billed charges,90% of total billed charges,194.83,90,,,percent of total billed charges,90% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,162.36,75,,,percent of total billed charges,75% of total billed charges,184.01,85,,,percent of total billed charges,85% of total billed charges,82.26,201.33,
CSF PCR Herpes 1,2535,CDM,300,RC,87529,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
CSF PCR Herpes 2,2536,CDM,300,RC,87529,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
Meningitis PCR-Herpes,2537,CDM,300,RC,87529,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
*CSF Panel-Herpe 6,2538,CDM,300,RC,87532,HCPCS,outpatient,,,80.43,60.32,,72.39,90,,,percent of total billed charges,90% of total billed charges,74.8,93,,,percent of total billed charges,93% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,68.37,85,,,percent of total billed charges,85% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,65.47,81.4,,,percent of total billed charges,81.4% of total billed charges,72.39,90,,,percent of total billed charges,90% of total billed charges,72.39,90,,,percent of total billed charges,90% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,60.32,75,,,percent of total billed charges,75% of total billed charges,68.37,85,,,percent of total billed charges,85% of total billed charges,30.56,74.8,
CSF PCR HSV 6,2539,CDM,300,RC,87532,HCPCS,outpatient,,,80.43,60.32,,72.39,90,,,percent of total billed charges,90% of total billed charges,74.8,93,,,percent of total billed charges,93% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,68.37,85,,,percent of total billed charges,85% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,65.47,81.4,,,percent of total billed charges,81.4% of total billed charges,72.39,90,,,percent of total billed charges,90% of total billed charges,72.39,90,,,percent of total billed charges,90% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,30.56,38,,,percent of total billed charges,38% of total billed charges,60.32,75,,,percent of total billed charges,75% of total billed charges,68.37,85,,,percent of total billed charges,85% of total billed charges,30.56,74.8,
"HIV-1 RNA, Quant. RT PCR",2540,CDM,300,RC,87536,HCPCS,outpatient,,,449.36,337.02,,404.42,90,,,percent of total billed charges,90% of total billed charges,417.9,93,,,percent of total billed charges,93% of total billed charges,170.76,38,,,percent of total billed charges,38% of total billed charges,170.76,38,,,percent of total billed charges,38% of total billed charges,381.96,85,,,percent of total billed charges,85% of total billed charges,170.76,38,,,percent of total billed charges,38% of total billed charges,365.78,81.4,,,percent of total billed charges,81.4% of total billed charges,404.42,90,,,percent of total billed charges,90% of total billed charges,404.42,90,,,percent of total billed charges,90% of total billed charges,170.76,38,,,percent of total billed charges,38% of total billed charges,170.76,38,,,percent of total billed charges,38% of total billed charges,170.76,38,,,percent of total billed charges,38% of total billed charges,337.02,75,,,percent of total billed charges,75% of total billed charges,381.96,85,,,percent of total billed charges,85% of total billed charges,170.76,417.9,
"(RES) MYCOPLASMA GENITALIUM, rRNA,TMA",2541,CDM,300,RC,87563,HCPCS,outpatient,,,112.1,84.08,,100.89,90,,,percent of total billed charges,90% of total billed charges,104.25,93,,,percent of total billed charges,93% of total billed charges,42.6,38,,,percent of total billed charges,38% of total billed charges,42.6,38,,,percent of total billed charges,38% of total billed charges,95.29,85,,,percent of total billed charges,85% of total billed charges,42.6,38,,,percent of total billed charges,38% of total billed charges,91.25,81.4,,,percent of total billed charges,81.4% of total billed charges,100.89,90,,,percent of total billed charges,90% of total billed charges,100.89,90,,,percent of total billed charges,90% of total billed charges,42.6,38,,,percent of total billed charges,38% of total billed charges,42.6,38,,,percent of total billed charges,38% of total billed charges,42.6,38,,,percent of total billed charges,38% of total billed charges,84.08,75,,,percent of total billed charges,75% of total billed charges,95.29,85,,,percent of total billed charges,85% of total billed charges,42.6,104.25,
**Resp Panel-Mycoplasma,2542,CDM,300,RC,87581,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
Resp panel Myco pneumoniae,2543,CDM,300,RC,87581,HCPCS,outpatient,,,86.15,64.61,,77.54,90,,,percent of total billed charges,90% of total billed charges,80.12,93,,,percent of total billed charges,93% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,73.23,85,,,percent of total billed charges,85% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,70.13,81.4,,,percent of total billed charges,81.4% of total billed charges,77.54,90,,,percent of total billed charges,90% of total billed charges,77.54,90,,,percent of total billed charges,90% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,32.74,38,,,percent of total billed charges,38% of total billed charges,64.61,75,,,percent of total billed charges,75% of total billed charges,73.23,85,,,percent of total billed charges,85% of total billed charges,32.74,80.12,
"(RES) N. GONORRHOEAE RNA, URO",2544,CDM,300,RC,87591,HCPCS,outpatient,,,103.12,77.34,,92.81,90,,,percent of total billed charges,90% of total billed charges,95.9,93,,,percent of total billed charges,93% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,83.94,81.4,,,percent of total billed charges,81.4% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,77.34,75,,,percent of total billed charges,75% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,95.9,
"Neisseria Gonorrhoeae, TMA (Rectal)",2545,CDM,300,RC,87591,HCPCS,outpatient,,,96.05,72.04,,86.45,90,,,percent of total billed charges,90% of total billed charges,89.33,93,,,percent of total billed charges,93% of total billed charges,36.5,38,,,percent of total billed charges,38% of total billed charges,36.5,38,,,percent of total billed charges,38% of total billed charges,81.64,85,,,percent of total billed charges,85% of total billed charges,36.5,38,,,percent of total billed charges,38% of total billed charges,78.18,81.4,,,percent of total billed charges,81.4% of total billed charges,86.45,90,,,percent of total billed charges,90% of total billed charges,86.45,90,,,percent of total billed charges,90% of total billed charges,36.5,38,,,percent of total billed charges,38% of total billed charges,36.5,38,,,percent of total billed charges,38% of total billed charges,36.5,38,,,percent of total billed charges,38% of total billed charges,72.04,75,,,percent of total billed charges,75% of total billed charges,81.64,85,,,percent of total billed charges,85% of total billed charges,36.5,89.33,
"Neisseria gonorrhoeae RNA, TMA, Throat",2546,CDM,300,RC,87591,HCPCS,outpatient,,,113.65,85.24,,102.29,90,,,percent of total billed charges,90% of total billed charges,105.69,93,,,percent of total billed charges,93% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,96.6,85,,,percent of total billed charges,85% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,92.51,81.4,,,percent of total billed charges,81.4% of total billed charges,102.29,90,,,percent of total billed charges,90% of total billed charges,102.29,90,,,percent of total billed charges,90% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,85.24,75,,,percent of total billed charges,75% of total billed charges,96.6,85,,,percent of total billed charges,85% of total billed charges,43.19,105.69,
Pro2-N.gonorrhoeae,2547,CDM,300,RC,87591,HCPCS,outpatient,,,102.84,77.13,,92.56,90,,,percent of total billed charges,90% of total billed charges,95.64,93,,,percent of total billed charges,93% of total billed charges,39.08,38,,,percent of total billed charges,38% of total billed charges,39.08,38,,,percent of total billed charges,38% of total billed charges,87.41,85,,,percent of total billed charges,85% of total billed charges,39.08,38,,,percent of total billed charges,38% of total billed charges,83.71,81.4,,,percent of total billed charges,81.4% of total billed charges,92.56,90,,,percent of total billed charges,90% of total billed charges,92.56,90,,,percent of total billed charges,90% of total billed charges,39.08,38,,,percent of total billed charges,38% of total billed charges,39.08,38,,,percent of total billed charges,38% of total billed charges,39.08,38,,,percent of total billed charges,38% of total billed charges,77.13,75,,,percent of total billed charges,75% of total billed charges,87.41,85,,,percent of total billed charges,85% of total billed charges,39.08,95.64,
"(RES) MONKEYPOX VIRUS DNA, QL PCR",2548,CDM,300,RC,87593,HCPCS,outpatient,,,62.42,46.82,,56.18,90,,,percent of total billed charges,90% of total billed charges,58.05,93,,,percent of total billed charges,93% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,62.42,,,,other,Not reimbursable per contract,23.72,38,,,percent of total billed charges,38% of total billed charges,50.81,81.4,,,percent of total billed charges,81.4% of total billed charges,56.18,90,,,percent of total billed charges,90% of total billed charges,56.18,90,,,percent of total billed charges,90% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,46.82,75,,,percent of total billed charges,75% of total billed charges,53.06,85,,,percent of total billed charges,85% of total billed charges,23.72,62.42,
"(RES) ORTHOPOXVIRUS DNA, QL PCR",2549,CDM,300,RC,87593,HCPCS,outpatient,,,62.42,46.82,,56.18,90,,,percent of total billed charges,90% of total billed charges,58.05,93,,,percent of total billed charges,93% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,62.42,,,,other,Not reimbursable per contract,23.72,38,,,percent of total billed charges,38% of total billed charges,50.81,81.4,,,percent of total billed charges,81.4% of total billed charges,56.18,90,,,percent of total billed charges,90% of total billed charges,56.18,90,,,percent of total billed charges,90% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,23.72,38,,,percent of total billed charges,38% of total billed charges,46.82,75,,,percent of total billed charges,75% of total billed charges,53.06,85,,,percent of total billed charges,85% of total billed charges,23.72,62.42,
OraRISK HPV,2550,CDM,300,RC,87624,HCPCS,outpatient,,,132.6,99.45,,119.34,90,,,percent of total billed charges,90% of total billed charges,123.32,93,,,percent of total billed charges,93% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,112.71,85,,,percent of total billed charges,85% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,107.94,81.4,,,percent of total billed charges,81.4% of total billed charges,119.34,90,,,percent of total billed charges,90% of total billed charges,119.34,90,,,percent of total billed charges,90% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,50.39,38,,,percent of total billed charges,38% of total billed charges,99.45,75,,,percent of total billed charges,75% of total billed charges,112.71,85,,,percent of total billed charges,85% of total billed charges,50.39,123.32,
* Old Respiratory group 12 - 25 targets,2551,CDM,300,RC,87633,HCPCS,outpatient,,,870.13,652.6,,783.12,90,,,percent of total billed charges,90% of total billed charges,809.22,93,,,percent of total billed charges,93% of total billed charges,330.65,38,,,percent of total billed charges,38% of total billed charges,330.65,38,,,percent of total billed charges,38% of total billed charges,739.61,85,,,percent of total billed charges,85% of total billed charges,330.65,38,,,percent of total billed charges,38% of total billed charges,708.29,81.4,,,percent of total billed charges,81.4% of total billed charges,783.12,90,,,percent of total billed charges,90% of total billed charges,783.12,90,,,percent of total billed charges,90% of total billed charges,330.65,38,,,percent of total billed charges,38% of total billed charges,330.65,38,,,percent of total billed charges,38% of total billed charges,330.65,38,,,percent of total billed charges,38% of total billed charges,652.6,75,,,percent of total billed charges,75% of total billed charges,739.61,85,,,percent of total billed charges,85% of total billed charges,330.65,809.22,
Adenovirus,2552,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Coronavirus 229E,2553,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Coronavirus  HKU1,2554,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Coronavirus NL63,2555,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Coronavirus OC43,2556,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Human Metapneumo.,2557,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Human Rhino/Entero,2558,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Influenza A-PCR H1N1,2559,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Influenza B PCR,2560,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Resp panel 12 - 25 targets 2.1 [Panel],2561,CDM,300,RC,87633,HCPCS,outpatient,,,574.33,430.75,,516.9,90,,,percent of total billed charges,90% of total billed charges,534.13,93,,,percent of total billed charges,93% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,488.18,85,,,percent of total billed charges,85% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,467.5,81.4,,,percent of total billed charges,81.4% of total billed charges,516.9,90,,,percent of total billed charges,90% of total billed charges,516.9,90,,,percent of total billed charges,90% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,430.75,75,,,percent of total billed charges,75% of total billed charges,488.18,85,,,percent of total billed charges,85% of total billed charges,218.25,534.13,
(RES) Resp panel 12 - 25 targets 2.1 [Panel],2562,CDM,300,RC,87633,HCPCS,outpatient,,,574.33,430.75,,516.9,90,,,percent of total billed charges,90% of total billed charges,534.13,93,,,percent of total billed charges,93% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,488.18,85,,,percent of total billed charges,85% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,467.5,81.4,,,percent of total billed charges,81.4% of total billed charges,516.9,90,,,percent of total billed charges,90% of total billed charges,516.9,90,,,percent of total billed charges,90% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,430.75,75,,,percent of total billed charges,75% of total billed charges,488.18,85,,,percent of total billed charges,85% of total billed charges,218.25,534.13,
Resp panel 12 - 25 targets[Panel],2563,CDM,300,RC,87633,HCPCS,outpatient,,,574.33,430.75,,516.9,90,,,percent of total billed charges,90% of total billed charges,534.13,93,,,percent of total billed charges,93% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,488.18,85,,,percent of total billed charges,85% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,467.5,81.4,,,percent of total billed charges,81.4% of total billed charges,516.9,90,,,percent of total billed charges,90% of total billed charges,516.9,90,,,percent of total billed charges,90% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,218.25,38,,,percent of total billed charges,38% of total billed charges,430.75,75,,,percent of total billed charges,75% of total billed charges,488.18,85,,,percent of total billed charges,85% of total billed charges,218.25,534.13,
Parainfluenza Virus 1,2564,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Parainfluenza Virus 2,2565,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Parainfluenza Virus 3,2566,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Parainfluenza Virus 4,2567,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Respiratory Syncytial Virus,2568,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
**Respiratory Bordetella pertussis,2569,CDM,300,RC,87633,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
**Respiratory Chlamydophila pneumoniae,2570,CDM,300,RC,87633,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
**Respiratory Mycoplasma pneumoniae,2571,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Influenza A H3,2572,CDM,300,RC,87633,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
RSV - Molecular,2573,CDM,300,RC,87634,HCPCS,outpatient,,,80.65,60.49,,72.59,90,,,percent of total billed charges,90% of total billed charges,75,93,,,percent of total billed charges,93% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,68.55,85,,,percent of total billed charges,85% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,65.65,81.4,,,percent of total billed charges,81.4% of total billed charges,72.59,90,,,percent of total billed charges,90% of total billed charges,72.59,90,,,percent of total billed charges,90% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,60.49,75,,,percent of total billed charges,75% of total billed charges,68.55,85,,,percent of total billed charges,85% of total billed charges,30.65,75,
RSV - Molecular,2574,CDM,300,RC,87634,HCPCS,outpatient,,,80.65,60.49,,72.59,90,,,percent of total billed charges,90% of total billed charges,75,93,,,percent of total billed charges,93% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,68.55,85,,,percent of total billed charges,85% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,65.65,81.4,,,percent of total billed charges,81.4% of total billed charges,72.59,90,,,percent of total billed charges,90% of total billed charges,72.59,90,,,percent of total billed charges,90% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,60.49,75,,,percent of total billed charges,75% of total billed charges,68.55,85,,,percent of total billed charges,85% of total billed charges,30.65,75,
COVID-19 Molecular in-house,2575,CDM,300,RC,87635,HCPCS,outpatient,,,81.18,60.89,,73.06,90,,,percent of total billed charges,90% of total billed charges,75.5,93,,,percent of total billed charges,93% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,69,85,,,percent of total billed charges,85% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,66.08,81.4,,,percent of total billed charges,81.4% of total billed charges,73.06,90,,,percent of total billed charges,90% of total billed charges,73.06,90,,,percent of total billed charges,90% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,60.89,75,,,percent of total billed charges,75% of total billed charges,69,85,,,percent of total billed charges,85% of total billed charges,30.85,75.5,
COVID-19 PCR,2576,CDM,300,RC,87635,HCPCS,outpatient,,,106.12,79.59,,95.51,90,,,percent of total billed charges,90% of total billed charges,98.69,93,,,percent of total billed charges,93% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,86.38,81.4,,,percent of total billed charges,81.4% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,95.51,90,,,percent of total billed charges,90% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,40.33,38,,,percent of total billed charges,38% of total billed charges,79.59,75,,,percent of total billed charges,75% of total billed charges,90.2,85,,,percent of total billed charges,85% of total billed charges,40.33,98.69,
SARS-CoV-2 PCR,2577,CDM,300,RC,87635,HCPCS,outpatient,,,84.89,63.67,,76.4,90,,,percent of total billed charges,90% of total billed charges,78.95,93,,,percent of total billed charges,93% of total billed charges,32.26,38,,,percent of total billed charges,38% of total billed charges,32.26,38,,,percent of total billed charges,38% of total billed charges,72.16,85,,,percent of total billed charges,85% of total billed charges,32.26,38,,,percent of total billed charges,38% of total billed charges,69.1,81.4,,,percent of total billed charges,81.4% of total billed charges,76.4,90,,,percent of total billed charges,90% of total billed charges,76.4,90,,,percent of total billed charges,90% of total billed charges,32.26,38,,,percent of total billed charges,38% of total billed charges,32.26,38,,,percent of total billed charges,38% of total billed charges,32.26,38,,,percent of total billed charges,38% of total billed charges,63.67,75,,,percent of total billed charges,75% of total billed charges,72.16,85,,,percent of total billed charges,85% of total billed charges,32.26,78.95,
MRSA PCR (SLVRMC),2578,CDM,300,RC,87640,HCPCS,outpatient,,,64.5,48.38,,58.05,90,,,percent of total billed charges,90% of total billed charges,59.99,93,,,percent of total billed charges,93% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,52.5,81.4,,,percent of total billed charges,81.4% of total billed charges,58.05,90,,,percent of total billed charges,90% of total billed charges,58.05,90,,,percent of total billed charges,90% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,48.38,75,,,percent of total billed charges,75% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,24.51,59.99,
MSSA PCR (SLVRMC),2579,CDM,300,RC,87641,HCPCS,outpatient,,,64.5,48.38,,58.05,90,,,percent of total billed charges,90% of total billed charges,59.99,93,,,percent of total billed charges,93% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,52.5,81.4,,,percent of total billed charges,81.4% of total billed charges,58.05,90,,,percent of total billed charges,90% of total billed charges,58.05,90,,,percent of total billed charges,90% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,24.51,38,,,percent of total billed charges,38% of total billed charges,48.38,75,,,percent of total billed charges,75% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,24.51,59.99,
STREP GR A-Molecular,2580,CDM,300,RC,87651,HCPCS,outpatient,,,81.18,60.89,,73.06,90,,,percent of total billed charges,90% of total billed charges,75.5,93,,,percent of total billed charges,93% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,69,85,,,percent of total billed charges,85% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,66.08,81.4,,,percent of total billed charges,81.4% of total billed charges,73.06,90,,,percent of total billed charges,90% of total billed charges,73.06,90,,,percent of total billed charges,90% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,30.85,38,,,percent of total billed charges,38% of total billed charges,60.89,75,,,percent of total billed charges,75% of total billed charges,69,85,,,percent of total billed charges,85% of total billed charges,30.85,75.5,
Group B Strep - Molecular DNA,2581,CDM,300,RC,87653,HCPCS,outpatient,,,104.42,78.32,,93.98,90,,,percent of total billed charges,90% of total billed charges,97.11,93,,,percent of total billed charges,93% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,85,81.4,,,percent of total billed charges,81.4% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,78.32,75,,,percent of total billed charges,75% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,97.11,
Group B Strep,2582,CDM,300,RC,87653,HCPCS,outpatient,,,104.42,78.32,,93.98,90,,,percent of total billed charges,90% of total billed charges,97.11,93,,,percent of total billed charges,93% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,85,81.4,,,percent of total billed charges,81.4% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,93.98,90,,,percent of total billed charges,90% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,39.68,38,,,percent of total billed charges,38% of total billed charges,78.32,75,,,percent of total billed charges,75% of total billed charges,88.76,85,,,percent of total billed charges,85% of total billed charges,39.68,97.11,
*CSF Panel-Group B Strep,2583,CDM,300,RC,87653,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
Meningitis PCR Strep b,2584,CDM,300,RC,87653,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
CSF PCR S. agalactiae,2585,CDM,300,RC,87653,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
Trichomonas RNA Qual. (U-males),2586,CDM,300,RC,87661,HCPCS,outpatient,,,191.01,143.26,,171.91,90,,,percent of total billed charges,90% of total billed charges,177.64,93,,,percent of total billed charges,93% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,162.36,85,,,percent of total billed charges,85% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,155.48,81.4,,,percent of total billed charges,81.4% of total billed charges,171.91,90,,,percent of total billed charges,90% of total billed charges,171.91,90,,,percent of total billed charges,90% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,143.26,75,,,percent of total billed charges,75% of total billed charges,162.36,85,,,percent of total billed charges,85% of total billed charges,72.58,177.64,
(RES) Trichamonas vaginalis,2587,CDM,300,RC,87661,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
"Trichomonas Vag. RNA, Qual. (SureSwab)",2588,CDM,300,RC,87661,HCPCS,outpatient,,,193.21,144.91,,173.89,90,,,percent of total billed charges,90% of total billed charges,179.69,93,,,percent of total billed charges,93% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,164.23,85,,,percent of total billed charges,85% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,157.27,81.4,,,percent of total billed charges,81.4% of total billed charges,173.89,90,,,percent of total billed charges,90% of total billed charges,173.89,90,,,percent of total billed charges,90% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,73.42,38,,,percent of total billed charges,38% of total billed charges,144.91,75,,,percent of total billed charges,75% of total billed charges,164.23,85,,,percent of total billed charges,85% of total billed charges,73.42,179.69,
"(RES) TRICHOMONAS VAGINALIS (TV), TMA",2589,CDM,300,RC,87661,HCPCS,outpatient,,,132.65,99.49,,119.39,90,,,percent of total billed charges,90% of total billed charges,123.36,93,,,percent of total billed charges,93% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,112.75,85,,,percent of total billed charges,85% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,107.98,81.4,,,percent of total billed charges,81.4% of total billed charges,119.39,90,,,percent of total billed charges,90% of total billed charges,119.39,90,,,percent of total billed charges,90% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,99.49,75,,,percent of total billed charges,75% of total billed charges,112.75,85,,,percent of total billed charges,85% of total billed charges,50.41,123.36,
"(RES) SURESWAB(R) TRICHOMONAS VAGINALIS RNA, QL, TMA",2590,CDM,300,RC,87661,HCPCS,outpatient,,,109.3,81.98,,98.37,90,,,percent of total billed charges,90% of total billed charges,101.65,93,,,percent of total billed charges,93% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,88.97,81.4,,,percent of total billed charges,81.4% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,81.98,75,,,percent of total billed charges,75% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,101.65,
Trichamonas vaginalis (SLVRMC),2591,CDM,300,RC,87661,HCPCS,outpatient,,,116.52,87.39,,104.87,90,,,percent of total billed charges,90% of total billed charges,108.36,93,,,percent of total billed charges,93% of total billed charges,44.28,38,,,percent of total billed charges,38% of total billed charges,44.28,38,,,percent of total billed charges,38% of total billed charges,99.04,85,,,percent of total billed charges,85% of total billed charges,44.28,38,,,percent of total billed charges,38% of total billed charges,94.85,81.4,,,percent of total billed charges,81.4% of total billed charges,104.87,90,,,percent of total billed charges,90% of total billed charges,104.87,90,,,percent of total billed charges,90% of total billed charges,44.28,38,,,percent of total billed charges,38% of total billed charges,44.28,38,,,percent of total billed charges,38% of total billed charges,44.28,38,,,percent of total billed charges,38% of total billed charges,87.39,75,,,percent of total billed charges,75% of total billed charges,99.04,85,,,percent of total billed charges,85% of total billed charges,44.28,108.36,
Zika virus RNA qual RT-PCR,2592,CDM,300,RC,87662,HCPCS,outpatient,,,585.61,439.21,,527.05,90,,,percent of total billed charges,90% of total billed charges,544.62,93,,,percent of total billed charges,93% of total billed charges,222.53,38,,,percent of total billed charges,38% of total billed charges,222.53,38,,,percent of total billed charges,38% of total billed charges,497.77,85,,,percent of total billed charges,85% of total billed charges,222.53,38,,,percent of total billed charges,38% of total billed charges,476.69,81.4,,,percent of total billed charges,81.4% of total billed charges,527.05,90,,,percent of total billed charges,90% of total billed charges,527.05,90,,,percent of total billed charges,90% of total billed charges,222.53,38,,,percent of total billed charges,38% of total billed charges,222.53,38,,,percent of total billed charges,38% of total billed charges,222.53,38,,,percent of total billed charges,38% of total billed charges,439.21,75,,,percent of total billed charges,75% of total billed charges,497.77,85,,,percent of total billed charges,85% of total billed charges,222.53,544.62,
Bordetella pertusis and parapertusis,2593,CDM,300,RC,87798,HCPCS,outpatient,,,355.05,266.29,,319.55,90,,,percent of total billed charges,90% of total billed charges,330.2,93,,,percent of total billed charges,93% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,301.79,85,,,percent of total billed charges,85% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,289.01,81.4,,,percent of total billed charges,81.4% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,266.29,75,,,percent of total billed charges,75% of total billed charges,301.79,85,,,percent of total billed charges,85% of total billed charges,134.92,330.2,
Norovirus RNA PCR,2594,CDM,300,RC,87798,HCPCS,outpatient,,,403.09,302.32,,362.78,90,,,percent of total billed charges,90% of total billed charges,374.87,93,,,percent of total billed charges,93% of total billed charges,153.17,38,,,percent of total billed charges,38% of total billed charges,153.17,38,,,percent of total billed charges,38% of total billed charges,342.63,85,,,percent of total billed charges,85% of total billed charges,153.17,38,,,percent of total billed charges,38% of total billed charges,328.12,81.4,,,percent of total billed charges,81.4% of total billed charges,362.78,90,,,percent of total billed charges,90% of total billed charges,362.78,90,,,percent of total billed charges,90% of total billed charges,153.17,38,,,percent of total billed charges,38% of total billed charges,153.17,38,,,percent of total billed charges,38% of total billed charges,153.17,38,,,percent of total billed charges,38% of total billed charges,302.32,75,,,percent of total billed charges,75% of total billed charges,342.63,85,,,percent of total billed charges,85% of total billed charges,153.17,374.87,
*CSF Panel-Cryto,2595,CDM,300,RC,87798,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
*CSF Panel-E. coli K1,2596,CDM,300,RC,87798,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
*CSF Panel-H inf,2597,CDM,300,RC,87798,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
*CSF Panel-Listeria,2598,CDM,300,RC,87798,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
*CSF Panel-n.men,2599,CDM,300,RC,87798,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
*CSF Panel-S pneumo,2600,CDM,300,RC,87798,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
*CSF Panel-Varicella,2601,CDM,300,RC,87798,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
*CSF Panel-Parechovirus,2602,CDM,300,RC,87798,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
CSF PCR Cryptococcus,2603,CDM,300,RC,87798,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
CSF PCR E. coli K1,2604,CDM,300,RC,87798,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
(Result) Norovirus RNA PCR,2605,CDM,300,RC,87798,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Varicella-Zoster Virus DNA, Qual, RT-PCR",2606,CDM,300,RC,87798,HCPCS,outpatient,,,335.44,251.58,,301.9,90,,,percent of total billed charges,90% of total billed charges,311.96,93,,,percent of total billed charges,93% of total billed charges,127.47,38,,,percent of total billed charges,38% of total billed charges,127.47,38,,,percent of total billed charges,38% of total billed charges,285.12,85,,,percent of total billed charges,85% of total billed charges,127.47,38,,,percent of total billed charges,38% of total billed charges,273.05,81.4,,,percent of total billed charges,81.4% of total billed charges,301.9,90,,,percent of total billed charges,90% of total billed charges,301.9,90,,,percent of total billed charges,90% of total billed charges,127.47,38,,,percent of total billed charges,38% of total billed charges,127.47,38,,,percent of total billed charges,38% of total billed charges,127.47,38,,,percent of total billed charges,38% of total billed charges,251.58,75,,,percent of total billed charges,75% of total billed charges,285.12,85,,,percent of total billed charges,85% of total billed charges,127.47,311.96,
Meningitis PCR - direct probe each organism,2607,CDM,300,RC,87798,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
"Hepatitis D Virus RNA, QL, PCR",2608,CDM,300,RC,87798,HCPCS,outpatient,,,460.46,345.35,,414.41,90,,,percent of total billed charges,90% of total billed charges,428.23,93,,,percent of total billed charges,93% of total billed charges,174.97,38,,,percent of total billed charges,38% of total billed charges,174.97,38,,,percent of total billed charges,38% of total billed charges,391.39,85,,,percent of total billed charges,85% of total billed charges,174.97,38,,,percent of total billed charges,38% of total billed charges,374.81,81.4,,,percent of total billed charges,81.4% of total billed charges,414.41,90,,,percent of total billed charges,90% of total billed charges,414.41,90,,,percent of total billed charges,90% of total billed charges,174.97,38,,,percent of total billed charges,38% of total billed charges,174.97,38,,,percent of total billed charges,38% of total billed charges,174.97,38,,,percent of total billed charges,38% of total billed charges,345.35,75,,,percent of total billed charges,75% of total billed charges,391.39,85,,,percent of total billed charges,85% of total billed charges,174.97,428.23,
"Mumps Virus RNA, Qual RT-PCR",2609,CDM,300,RC,87798,HCPCS,outpatient,,,495.72,371.79,,446.15,90,,,percent of total billed charges,90% of total billed charges,461.02,93,,,percent of total billed charges,93% of total billed charges,188.37,38,,,percent of total billed charges,38% of total billed charges,188.37,38,,,percent of total billed charges,38% of total billed charges,421.36,85,,,percent of total billed charges,85% of total billed charges,188.37,38,,,percent of total billed charges,38% of total billed charges,403.52,81.4,,,percent of total billed charges,81.4% of total billed charges,446.15,90,,,percent of total billed charges,90% of total billed charges,446.15,90,,,percent of total billed charges,90% of total billed charges,188.37,38,,,percent of total billed charges,38% of total billed charges,188.37,38,,,percent of total billed charges,38% of total billed charges,188.37,38,,,percent of total billed charges,38% of total billed charges,371.79,75,,,percent of total billed charges,75% of total billed charges,421.36,85,,,percent of total billed charges,85% of total billed charges,188.37,461.02,
"(RES) SURESWAB(R), MYCOPLASMA HOMINIS, RT- PCR",2610,CDM,300,RC,87798,HCPCS,outpatient,,,144.1,108.08,,129.69,90,,,percent of total billed charges,90% of total billed charges,134.01,93,,,percent of total billed charges,93% of total billed charges,54.76,38,,,percent of total billed charges,38% of total billed charges,54.76,38,,,percent of total billed charges,38% of total billed charges,122.49,85,,,percent of total billed charges,85% of total billed charges,54.76,38,,,percent of total billed charges,38% of total billed charges,117.3,81.4,,,percent of total billed charges,81.4% of total billed charges,129.69,90,,,percent of total billed charges,90% of total billed charges,129.69,90,,,percent of total billed charges,90% of total billed charges,54.76,38,,,percent of total billed charges,38% of total billed charges,54.76,38,,,percent of total billed charges,38% of total billed charges,54.76,38,,,percent of total billed charges,38% of total billed charges,108.08,75,,,percent of total billed charges,75% of total billed charges,122.49,85,,,percent of total billed charges,85% of total billed charges,54.76,134.01,
(RES) U. PARVUM DNA,2611,CDM,300,RC,87798,HCPCS,outpatient,,,143.34,107.51,,129.01,90,,,percent of total billed charges,90% of total billed charges,133.31,93,,,percent of total billed charges,93% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,121.84,85,,,percent of total billed charges,85% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,116.68,81.4,,,percent of total billed charges,81.4% of total billed charges,129.01,90,,,percent of total billed charges,90% of total billed charges,129.01,90,,,percent of total billed charges,90% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,107.51,75,,,percent of total billed charges,75% of total billed charges,121.84,85,,,percent of total billed charges,85% of total billed charges,54.47,133.31,
"West Nile Virus RNA, Qual, RT PCR CSF",2612,CDM,300,RC,87798,HCPCS,outpatient,,,493.53,370.15,,444.18,90,,,percent of total billed charges,90% of total billed charges,458.98,93,,,percent of total billed charges,93% of total billed charges,187.54,38,,,percent of total billed charges,38% of total billed charges,187.54,38,,,percent of total billed charges,38% of total billed charges,419.5,85,,,percent of total billed charges,85% of total billed charges,187.54,38,,,percent of total billed charges,38% of total billed charges,401.73,81.4,,,percent of total billed charges,81.4% of total billed charges,444.18,90,,,percent of total billed charges,90% of total billed charges,444.18,90,,,percent of total billed charges,90% of total billed charges,187.54,38,,,percent of total billed charges,38% of total billed charges,187.54,38,,,percent of total billed charges,38% of total billed charges,187.54,38,,,percent of total billed charges,38% of total billed charges,370.15,75,,,percent of total billed charges,75% of total billed charges,419.5,85,,,percent of total billed charges,85% of total billed charges,187.54,458.98,
CSF PCR H. Influenza,2613,CDM,300,RC,87798,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
CSF PCR Listeria Monocytogenes,2614,CDM,300,RC,87798,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
CSF PCR N. Meningitidis,2615,CDM,300,RC,87798,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
CSF PCR Parechovirus,2616,CDM,300,RC,87798,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
CSF PCR S. pneumoniae,2617,CDM,300,RC,87798,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
CSF PCR Varicella,2618,CDM,300,RC,87798,HCPCS,outpatient,,,69.62,52.22,,62.66,90,,,percent of total billed charges,90% of total billed charges,64.75,93,,,percent of total billed charges,93% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,56.67,81.4,,,percent of total billed charges,81.4% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,62.66,90,,,percent of total billed charges,90% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,26.46,38,,,percent of total billed charges,38% of total billed charges,52.22,75,,,percent of total billed charges,75% of total billed charges,59.18,85,,,percent of total billed charges,85% of total billed charges,26.46,64.75,
(RES) U. UREALYTICUM DNA,2619,CDM,300,RC,87798,HCPCS,outpatient,,,143.34,107.51,,129.01,90,,,percent of total billed charges,90% of total billed charges,133.31,93,,,percent of total billed charges,93% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,121.84,85,,,percent of total billed charges,85% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,116.68,81.4,,,percent of total billed charges,81.4% of total billed charges,129.01,90,,,percent of total billed charges,90% of total billed charges,129.01,90,,,percent of total billed charges,90% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,54.47,38,,,percent of total billed charges,38% of total billed charges,107.51,75,,,percent of total billed charges,75% of total billed charges,121.84,85,,,percent of total billed charges,85% of total billed charges,54.47,133.31,
"Chikungunya Virus RNA, Qualitative, Real-Time PCR",2620,CDM,300,RC,87798,HCPCS,outpatient,,,436.5,327.38,,392.85,90,,,percent of total billed charges,90% of total billed charges,405.95,93,,,percent of total billed charges,93% of total billed charges,165.87,38,,,percent of total billed charges,38% of total billed charges,165.87,38,,,percent of total billed charges,38% of total billed charges,371.03,85,,,percent of total billed charges,85% of total billed charges,165.87,38,,,percent of total billed charges,38% of total billed charges,355.31,81.4,,,percent of total billed charges,81.4% of total billed charges,392.85,90,,,percent of total billed charges,90% of total billed charges,392.85,90,,,percent of total billed charges,90% of total billed charges,165.87,38,,,percent of total billed charges,38% of total billed charges,165.87,38,,,percent of total billed charges,38% of total billed charges,165.87,38,,,percent of total billed charges,38% of total billed charges,327.38,75,,,percent of total billed charges,75% of total billed charges,371.03,85,,,percent of total billed charges,85% of total billed charges,165.87,405.95,
"Measles Virus, QL, RT-PCR, Throat",2621,CDM,300,RC,87798,HCPCS,outpatient,,,372.64,279.48,,335.38,90,,,percent of total billed charges,90% of total billed charges,346.56,93,,,percent of total billed charges,93% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,303.33,81.4,,,percent of total billed charges,81.4% of total billed charges,335.38,90,,,percent of total billed charges,90% of total billed charges,335.38,90,,,percent of total billed charges,90% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,279.48,75,,,percent of total billed charges,75% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,346.56,
**Respiratory Panel-Pertussis,2622,CDM,300,RC,87798,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
Resp panel B. pertussis,2623,CDM,300,RC,87798,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
Resp Panel B. Parapertussis,2624,CDM,300,RC,87798,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
"BK Virus DNA, QL, Urine",2625,CDM,300,RC,87798,HCPCS,outpatient,,,528.83,396.62,,475.95,90,,,percent of total billed charges,90% of total billed charges,491.81,93,,,percent of total billed charges,93% of total billed charges,200.96,38,,,percent of total billed charges,38% of total billed charges,200.96,38,,,percent of total billed charges,38% of total billed charges,449.51,85,,,percent of total billed charges,85% of total billed charges,200.96,38,,,percent of total billed charges,38% of total billed charges,430.47,81.4,,,percent of total billed charges,81.4% of total billed charges,475.95,90,,,percent of total billed charges,90% of total billed charges,475.95,90,,,percent of total billed charges,90% of total billed charges,200.96,38,,,percent of total billed charges,38% of total billed charges,200.96,38,,,percent of total billed charges,38% of total billed charges,200.96,38,,,percent of total billed charges,38% of total billed charges,396.62,75,,,percent of total billed charges,75% of total billed charges,449.51,85,,,percent of total billed charges,85% of total billed charges,200.96,491.81,
Quantitative BK Virus PCR Plasma,2626,CDM,300,RC,87799,HCPCS,outpatient,,,493.02,369.77,,443.72,90,,,percent of total billed charges,90% of total billed charges,458.51,93,,,percent of total billed charges,93% of total billed charges,187.35,38,,,percent of total billed charges,38% of total billed charges,187.35,38,,,percent of total billed charges,38% of total billed charges,419.07,85,,,percent of total billed charges,85% of total billed charges,187.35,38,,,percent of total billed charges,38% of total billed charges,401.32,81.4,,,percent of total billed charges,81.4% of total billed charges,443.72,90,,,percent of total billed charges,90% of total billed charges,443.72,90,,,percent of total billed charges,90% of total billed charges,187.35,38,,,percent of total billed charges,38% of total billed charges,187.35,38,,,percent of total billed charges,38% of total billed charges,187.35,38,,,percent of total billed charges,38% of total billed charges,369.77,75,,,percent of total billed charges,75% of total billed charges,419.07,85,,,percent of total billed charges,85% of total billed charges,187.35,458.51,
Parvo B-19 Quant,2627,CDM,300,RC,87799,HCPCS,outpatient,,,629.93,472.45,,566.94,90,,,percent of total billed charges,90% of total billed charges,585.83,93,,,percent of total billed charges,93% of total billed charges,239.37,38,,,percent of total billed charges,38% of total billed charges,239.37,38,,,percent of total billed charges,38% of total billed charges,535.44,85,,,percent of total billed charges,85% of total billed charges,239.37,38,,,percent of total billed charges,38% of total billed charges,512.76,81.4,,,percent of total billed charges,81.4% of total billed charges,566.94,90,,,percent of total billed charges,90% of total billed charges,566.94,90,,,percent of total billed charges,90% of total billed charges,239.37,38,,,percent of total billed charges,38% of total billed charges,239.37,38,,,percent of total billed charges,38% of total billed charges,239.37,38,,,percent of total billed charges,38% of total billed charges,472.45,75,,,percent of total billed charges,75% of total billed charges,535.44,85,,,percent of total billed charges,85% of total billed charges,239.37,585.83,
"Varicella-Zoster Virus DNA, Quant, RT-PCR",2628,CDM,300,RC,87799,HCPCS,outpatient,,,600.43,450.32,,540.39,90,,,percent of total billed charges,90% of total billed charges,558.4,93,,,percent of total billed charges,93% of total billed charges,228.16,38,,,percent of total billed charges,38% of total billed charges,228.16,38,,,percent of total billed charges,38% of total billed charges,510.37,85,,,percent of total billed charges,85% of total billed charges,228.16,38,,,percent of total billed charges,38% of total billed charges,488.75,81.4,,,percent of total billed charges,81.4% of total billed charges,540.39,90,,,percent of total billed charges,90% of total billed charges,540.39,90,,,percent of total billed charges,90% of total billed charges,228.16,38,,,percent of total billed charges,38% of total billed charges,228.16,38,,,percent of total billed charges,38% of total billed charges,228.16,38,,,percent of total billed charges,38% of total billed charges,450.32,75,,,percent of total billed charges,75% of total billed charges,510.37,85,,,percent of total billed charges,85% of total billed charges,228.16,558.4,
Herpes Virus 7DNA Quant,2629,CDM,300,RC,87799,HCPCS,outpatient,,,537.06,402.8,,483.35,90,,,percent of total billed charges,90% of total billed charges,499.47,93,,,percent of total billed charges,93% of total billed charges,204.08,38,,,percent of total billed charges,38% of total billed charges,204.08,38,,,percent of total billed charges,38% of total billed charges,456.5,85,,,percent of total billed charges,85% of total billed charges,204.08,38,,,percent of total billed charges,38% of total billed charges,437.17,81.4,,,percent of total billed charges,81.4% of total billed charges,483.35,90,,,percent of total billed charges,90% of total billed charges,483.35,90,,,percent of total billed charges,90% of total billed charges,204.08,38,,,percent of total billed charges,38% of total billed charges,204.08,38,,,percent of total billed charges,38% of total billed charges,204.08,38,,,percent of total billed charges,38% of total billed charges,402.8,75,,,percent of total billed charges,75% of total billed charges,456.5,85,,,percent of total billed charges,85% of total billed charges,204.08,499.47,
"Epstein BV DNA, PCR",2630,CDM,300,RC,87799,HCPCS,outpatient,,,385.15,288.86,,346.64,90,,,percent of total billed charges,90% of total billed charges,358.19,93,,,percent of total billed charges,93% of total billed charges,146.36,38,,,percent of total billed charges,38% of total billed charges,146.36,38,,,percent of total billed charges,38% of total billed charges,327.38,85,,,percent of total billed charges,85% of total billed charges,146.36,38,,,percent of total billed charges,38% of total billed charges,313.51,81.4,,,percent of total billed charges,81.4% of total billed charges,346.64,90,,,percent of total billed charges,90% of total billed charges,346.64,90,,,percent of total billed charges,90% of total billed charges,146.36,38,,,percent of total billed charges,38% of total billed charges,146.36,38,,,percent of total billed charges,38% of total billed charges,146.36,38,,,percent of total billed charges,38% of total billed charges,288.86,75,,,percent of total billed charges,75% of total billed charges,327.38,85,,,percent of total billed charges,85% of total billed charges,146.36,358.19,
(RES) ATOPOBIUM VAGINAE,2631,CDM,300,RC,87799,HCPCS,outpatient,,,109.3,81.98,,98.37,90,,,percent of total billed charges,90% of total billed charges,101.65,93,,,percent of total billed charges,93% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,88.97,81.4,,,percent of total billed charges,81.4% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,81.98,75,,,percent of total billed charges,75% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,101.65,
(RES) GARDNERELLA VAGINALIS,2632,CDM,300,RC,87799,HCPCS,outpatient,,,109.3,81.98,,98.37,90,,,percent of total billed charges,90% of total billed charges,101.65,93,,,percent of total billed charges,93% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,88.97,81.4,,,percent of total billed charges,81.4% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,81.98,75,,,percent of total billed charges,75% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,101.65,
(RES) MEGASPHAERA SPECIES,2633,CDM,300,RC,87799,HCPCS,outpatient,,,109.3,81.98,,98.37,90,,,percent of total billed charges,90% of total billed charges,101.65,93,,,percent of total billed charges,93% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,88.97,81.4,,,percent of total billed charges,81.4% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,98.37,90,,,percent of total billed charges,90% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,41.53,38,,,percent of total billed charges,38% of total billed charges,81.98,75,,,percent of total billed charges,75% of total billed charges,92.91,85,,,percent of total billed charges,85% of total billed charges,41.53,101.65,
"Hepatitis D Virus RNA, Quant, RT-PCR",2634,CDM,300,RC,87799,HCPCS,outpatient,,,654.84,491.13,,589.36,90,,,percent of total billed charges,90% of total billed charges,609,93,,,percent of total billed charges,93% of total billed charges,248.84,38,,,percent of total billed charges,38% of total billed charges,248.84,38,,,percent of total billed charges,38% of total billed charges,556.61,85,,,percent of total billed charges,85% of total billed charges,248.84,38,,,percent of total billed charges,38% of total billed charges,533.04,81.4,,,percent of total billed charges,81.4% of total billed charges,589.36,90,,,percent of total billed charges,90% of total billed charges,589.36,90,,,percent of total billed charges,90% of total billed charges,248.84,38,,,percent of total billed charges,38% of total billed charges,248.84,38,,,percent of total billed charges,38% of total billed charges,248.84,38,,,percent of total billed charges,38% of total billed charges,491.13,75,,,percent of total billed charges,75% of total billed charges,556.61,85,,,percent of total billed charges,85% of total billed charges,248.84,609,
Rapid Strep,2635,CDM,300,RC,87800,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
MYCO TB DNA test,2636,CDM,300,RC,87801,HCPCS,outpatient,,,220.81,165.61,,198.73,90,,,percent of total billed charges,90% of total billed charges,205.35,93,,,percent of total billed charges,93% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,187.69,85,,,percent of total billed charges,85% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,179.74,81.4,,,percent of total billed charges,81.4% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,165.61,75,,,percent of total billed charges,75% of total billed charges,187.69,85,,,percent of total billed charges,85% of total billed charges,83.91,205.35,
(RES) Bacterial Vaginosis,2637,CDM,300,RC,87801,HCPCS,outpatient,,,71.27,53.45,,64.14,90,,,percent of total billed charges,90% of total billed charges,66.28,93,,,percent of total billed charges,93% of total billed charges,27.08,38,,,percent of total billed charges,38% of total billed charges,27.08,38,,,percent of total billed charges,38% of total billed charges,60.58,85,,,percent of total billed charges,85% of total billed charges,27.08,38,,,percent of total billed charges,38% of total billed charges,58.01,81.4,,,percent of total billed charges,81.4% of total billed charges,64.14,90,,,percent of total billed charges,90% of total billed charges,64.14,90,,,percent of total billed charges,90% of total billed charges,27.08,38,,,percent of total billed charges,38% of total billed charges,27.08,38,,,percent of total billed charges,38% of total billed charges,27.08,38,,,percent of total billed charges,38% of total billed charges,53.45,75,,,percent of total billed charges,75% of total billed charges,60.58,85,,,percent of total billed charges,85% of total billed charges,27.08,66.28,
"Borrelia Species DNA, PCR, w Rflx, Blood",2638,CDM,300,RC,87801,HCPCS,outpatient,,,491.07,368.3,,441.96,90,,,percent of total billed charges,90% of total billed charges,456.7,93,,,percent of total billed charges,93% of total billed charges,186.61,38,,,percent of total billed charges,38% of total billed charges,186.61,38,,,percent of total billed charges,38% of total billed charges,417.41,85,,,percent of total billed charges,85% of total billed charges,186.61,38,,,percent of total billed charges,38% of total billed charges,399.73,81.4,,,percent of total billed charges,81.4% of total billed charges,441.96,90,,,percent of total billed charges,90% of total billed charges,441.96,90,,,percent of total billed charges,90% of total billed charges,186.61,38,,,percent of total billed charges,38% of total billed charges,186.61,38,,,percent of total billed charges,38% of total billed charges,186.61,38,,,percent of total billed charges,38% of total billed charges,368.3,75,,,percent of total billed charges,75% of total billed charges,417.41,85,,,percent of total billed charges,85% of total billed charges,186.61,456.7,
Mycobact. TB Complex & Rifampin Resist.,2639,CDM,300,RC,87801,HCPCS,outpatient,,,472.61,354.46,,425.35,90,,,percent of total billed charges,90% of total billed charges,439.53,93,,,percent of total billed charges,93% of total billed charges,179.59,38,,,percent of total billed charges,38% of total billed charges,179.59,38,,,percent of total billed charges,38% of total billed charges,401.72,85,,,percent of total billed charges,85% of total billed charges,179.59,38,,,percent of total billed charges,38% of total billed charges,384.7,81.4,,,percent of total billed charges,81.4% of total billed charges,425.35,90,,,percent of total billed charges,90% of total billed charges,425.35,90,,,percent of total billed charges,90% of total billed charges,179.59,38,,,percent of total billed charges,38% of total billed charges,179.59,38,,,percent of total billed charges,38% of total billed charges,179.59,38,,,percent of total billed charges,38% of total billed charges,354.46,75,,,percent of total billed charges,75% of total billed charges,401.72,85,,,percent of total billed charges,85% of total billed charges,179.59,439.53,
C. diff screen,2640,CDM,300,RC,87803,HCPCS,outpatient,,,145.29,108.97,,130.76,90,,,percent of total billed charges,90% of total billed charges,135.12,93,,,percent of total billed charges,93% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,123.5,85,,,percent of total billed charges,85% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,118.27,81.4,,,percent of total billed charges,81.4% of total billed charges,130.76,90,,,percent of total billed charges,90% of total billed charges,130.76,90,,,percent of total billed charges,90% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,108.97,75,,,percent of total billed charges,75% of total billed charges,123.5,85,,,percent of total billed charges,85% of total billed charges,55.21,135.12,
Influenza A and B,2641,CDM,300,RC,87804,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,101.34,
(Result) Influenza A,2642,CDM,300,RC,87804,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) Influenza B,2643,CDM,300,RC,87804,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Clinic Influenza A & B Test,2644,CDM,300,RC,87804,HCPCS,outpatient,,,63.17,47.38,,56.85,90,,,percent of total billed charges,90% of total billed charges,58.75,93,,,percent of total billed charges,93% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,53.69,85,,,percent of total billed charges,85% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,51.42,81.4,,,percent of total billed charges,81.4% of total billed charges,56.85,90,,,percent of total billed charges,90% of total billed charges,56.85,90,,,percent of total billed charges,90% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,47.38,75,,,percent of total billed charges,75% of total billed charges,53.69,85,,,percent of total billed charges,85% of total billed charges,24,58.75,
Rapid Influenza A/B,2645,CDM,300,RC,87804,HCPCS,outpatient,,,63.17,47.38,,56.85,90,,,percent of total billed charges,90% of total billed charges,58.75,93,,,percent of total billed charges,93% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,53.69,85,,,percent of total billed charges,85% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,51.42,81.4,,,percent of total billed charges,81.4% of total billed charges,56.85,90,,,percent of total billed charges,90% of total billed charges,56.85,90,,,percent of total billed charges,90% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,24,38,,,percent of total billed charges,38% of total billed charges,47.38,75,,,percent of total billed charges,75% of total billed charges,53.69,85,,,percent of total billed charges,85% of total billed charges,24,58.75,
HIV 1/2 Antigen/Antibody Combo,2646,CDM,300,RC,87806,HCPCS,outpatient,,,78.03,58.52,,70.23,90,,,percent of total billed charges,90% of total billed charges,72.57,93,,,percent of total billed charges,93% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,66.33,85,,,percent of total billed charges,85% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,63.52,81.4,,,percent of total billed charges,81.4% of total billed charges,70.23,90,,,percent of total billed charges,90% of total billed charges,70.23,90,,,percent of total billed charges,90% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,29.65,38,,,percent of total billed charges,38% of total billed charges,58.52,75,,,percent of total billed charges,75% of total billed charges,66.33,85,,,percent of total billed charges,85% of total billed charges,29.65,72.57,
RSV,2647,CDM,300,RC,87807,HCPCS,outpatient,,,151.15,113.36,,136.04,90,,,percent of total billed charges,90% of total billed charges,140.57,93,,,percent of total billed charges,93% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,123.04,81.4,,,percent of total billed charges,81.4% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,113.36,75,,,percent of total billed charges,75% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,140.57,
Strep pneumonomiae ag,2648,CDM,300,RC,87899,HCPCS,outpatient,,,184.48,138.36,,166.03,90,,,percent of total billed charges,90% of total billed charges,171.57,93,,,percent of total billed charges,93% of total billed charges,70.1,38,,,percent of total billed charges,38% of total billed charges,70.1,38,,,percent of total billed charges,38% of total billed charges,156.81,85,,,percent of total billed charges,85% of total billed charges,70.1,38,,,percent of total billed charges,38% of total billed charges,150.17,81.4,,,percent of total billed charges,81.4% of total billed charges,166.03,90,,,percent of total billed charges,90% of total billed charges,166.03,90,,,percent of total billed charges,90% of total billed charges,70.1,38,,,percent of total billed charges,38% of total billed charges,70.1,38,,,percent of total billed charges,38% of total billed charges,70.1,38,,,percent of total billed charges,38% of total billed charges,138.36,75,,,percent of total billed charges,75% of total billed charges,156.81,85,,,percent of total billed charges,85% of total billed charges,70.1,171.57,
"Strep pneumoniae Antigens, Urine",2649,CDM,300,RC,87899,HCPCS,outpatient,,,178.5,133.88,,160.65,90,,,percent of total billed charges,90% of total billed charges,166.01,93,,,percent of total billed charges,93% of total billed charges,67.83,38,,,percent of total billed charges,38% of total billed charges,67.83,38,,,percent of total billed charges,38% of total billed charges,151.73,85,,,percent of total billed charges,85% of total billed charges,67.83,38,,,percent of total billed charges,38% of total billed charges,145.3,81.4,,,percent of total billed charges,81.4% of total billed charges,160.65,90,,,percent of total billed charges,90% of total billed charges,160.65,90,,,percent of total billed charges,90% of total billed charges,67.83,38,,,percent of total billed charges,38% of total billed charges,67.83,38,,,percent of total billed charges,38% of total billed charges,67.83,38,,,percent of total billed charges,38% of total billed charges,133.88,75,,,percent of total billed charges,75% of total billed charges,151.73,85,,,percent of total billed charges,85% of total billed charges,67.83,166.01,
"HIV-1 Resistance, Proviral DNA (RT, PI Inh)",2650,CDM,300,RC,87900,HCPCS,outpatient,,,984.22,738.17,,885.8,90,,,percent of total billed charges,90% of total billed charges,915.32,93,,,percent of total billed charges,93% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,836.59,85,,,percent of total billed charges,85% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,801.16,81.4,,,percent of total billed charges,81.4% of total billed charges,885.8,90,,,percent of total billed charges,90% of total billed charges,885.8,90,,,percent of total billed charges,90% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,738.17,75,,,percent of total billed charges,75% of total billed charges,836.59,85,,,percent of total billed charges,85% of total billed charges,374,915.32,
"(RES) HIV 1 PR, RT PROVIRAL DNA",2651,CDM,300,RC,87900,HCPCS,outpatient,,,984.22,738.17,,885.8,90,,,percent of total billed charges,90% of total billed charges,915.32,93,,,percent of total billed charges,93% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,836.59,85,,,percent of total billed charges,85% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,801.16,81.4,,,percent of total billed charges,81.4% of total billed charges,885.8,90,,,percent of total billed charges,90% of total billed charges,885.8,90,,,percent of total billed charges,90% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,374,38,,,percent of total billed charges,38% of total billed charges,738.17,75,,,percent of total billed charges,75% of total billed charges,836.59,85,,,percent of total billed charges,85% of total billed charges,374,915.32,
"HEP C VIRAL RNA, GENOTYPE, LIPA(R)",2652,CDM,300,RC,87902,HCPCS,outpatient,,,580.08,435.06,,522.07,90,,,percent of total billed charges,90% of total billed charges,539.47,93,,,percent of total billed charges,93% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,493.07,85,,,percent of total billed charges,85% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,472.19,81.4,,,percent of total billed charges,81.4% of total billed charges,522.07,90,,,percent of total billed charges,90% of total billed charges,522.07,90,,,percent of total billed charges,90% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,220.43,38,,,percent of total billed charges,38% of total billed charges,435.06,75,,,percent of total billed charges,75% of total billed charges,493.07,85,,,percent of total billed charges,85% of total billed charges,220.43,539.47,
Hep C Viral RNA Genotype 3 NS5a Drug Resist.,2653,CDM,300,RC,87902,HCPCS,outpatient,,,807.4,605.55,,726.66,90,,,percent of total billed charges,90% of total billed charges,750.88,93,,,percent of total billed charges,93% of total billed charges,306.81,38,,,percent of total billed charges,38% of total billed charges,306.81,38,,,percent of total billed charges,38% of total billed charges,686.29,85,,,percent of total billed charges,85% of total billed charges,306.81,38,,,percent of total billed charges,38% of total billed charges,657.22,81.4,,,percent of total billed charges,81.4% of total billed charges,726.66,90,,,percent of total billed charges,90% of total billed charges,726.66,90,,,percent of total billed charges,90% of total billed charges,306.81,38,,,percent of total billed charges,38% of total billed charges,306.81,38,,,percent of total billed charges,38% of total billed charges,306.81,38,,,percent of total billed charges,38% of total billed charges,605.55,75,,,percent of total billed charges,75% of total billed charges,686.29,85,,,percent of total billed charges,85% of total billed charges,306.81,750.88,
"HEP C RNA Geno, 1 NS5b Resistance",2654,CDM,300,RC,87902,HCPCS,outpatient,,,856.91,642.68,,771.22,90,,,percent of total billed charges,90% of total billed charges,796.93,93,,,percent of total billed charges,93% of total billed charges,325.63,38,,,percent of total billed charges,38% of total billed charges,325.63,38,,,percent of total billed charges,38% of total billed charges,728.37,85,,,percent of total billed charges,85% of total billed charges,325.63,38,,,percent of total billed charges,38% of total billed charges,697.52,81.4,,,percent of total billed charges,81.4% of total billed charges,771.22,90,,,percent of total billed charges,90% of total billed charges,771.22,90,,,percent of total billed charges,90% of total billed charges,325.63,38,,,percent of total billed charges,38% of total billed charges,325.63,38,,,percent of total billed charges,38% of total billed charges,325.63,38,,,percent of total billed charges,38% of total billed charges,642.68,75,,,percent of total billed charges,75% of total billed charges,728.37,85,,,percent of total billed charges,85% of total billed charges,325.63,796.93,
Hepatitis C Viral RNA Genotype 1 NS5a Drug Resistance,2655,CDM,300,RC,87902,HCPCS,outpatient,,,823.55,617.66,,741.2,90,,,percent of total billed charges,90% of total billed charges,765.9,93,,,percent of total billed charges,93% of total billed charges,312.95,38,,,percent of total billed charges,38% of total billed charges,312.95,38,,,percent of total billed charges,38% of total billed charges,700.02,85,,,percent of total billed charges,85% of total billed charges,312.95,38,,,percent of total billed charges,38% of total billed charges,670.37,81.4,,,percent of total billed charges,81.4% of total billed charges,741.2,90,,,percent of total billed charges,90% of total billed charges,741.2,90,,,percent of total billed charges,90% of total billed charges,312.95,38,,,percent of total billed charges,38% of total billed charges,312.95,38,,,percent of total billed charges,38% of total billed charges,312.95,38,,,percent of total billed charges,38% of total billed charges,617.66,75,,,percent of total billed charges,75% of total billed charges,700.02,85,,,percent of total billed charges,85% of total billed charges,312.95,765.9,
"HIV-1 Resistance, Proviral DNA (Integrase Inh)",2656,CDM,300,RC,87906,HCPCS,outpatient,,,520.2,390.15,,468.18,90,,,percent of total billed charges,90% of total billed charges,483.79,93,,,percent of total billed charges,93% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,423.44,81.4,,,percent of total billed charges,81.4% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,197.68,38,,,percent of total billed charges,38% of total billed charges,390.15,75,,,percent of total billed charges,75% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,197.68,483.79,
"Cytopathology, Non-Gynecological",2657,CDM,300,RC,88112,HCPCS,outpatient,,,331.28,248.46,,298.15,90,,,percent of total billed charges,90% of total billed charges,308.09,93,,,percent of total billed charges,93% of total billed charges,125.89,38,,,percent of total billed charges,38% of total billed charges,125.89,38,,,percent of total billed charges,38% of total billed charges,281.59,85,,,percent of total billed charges,85% of total billed charges,125.89,38,,,percent of total billed charges,38% of total billed charges,269.66,81.4,,,percent of total billed charges,81.4% of total billed charges,298.15,90,,,percent of total billed charges,90% of total billed charges,298.15,90,,,percent of total billed charges,90% of total billed charges,125.89,38,,,percent of total billed charges,38% of total billed charges,125.89,38,,,percent of total billed charges,38% of total billed charges,125.89,38,,,percent of total billed charges,38% of total billed charges,248.46,75,,,percent of total billed charges,75% of total billed charges,281.59,85,,,percent of total billed charges,85% of total billed charges,125.89,308.09,
(RES) Leukemia/Lymphoma CD2,2658,CDM,300,RC,88184,HCPCS,outpatient,,,79.59,59.69,,71.63,90,,,percent of total billed charges,90% of total billed charges,74.02,93,,,percent of total billed charges,93% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,67.65,85,,,percent of total billed charges,85% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,64.79,81.4,,,percent of total billed charges,81.4% of total billed charges,71.63,90,,,percent of total billed charges,90% of total billed charges,71.63,90,,,percent of total billed charges,90% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,30.24,38,,,percent of total billed charges,38% of total billed charges,59.69,75,,,percent of total billed charges,75% of total billed charges,67.65,85,,,percent of total billed charges,85% of total billed charges,30.24,74.02,
Flow Cyto TC 1 marker,2659,CDM,300,RC,88184,HCPCS,outpatient,,,519.57,389.68,,467.61,90,,,percent of total billed charges,90% of total billed charges,483.2,93,,,percent of total billed charges,93% of total billed charges,197.44,38,,,percent of total billed charges,38% of total billed charges,197.44,38,,,percent of total billed charges,38% of total billed charges,441.63,85,,,percent of total billed charges,85% of total billed charges,197.44,38,,,percent of total billed charges,38% of total billed charges,422.93,81.4,,,percent of total billed charges,81.4% of total billed charges,467.61,90,,,percent of total billed charges,90% of total billed charges,467.61,90,,,percent of total billed charges,90% of total billed charges,197.44,38,,,percent of total billed charges,38% of total billed charges,197.44,38,,,percent of total billed charges,38% of total billed charges,197.44,38,,,percent of total billed charges,38% of total billed charges,389.68,75,,,percent of total billed charges,75% of total billed charges,441.63,85,,,percent of total billed charges,85% of total billed charges,197.44,483.2,
B Cell CD 19/20cyto pheno,2660,CDM,300,RC,88184,HCPCS,outpatient,,,324.73,243.55,,292.26,90,,,percent of total billed charges,90% of total billed charges,302,93,,,percent of total billed charges,93% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,276.02,85,,,percent of total billed charges,85% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,264.33,81.4,,,percent of total billed charges,81.4% of total billed charges,292.26,90,,,percent of total billed charges,90% of total billed charges,292.26,90,,,percent of total billed charges,90% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,243.55,75,,,percent of total billed charges,75% of total billed charges,276.02,85,,,percent of total billed charges,85% of total billed charges,123.4,302,
(RES) Leukemia/Lymphoma CD3,2661,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD4,2662,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD5,2663,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD7,2664,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD8,2665,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD10,2666,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD11c,2667,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD13,2668,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD19,2669,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD20,2670,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
B cell CD 19/20 cyto cell surface,2671,CDM,300,RC,88185,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,100.66,
(RES) Leukemia/Lymphoma CD23,2672,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD33,2673,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD34,2674,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD38,2675,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD45,2676,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD56,2677,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD117,2678,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma HLA_DR,2679,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma Kappa CD19+,2680,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
Flow Cyto TC add-on,2681,CDM,300,RC,88185,HCPCS,outpatient,,,179.68,134.76,,161.71,90,,,percent of total billed charges,90% of total billed charges,167.1,93,,,percent of total billed charges,93% of total billed charges,68.28,38,,,percent of total billed charges,38% of total billed charges,68.28,38,,,percent of total billed charges,38% of total billed charges,152.73,85,,,percent of total billed charges,85% of total billed charges,68.28,38,,,percent of total billed charges,38% of total billed charges,146.26,81.4,,,percent of total billed charges,81.4% of total billed charges,161.71,90,,,percent of total billed charges,90% of total billed charges,161.71,90,,,percent of total billed charges,90% of total billed charges,68.28,38,,,percent of total billed charges,38% of total billed charges,68.28,38,,,percent of total billed charges,38% of total billed charges,68.28,38,,,percent of total billed charges,38% of total billed charges,134.76,75,,,percent of total billed charges,75% of total billed charges,152.73,85,,,percent of total billed charges,85% of total billed charges,68.28,167.1,
(RES) Leukemia/Lymphoma Lambda CD19+,2682,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
(RES) Leukemia/Lymphoma CD64,2683,CDM,300,RC,88185,HCPCS,outpatient,,,85.15,63.86,,76.64,90,,,percent of total billed charges,90% of total billed charges,79.19,93,,,percent of total billed charges,93% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,69.31,81.4,,,percent of total billed charges,81.4% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,76.64,90,,,percent of total billed charges,90% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,32.36,38,,,percent of total billed charges,38% of total billed charges,63.86,75,,,percent of total billed charges,75% of total billed charges,72.38,85,,,percent of total billed charges,85% of total billed charges,32.36,79.19,
Flow Cyto read 2-8,2684,CDM,300,RC,88187,HCPCS,outpatient,,,47.63,35.72,,42.87,90,,,percent of total billed charges,90% of total billed charges,44.3,93,,,percent of total billed charges,93% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,40.49,85,,,percent of total billed charges,85% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,38.77,81.4,,,percent of total billed charges,81.4% of total billed charges,42.87,90,,,percent of total billed charges,90% of total billed charges,42.87,90,,,percent of total billed charges,90% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,35.72,75,,,percent of total billed charges,75% of total billed charges,40.49,85,,,percent of total billed charges,85% of total billed charges,18.1,44.3,
B Cell CD19/20 Cytopath,2685,CDM,300,RC,88187,HCPCS,outpatient,,,47.63,35.72,,42.87,90,,,percent of total billed charges,90% of total billed charges,44.3,93,,,percent of total billed charges,93% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,40.49,85,,,percent of total billed charges,85% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,38.77,81.4,,,percent of total billed charges,81.4% of total billed charges,42.87,90,,,percent of total billed charges,90% of total billed charges,42.87,90,,,percent of total billed charges,90% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,18.1,38,,,percent of total billed charges,38% of total billed charges,35.72,75,,,percent of total billed charges,75% of total billed charges,40.49,85,,,percent of total billed charges,85% of total billed charges,18.1,44.3,
(RES) Leukemia/Lymphoma Interp.,2686,CDM,300,RC,88189,HCPCS,outpatient,,,55.18,41.39,,49.66,90,,,percent of total billed charges,90% of total billed charges,51.32,93,,,percent of total billed charges,93% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,46.9,85,,,percent of total billed charges,85% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,44.92,81.4,,,percent of total billed charges,81.4% of total billed charges,49.66,90,,,percent of total billed charges,90% of total billed charges,49.66,90,,,percent of total billed charges,90% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,20.97,38,,,percent of total billed charges,38% of total billed charges,41.39,75,,,percent of total billed charges,75% of total billed charges,46.9,85,,,percent of total billed charges,85% of total billed charges,20.97,51.32,
Fragile X Chromosome  Analysis,2687,CDM,300,RC,88230,HCPCS,outpatient,,,1408.46,1056.35,,1267.61,90,,,percent of total billed charges,90% of total billed charges,1309.87,93,,,percent of total billed charges,93% of total billed charges,535.21,38,,,percent of total billed charges,38% of total billed charges,535.21,38,,,percent of total billed charges,38% of total billed charges,1197.19,85,,,percent of total billed charges,85% of total billed charges,535.21,38,,,percent of total billed charges,38% of total billed charges,1146.49,81.4,,,percent of total billed charges,81.4% of total billed charges,1267.61,90,,,percent of total billed charges,90% of total billed charges,1267.61,90,,,percent of total billed charges,90% of total billed charges,535.21,38,,,percent of total billed charges,38% of total billed charges,535.21,38,,,percent of total billed charges,38% of total billed charges,535.21,38,,,percent of total billed charges,38% of total billed charges,1056.35,75,,,percent of total billed charges,75% of total billed charges,1197.19,85,,,percent of total billed charges,85% of total billed charges,535.21,1309.87,
Chromosome Analysis,2688,CDM,300,RC,88230,HCPCS,outpatient,,,882.65,661.99,,794.39,90,,,percent of total billed charges,90% of total billed charges,820.86,93,,,percent of total billed charges,93% of total billed charges,335.41,38,,,percent of total billed charges,38% of total billed charges,335.41,38,,,percent of total billed charges,38% of total billed charges,750.25,85,,,percent of total billed charges,85% of total billed charges,335.41,38,,,percent of total billed charges,38% of total billed charges,718.48,81.4,,,percent of total billed charges,81.4% of total billed charges,794.39,90,,,percent of total billed charges,90% of total billed charges,794.39,90,,,percent of total billed charges,90% of total billed charges,335.41,38,,,percent of total billed charges,38% of total billed charges,335.41,38,,,percent of total billed charges,38% of total billed charges,335.41,38,,,percent of total billed charges,38% of total billed charges,661.99,75,,,percent of total billed charges,75% of total billed charges,750.25,85,,,percent of total billed charges,85% of total billed charges,335.41,820.86,
"Bladder Cancer, Fish",2689,CDM,300,RC,88271,HCPCS,outpatient,,,1170.6,877.95,,1053.54,90,,,percent of total billed charges,90% of total billed charges,1088.66,93,,,percent of total billed charges,93% of total billed charges,444.83,38,,,percent of total billed charges,38% of total billed charges,444.83,38,,,percent of total billed charges,38% of total billed charges,995.01,85,,,percent of total billed charges,85% of total billed charges,444.83,38,,,percent of total billed charges,38% of total billed charges,952.87,81.4,,,percent of total billed charges,81.4% of total billed charges,1053.54,90,,,percent of total billed charges,90% of total billed charges,1053.54,90,,,percent of total billed charges,90% of total billed charges,444.83,38,,,percent of total billed charges,38% of total billed charges,444.83,38,,,percent of total billed charges,38% of total billed charges,444.83,38,,,percent of total billed charges,38% of total billed charges,877.95,75,,,percent of total billed charges,75% of total billed charges,995.01,85,,,percent of total billed charges,85% of total billed charges,444.83,1088.66,
Fish Chromosomal Analysis Preg.,2690,CDM,300,RC,88271,HCPCS,outpatient,,,684.97,513.73,,616.47,90,,,percent of total billed charges,90% of total billed charges,637.02,93,,,percent of total billed charges,93% of total billed charges,260.29,38,,,percent of total billed charges,38% of total billed charges,260.29,38,,,percent of total billed charges,38% of total billed charges,582.22,85,,,percent of total billed charges,85% of total billed charges,260.29,38,,,percent of total billed charges,38% of total billed charges,557.57,81.4,,,percent of total billed charges,81.4% of total billed charges,616.47,90,,,percent of total billed charges,90% of total billed charges,616.47,90,,,percent of total billed charges,90% of total billed charges,260.29,38,,,percent of total billed charges,38% of total billed charges,260.29,38,,,percent of total billed charges,38% of total billed charges,260.29,38,,,percent of total billed charges,38% of total billed charges,513.73,75,,,percent of total billed charges,75% of total billed charges,582.22,85,,,percent of total billed charges,85% of total billed charges,260.29,637.02,
FISH B CLL-Cyto DNA probe,2691,CDM,300,RC,88271,HCPCS,outpatient,,,207.84,155.88,,187.06,90,,,percent of total billed charges,90% of total billed charges,193.29,93,,,percent of total billed charges,93% of total billed charges,78.98,38,,,percent of total billed charges,38% of total billed charges,78.98,38,,,percent of total billed charges,38% of total billed charges,176.66,85,,,percent of total billed charges,85% of total billed charges,78.98,38,,,percent of total billed charges,38% of total billed charges,169.18,81.4,,,percent of total billed charges,81.4% of total billed charges,187.06,90,,,percent of total billed charges,90% of total billed charges,187.06,90,,,percent of total billed charges,90% of total billed charges,78.98,38,,,percent of total billed charges,38% of total billed charges,78.98,38,,,percent of total billed charges,38% of total billed charges,78.98,38,,,percent of total billed charges,38% of total billed charges,155.88,75,,,percent of total billed charges,75% of total billed charges,176.66,85,,,percent of total billed charges,85% of total billed charges,78.98,193.29,
FISH B CLL -Cyto interphase 100-300 cells,2692,CDM,300,RC,88275,HCPCS,outpatient,,,210,157.5,,189,90,,,percent of total billed charges,90% of total billed charges,195.3,93,,,percent of total billed charges,93% of total billed charges,79.8,38,,,percent of total billed charges,38% of total billed charges,79.8,38,,,percent of total billed charges,38% of total billed charges,178.5,85,,,percent of total billed charges,85% of total billed charges,79.8,38,,,percent of total billed charges,38% of total billed charges,170.94,81.4,,,percent of total billed charges,81.4% of total billed charges,189,90,,,percent of total billed charges,90% of total billed charges,189,90,,,percent of total billed charges,90% of total billed charges,79.8,38,,,percent of total billed charges,38% of total billed charges,79.8,38,,,percent of total billed charges,38% of total billed charges,79.8,38,,,percent of total billed charges,38% of total billed charges,157.5,75,,,percent of total billed charges,75% of total billed charges,178.5,85,,,percent of total billed charges,85% of total billed charges,79.8,195.3,
FISH B CLL-Cyto Physician Interp,2693,CDM,300,RC,88291,HCPCS,outpatient,,,162.36,121.77,,146.12,90,,,percent of total billed charges,90% of total billed charges,150.99,93,,,percent of total billed charges,93% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,132.16,81.4,,,percent of total billed charges,81.4% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,121.77,75,,,percent of total billed charges,75% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,150.99,
"Body Fluid Count, and Differential",2694,CDM,300,RC,89051,HCPCS,outpatient,,,87.03,65.27,,78.33,90,,,percent of total billed charges,90% of total billed charges,80.94,93,,,percent of total billed charges,93% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,70.84,81.4,,,percent of total billed charges,81.4% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,78.33,90,,,percent of total billed charges,90% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,33.07,38,,,percent of total billed charges,38% of total billed charges,65.27,75,,,percent of total billed charges,75% of total billed charges,73.98,85,,,percent of total billed charges,85% of total billed charges,33.07,80.94,
Fluid Cell Count with Diff   Alamosa,2695,CDM,300,RC,89051,HCPCS,outpatient,,,98.62,73.97,,88.76,90,,,percent of total billed charges,90% of total billed charges,91.72,93,,,percent of total billed charges,93% of total billed charges,37.48,38,,,percent of total billed charges,38% of total billed charges,37.48,38,,,percent of total billed charges,38% of total billed charges,83.83,85,,,percent of total billed charges,85% of total billed charges,37.48,38,,,percent of total billed charges,38% of total billed charges,80.28,81.4,,,percent of total billed charges,81.4% of total billed charges,88.76,90,,,percent of total billed charges,90% of total billed charges,88.76,90,,,percent of total billed charges,90% of total billed charges,37.48,38,,,percent of total billed charges,38% of total billed charges,37.48,38,,,percent of total billed charges,38% of total billed charges,37.48,38,,,percent of total billed charges,38% of total billed charges,73.97,75,,,percent of total billed charges,75% of total billed charges,83.83,85,,,percent of total billed charges,85% of total billed charges,37.48,91.72,
(result) BFC - Other Cells%,2696,CDM,300,RC,89051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC - Source,2697,CDM,300,RC,89051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC - Volume,2698,CDM,300,RC,89051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC - Color,2699,CDM,300,RC,89051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC - Clarity,2700,CDM,300,RC,89051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC - WBC,2701,CDM,300,RC,89051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC - RBC,2702,CDM,300,RC,89051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC - Neutrophils %,2703,CDM,300,RC,89051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC - Mononuclear Cells%,2704,CDM,300,RC,89051,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Crystals Synovial,2705,CDM,300,RC,89060,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,150.39,
Crystal evauation - synovial (alamosa lab),2706,CDM,300,RC,89060,HCPCS,outpatient,,,143.59,107.69,,129.23,90,,,percent of total billed charges,90% of total billed charges,133.54,93,,,percent of total billed charges,93% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,122.05,85,,,percent of total billed charges,85% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,116.88,81.4,,,percent of total billed charges,81.4% of total billed charges,129.23,90,,,percent of total billed charges,90% of total billed charges,129.23,90,,,percent of total billed charges,90% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,54.56,38,,,percent of total billed charges,38% of total billed charges,107.69,75,,,percent of total billed charges,75% of total billed charges,122.05,85,,,percent of total billed charges,85% of total billed charges,54.56,133.54,
Semen analysis post VAS Check,2707,CDM,300,RC,89321,HCPCS,outpatient,,,114.86,86.15,,103.37,90,,,percent of total billed charges,90% of total billed charges,106.82,93,,,percent of total billed charges,93% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,97.63,85,,,percent of total billed charges,85% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,93.5,81.4,,,percent of total billed charges,81.4% of total billed charges,103.37,90,,,percent of total billed charges,90% of total billed charges,103.37,90,,,percent of total billed charges,90% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,43.65,38,,,percent of total billed charges,38% of total billed charges,86.15,75,,,percent of total billed charges,75% of total billed charges,97.63,85,,,percent of total billed charges,85% of total billed charges,43.65,106.82,
MOTILITY,2708,CDM,300,RC,89321,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SPERMATAZOA,2709,CDM,300,RC,89321,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Post-Vas, Spermatozoa",2710,CDM,300,RC,89321,HCPCS,outpatient,,,85.96,64.47,,77.36,90,,,percent of total billed charges,90% of total billed charges,79.94,93,,,percent of total billed charges,93% of total billed charges,32.66,38,,,percent of total billed charges,38% of total billed charges,32.66,38,,,percent of total billed charges,38% of total billed charges,73.07,85,,,percent of total billed charges,85% of total billed charges,32.66,38,,,percent of total billed charges,38% of total billed charges,69.97,81.4,,,percent of total billed charges,81.4% of total billed charges,77.36,90,,,percent of total billed charges,90% of total billed charges,77.36,90,,,percent of total billed charges,90% of total billed charges,32.66,38,,,percent of total billed charges,38% of total billed charges,32.66,38,,,percent of total billed charges,38% of total billed charges,32.66,38,,,percent of total billed charges,38% of total billed charges,64.47,75,,,percent of total billed charges,75% of total billed charges,73.07,85,,,percent of total billed charges,85% of total billed charges,32.66,79.94,
Uric Acid 24hr with Creat,2711,CDM,300,RC,907,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Galloping Gorilla Courier Charge(Childrens Hospital),2712,CDM,300,RC,99000,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
Therapeutic Phlebotamy,2713,CDM,940,RC,99195,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
Alpha-1 Antitrypsin Mutation Analysis-Quant,2714,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HIV 1/2 Antibodies,2715,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HIV 1/2 AB,2716,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
AEROBIC BACTERIUM ID & SENSI,2717,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Resppanel4 FLUA,2718,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ACTH Stimulation-3 specs,2719,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Adalimumab Level & Anti-Drug AB, IBD",2720,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Advanced Lipid w/ Inflamm. Cardio IQ,2721,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HIV 1/2 Antigen,2722,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Aldosterone/Plasma Renin Activity,2723,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ALK PHOS ISOENZYME,2724,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Allergy-Mold Profile w/IgE (serum),2725,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
AML Prognostic Panel (Normal Karyotype),2726,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Amphetamine Confirmation,2727,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ANA Screen IFA Lupus Panel 2,2728,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ANCA Screen w/MPO and PR3,2729,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ANCA Vasculitides,2730,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Angioedema Panel, Hereditary",2731,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Anti-Synthetase Panel 1,2732,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Antidepressants Panel, Serum",2733,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Allergy Panel 14, Pediatric",2734,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Antiphospholipid AB Panel,2735,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Antiphospholipid Syndrome Diagnostic Panel,2736,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Allergy Panel 17, Salad Group",2737,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) HCG, Quant **",2738,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COVIDSH,2739,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Supplemental Oxygen,2740,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Glucose-PRELIMRPT,2741,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Note-Supplemental Oxygen,2742,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PRELIMRPT-VBG,2743,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMMENT-HEPC,2744,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
COMMENT-CHL/GON,2745,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
COMMENT-Drug Tox ETOH,2746,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)GLUCOSE,2747,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)UREA NITROGEN (BUN),2748,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CREATININE - Clearance,2749,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) eGFR - Creatinine Clearance,2750,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)BUN/CREATININE RATIO,2751,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)SODIUM,2752,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)POTASSIUM,2753,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)CHLORIDE,2754,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)CARBON DIOXIDE,2755,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)ALBUMIN,2756,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)GLOBULIN,2757,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)ALBUMIN/GLOBULIN RATIO,2758,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES)BILIRUBIN, TOTAL",2759,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LD,2760,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)AST,2761,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)ALT,2762,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TIBC-% SATURATION,2763,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DIRECT LDL,2764,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) HDL CHOLESTEROL,2765,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LDL-CHOLESTEROL,2766,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CHOL/HDLC RATIO,2767,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NON HDL CHOLESTEROL,2768,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SODIUM/CREAT RATIO,2769,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) POTASSIUM, RANDOM URINE",2770,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) POTASSIUM/CREAT RATIO,2771,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) UREA NITROGEN, 24 HR UR",2772,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) CALCIUM/CREATININE RATIO,2773,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CALCIUM/CREATININE RATIO,2774,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HEIGHT FEET,2775,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CREATININE CLEARANCE,2776,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HEIGHT INCHES,2777,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) WEIGHT POUNDS,2778,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Body surface area,2779,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) WHITE BLOOD CELL COUNT-OB,2780,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RED BLOOD CELL COUNT-OB,2781,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HEMOGLOBIN-OB,2782,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HEMATOCRIT-OB,2783,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MCV-OB,2784,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MCH-OB,2785,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MCHC-OB,2786,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RDW-OB,2787,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PLATELET COUNT-OB,2788,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NEUTROPHILS-OB,2789,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BAND NEUTROPHILS,2790,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE BAND NEUTROPHILS,2791,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE NEUTROPHILS-OB,2792,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LYMPHOCYTES-OB,2793,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) REACTIVE LYMPHOCYTES,2794,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE LYMPHOCYTES-OB,2795,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MONOCYTES-OB,2796,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE MONOCYTES-OB,2797,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EOSINOPHILS-OB,2798,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE EOSINOPHILS-OB,2799,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BASOPHILS-OB,2800,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE BASOPHILS-OB,2801,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMMENT-OB,2802,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MPV-OB,2803,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COAG FACTOR II ACTIVITY,2804,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DRVVT 1:1 MIX,2805,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DRVVT MIX INTERPRETATION,2806,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MALARIA/BABESIA/OTHER BLOOD PARASITES,2807,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) RETICULOCYTE, ABSOLUTE",2808,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SICKLE CELL SCREEN,2809,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SITE,2810,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CRYSTALS, SYNOVIAL FLUID",2811,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DIRECT ANTIGLOBULIN TEST,2812,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABO GROUP-OB,2813,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RH TYPE-OB,2814,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) AB SCREEN, RBC W/REFL ID, TITER AND AG-OB",2815,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GLIADIN (DEAMIDATED) AB (IGA),2816,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GLIADIN (DEAMIDATED) AB (IGG),2817,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) HETEROPHILE, MONO SCREEN",2818,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RPR (MONITOR) W/REFL TITER,2819,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VDRL, CSF",2820,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) % CD3 (MATURE T CELLS),2821,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE CD3+ CELLS,2822,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) % CD4,2823,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE CD4+ CELLS,2824,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) % CD8,2825,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE CD8+ CELLS,2826,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CD4/CD8 RATIO,2827,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) % CD16+CD56 (NKC),2828,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE NK CELLS (CD16+CD56+CELLS),2829,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) % CD19 (B CELLS),2830,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE CD19+ CELLS,2831,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABSOLUTE LYMPHOCYTES,2832,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CLINICAL INFORMATION:,2833,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SPECIMEN TYPE:,2834,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) VIABILITY:,2835,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION:,2836,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SAMPLE DESCRIPTION:,2837,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GATING STRATEGY:,2838,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MARKERS:,2839,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NUMBER OF MARKERS:,2840,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) S. PNEUMONIAE ANTIGENS, URINE",2841,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) IFE INTERPRETATION,2842,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ERYTHROPOIETIN,2843,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) DNA AB (DS) CRITHIDIA,IFA",2844,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SMOOTH MUSCLE AB SCREEN,2845,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)18 KD (IGG) BAND,2846,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 23 KD (IGG) BAND,2847,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 28 KD (IGG) BAND,2848,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)  30 KD (IGG) BAND,2849,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 45 KD (IGG) BAND,2850,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 58 KD (IGG) BAND,2851,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 66 KD (IGG) BAND,2852,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 93 KD (IGG) BAND,2853,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RIBOSOMAL P ANTIBODY,2854,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 41 KD (IGM) BAND,2855,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 39 KD (IGG) BAND,2856,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 41 KD (IGG) BAND,2857,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 23 KD (IGM) BAND,2858,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 39 KD (IGM) BAND,2859,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) KAPPA/LAMBDA LIGHT CHAINS FREE WITH RATIO, SERUM",2860,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) OXALIC ACID, 24 HR URINE",2861,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)-FRUCTOSAMINE,2862,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RAM,2863,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EPINEPHRINE,2864,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NOREPINEPHRINE,2865,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DOPAMINE,2866,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TOTAL CATECHOLAMINES,2867,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CK-BB,2868,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CK-MB,2869,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CK-MM,2870,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ALBUMIN,2871,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ALPHA 1 GLOBULIN,2872,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ALPHA 2 GLOBULIN,2873,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GAMMA GLOBULIN,2874,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LD 1,2875,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LD 2,2876,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LD 3,2877,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LD 4,2878,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LD 5,2879,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION,2880,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION-CKI,2881,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABNORMAL PROTEIN BAND 1,2882,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABNORMAL PROTEIN BAND 2,2883,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABNORMAL PROTEIN BAND 3,2884,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) ALBUMIN, 24 HOUR URINE",2885,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) MICROALBUMIN/CREATININE RATIO, RANDOM URINE",2886,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTESTINAL ISOENZYMES,2887,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BONE ISOENZYMES,2888,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LIVER ISOENZYMES,2889,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PLACENTAL ISOENZYMES,2890,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CALCIUM, IONIZED",2891,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ZONISAMIDE,2892,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) FECAL LIPIDS, 24 HR",2893,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TROPONIN T,2894,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GASTRIN,2895,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HEPATITIS BE ANTIBODY,2896,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) PSA, % FREE",2897,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) FOLATE, RBC",2898,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CORTISOL, P.M.",2899,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CORTISOL,2900,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) FREE T4 INDEX (T7),2901,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) TSH,2902,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SHRIMP (F24) IGE,2903,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CLASS,2904,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EGG WHITE (F1) IGE,2905,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) CLASS,2906,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) AVOCADO (F96) IGE,2907,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
CLASS,2908,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Maternal Weight,2909,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Mother's Ethnic Origin,2910,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Insulin Depend Diabetic,2911,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Hx Of Neural Tube Defects,2912,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) HEPATITIS A AB, TOTAL W/REFL IGM",2913,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EDD Determined by,2914,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Prev Pregnancy Down Synd,2915,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Donor Egg,2916,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Donor Age: Egg Retrieval,2917,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Repeat Specimen,2918,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Number of Fetuses,2919,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Est'd Date of Delivery,2920,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CASHEW NUT (F202) IGE,2921,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)CLASS,2922,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VITAMIN D, 25-OH, D2",2923,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VITAMIN D, 25-OH, D3",2924,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) MYOGLOBIN, SERUM",2925,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) HCV RNA, QUANTITATIVE REAL TIME PCR",2926,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION-,2927,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Risk for ONTD,2928,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Age Risk Down Syndrome,2929,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MSS Down Syndrome Risk,2930,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MSS Trisomy 18 Risk,2931,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) AFP, Serum",2932,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) AFP MoM,2933,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) Estriol, Free",2934,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Estriol MoM,2935,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) hCG, Serum",2936,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) hCG MoM,2937,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) Inhibin A, Dimeric",2938,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Inhibin A MoM,2939,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMMENTS:,2940,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMMENT:,2941,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Calc'd Gestational Age,2942,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) INTERPRETATION:,2943,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SOURCE-HSV CULTURE,2944,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HSV CULTURE:,2945,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TRICHOMONAS:,2946,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HSV TYPE 2:,2947,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HSV TYPE 1:,2948,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) HIV 1 RNA, QN PCR",2949,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES)HIV 1 RNA, QN PCR",2950,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TOXOPLASMA ANTIBODY (IGM),2951,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION:EBV,2952,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MEASLES ANTIBODY (IGM),2953,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CULTURE,2954,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) FUNGAL ISOLATE IDENTIFICATION,2955,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CULTURE, FUNGUS W/SMEAR NOT HAIR, SKIN, BLOOD",2956,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CULTURE,FUNGUS,SKIN,HAIR, NAIL W/DIRECT FLUOR/KOH",2957,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) AEROBIC BACTERIUM ID AND SUSCEPTIBILITY,2958,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CONCENTRATE (1),2959,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CAMPYLOBACTER SPP. AG,EIA",2960,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CULTURE, YEAST, WITH LIMITED SUSCEPTIBILITY",2961,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) IODINE, SERUM/PLASMA",2962,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LEAD(B) COLLECTION SAMPLE,2963,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DIGOXIN,2964,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) METHOTREXATE,2965,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CADMIUM, BLOOD",2966,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CARBOXYHEMOGLOBIN, BLOOD",2967,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) COPPER, 24 HOUR URINE",2968,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) AMITRIPTYLINE,2969,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NORTRIPTYLINE,2970,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TOTAL,2971,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMMENT,2972,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) PHENYTOIN, FREE",2973,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Amphetamines,2974,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Barbiturates,2975,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Benzodiazepines,2976,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) Marijuana Metabolite,2977,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Marijuana Metabolite,2978,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Cocaine Metabolite,2979,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Methadone Metabolite,2980,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Opiates,2981,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Oxycodone,2982,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Tramadol,2983,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Specific Gravity,2984,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) pH,2985,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) Creatinine,2986,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Oxidant,2987,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PROINSULIN,2988,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RETINOL BINDING PROTEIN,2989,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CREATININE, URINE",2990,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TOTAL VOLUME:,2991,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ENTAMOEBA HISTOLYTICA IGG ELISA,2992,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) FILARIA AB (IGG4),2993,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
INTERPRETATION -,2994,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) COCCIDIOIDES AB, CF,SERUM",2995,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) FRANCISELLA TULARENSIS AB, DA",2996,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VARICELLA ZOSTER VIRUS (VZV) DNA, QL RT PCR",2997,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HEPATITIS D VIRUS AB (IGM),2998,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) NICKEL, BLOOD",2999,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ANAEROBIC BACTERIAL ID,3000,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) PREGNENOLONE, LC/MS",3001,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CARNITINE, TOTAL",3002,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CARNITINE, FREE",3003,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CARNITINE ESTERS,3004,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) DHEA, UNCONJUGATED",3005,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ESTRONE,3006,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GLUCAGON,3007,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) OLIGOCLONAL BANDS (IGG), CSF",3008,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TSI,3009,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) T4, FREE, DIRECT DIALYSIS",3010,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VASOACTIVE INTESTINAL POLYPEPTIDE(VIP),PLASMA",3011,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) FSH (FOLLICLE STIMULATING HORMONE), PEDIATRICS",3012,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) MAGNESIUM, 24HR URINE",3013,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) METHYLENETETRAHYDROFOLATE REDUCTASE (MTHFR), DNA",3014,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) ALKALINE PHOSPHATASE, BONE SPECIFIC",3015,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) VITAMIN A (RETINOL),3016,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VITAMIN B1 (THIAMINE), BLOOD, LC/MS/MS",3017,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) N TELOPEPTIDE (NTx), 24 U",3018,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) VITAMIN C,3019,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ALPHA-TOCOPHEROL,3020,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BETA-GAMMA-TOCOPHEROL,3021,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODY,3022,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) ACETYLCHOLINE RECEPTOR MODULATING ANTIBODY,3023,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ALPHA SUBUNIT,3024,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TOTAL VOLUME,3025,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) C1 ESTERASE INHIBITOR, PROTEIN",3026,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) VITAMIN B2 (RIBOFLAVIN),3027,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TOTAL SPECIMEN WEIGHT,3028,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
COLLECTION DURATION,3029,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) MANGANESE, BLOOD",3030,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PHOSPHOLIPIDS,3031,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LDL CHOLESTEROL,3032,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) VLDL,3033,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) HISTAMINE, PLASMA",3034,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) MAGNESIUM, RBC",3035,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HEPTACARBOXYPORPHYRIN,3036,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HEXACARBOXYPORPHYRIN,3037,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PENTACARBOXYPORPHYRIN,3038,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TOTAL PORPHYRINS,3039,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) VITAMIN K,3040,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) PORPHOBILINOGEN, QN, RANDOM URINE",3041,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) SIROLIMUS, LC/MS/MS",3042,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) AMIODARONE,3043,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DESETHYLAMIODARONE,3044,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SELENIUM,3045,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ISLET CELL ANTIBODY SCREEN,3046,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) ESTRADIOL, ULTRASENSITIVE LC/MS",3047,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) ESTRIOL, SERUM",3048,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) INTERLEUKIN 6 (IL 6), SERUM",3049,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BETA-HYDROXYBUTYRATE,3050,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HAEMOPHILUS INFLUENZA TYPE B ANTIBODY (IGG),3051,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CORTISONE, SERUM",3052,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INHIBIN A,3053,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMPLEMENT COMPONENT C1Q,3054,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) ALDOSTERONE, URINE",3055,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DELTA AMINOLEVULINIC ACID RANDOM URINE,3056,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) MITOCHONDRIA M2 ANTIBODY (IGG), EIA",3057,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) GAMMA HYDROXYBUTYRIC ACID SCREEN, SERUM/PLASMA",3058,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) BLADDER CANCER, FISH",3059,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TOTAL VOLUME,3060,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PL 7 AUTOABS,3061,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PL 12 AUTOABS,3062,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MI 2 AUTOABS,3063,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) KU AUTOABS,3064,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EJ AUTOABS,3065,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) OJ AUTOABS,3066,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SRP AUTOABS,3067,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) PSA, HAMA",3068,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
VIABILITY:,3069,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SAMPLE DESCRIPTION,3070,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CD20,3071,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INHIBIN B,3072,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) BK VIRUS DNA, QN PCR",3073,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MDA,3074,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MDMA,3075,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MDEA,3076,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF),3077,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CYCLOSPORINE A TROUGH, LC/MS/MS, BLOOD",3078,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) ALPHA-1-ANTITRYPSIN, FECES",3079,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SOLUBLE LIVER ANTIGEN (SLA) AUTOANTIBODY,3080,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) METANEPHRINES,3081,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NORMETANEPHRINES,3082,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RESULT) METANEPHRINES, TOTAL",3083,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) EPINEPHRINE, 24 HR URINE",3084,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) NOREPINEPHRINE, 24 HR UR",3085,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CALC TOTAL (E+NE)-CATFR,3086,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) DOPAMINE, 24 HR URINE",3087,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) 5-HIAA, 24 HOUR URINE",3088,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CREATININE, 24-HOUR URINE",3089,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CULT, VARICELLA ZOSTER",3090,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ADIPONECTIN,3091,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CYSTIC FIBROSIS D1152H,3092,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) IGVH STATUS,3093,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ESTERIFIED/FREE RATIO:,3094,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)17-HYDROXYPROGESTERONE,3095,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CLINICAL INDICATION 2,3096,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) REFERRING PHYSICIAN,3097,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CORTICOSTERONE,3098,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HLA-B27,3099,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RESULTS REVIEWED BY:,3100,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION - APLAB,3101,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) TREPONEMA PALLIDUM AB, PARTICLE AGGLUTINATION",3102,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TPMT GENOTYPE,3103,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 5'NUCLEOTIDASE,3104,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) DONOR, HTLV I/II ANTIBODY SCREEN",3105,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) NEPHRINE, FREE",3106,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) NORMETANEPHRINE, FREE",3107,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) TOTAL, FREE (MN+NMN)",3108,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MYCOPHENOLIC ACID,3109,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MPA GLUCURONIDE,3110,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Auto-ASPERGILLUS AG,EIA,SERUM",3111,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HLA B*5701 TYPING,3112,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LDL PARTICLE NUMBER,3113,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LDL PEAK SIZE,3114,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LDL PATTERN,3115,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CORTISOL, LC/MS, SALIVA",3116,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CD57+/CD3- OF % LYMPHS,3117,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CD57+/CD3- OF % WBC,3118,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CD57+/CD8- OF % LYMPHS,3119,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CD57+/CD8- OF % WBC,3120,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CD57+/CD3-/CD8- OF % LYMPHS,3121,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CD57+/CD3-/CD8- OF % WBC,3122,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) MUMPS VIRUS RNA, QL REAL TIME PCR",3123,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VITAMIN D, 1,25 (OH)2, TOTAL",3124,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VITAMIN D3, 1,25 (OH)2",3125,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VITAMIN D2, 1,25 (OH)2",3126,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) METANEPHRINE,3127,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NORMETANEPHRINE,3128,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) METANEPHRINES, TOTAL",3129,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BETA 2 TRANSFERRIN,3130,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) BK VIRUS DNA, QL REAL TIME PCR, URINE",3131,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SOURCE,3132,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Result) SOURCE,3133,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NIDUS-stone,3134,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMPONENT 1-stone,3135,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) STONE WEIGHT-stone,3136,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SPECIMEN SOURCE-stone,3137,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ALDO/PRA RATIO,3138,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) FISH,B CELL CHRONIC LYMPH LEUKEMIA PANEL",3139,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TYROSINE,3140,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) WEST NILE VIRUS RNA, QL PCR",3141,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION VW COMP,3142,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DENGUE FEVER AB (IGG),3143,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) C. ALBICANS IgG,3144,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)C.ALBICANS IgM,3145,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Date of Birth,3146,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Z SCORE (FEMALE),3147,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CLOSTRIDIUM DIFFICILE TOXINB,QL REAL TIME PCR",3148,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HDL LARGE,3149,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TPMT ACTIVITY,3150,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
INTERPRETATION:,3151,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) COCCIDIOIDES AB (IGG), IMMUNODIFFUSION, CSF",3152,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Z SCORE (MALE),3153,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ORGANISM,3154,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RESULT) TESTOSTERONE, FREE",3155,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CLINICAL INDICATION,3156,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CHROMIUM, BLOOD",3157,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SOURCE,3158,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) FLUNITRAZEPAM,3159,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 7 AMINOFLUNITRAZEPAM,3160,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) N DESMETHYLFLUNITRAZEPAM,3161,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SOURCE:,3162,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) T. PALLIDUM AB,3163,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LEPTIN,3164,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DEOXYCORTICOSTERONE,3165,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) AMPICILLIN/SULBACTAM,3166,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CLINDAMYCIN,3167,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) IMIPENEM,3168,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MEROPENEM,3169,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) METRONIDAZOLE,3170,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PENICILLIN,3171,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) BORRELIA SPP DNA, REAL TIME PCR, BLOOD",3172,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BLOCK/SPECIMEN ID,3173,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) DIHYDROTESTOSTERONE, LC/MS/MS",3174,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HSV 1,3175,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HSV 2,3176,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) EVEROLIMUS,LC/MS/MS,BLOOD",3177,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) NICOTINE, SERUM/PLASMA",3178,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) COTININE, SERUM/PLASMA",3179,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) NICOTINE, URINE",3180,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) COTININE, URINE",3181,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SMN1,3182,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) APOE GENOTYPE,3183,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) TRICHOMONAS VAGINALIS RNA QUALITATIVE TMA, MALES",3184,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION-PORPHY,3185,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SAMPLE ID,3186,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) COBALT, SERUM/PLASMA",3187,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)INTERPRETATION,3188,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MUTATION RATE,3189,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) 3 OH COTININE, URINE",3190,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NOR NICOTINE,3191,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NOR COTININE,3192,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ANABASINE,3193,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) 3OH COTININE,SERUM/PLASMA",3194,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) OMEGA 3 (EPA+DHA) INDEX,3195,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RISK,3196,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) OMEGA 6/OMEGA 3 RATIO,3197,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EPA/ARACHIDONIC ACID RATIO,3198,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) ARACHIDONIC ACID,3199,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) EPA,3200,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) DHA,3201,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NICOTINIC ACID,3202,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NICOTINAMIDE,3203,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SOLUBLE TRANSFERRIN RECEPTOR,3204,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
INTERP,3205,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
METHODS,3206,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
COMMENTS,3207,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
REFERENCES,3208,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BV CATEGORY:,3209,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PRIOR RESULT,3210,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
INTERPRET.,3211,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HUMAN TRANSFORMING GROWTH FACTOR BETA 1 (TGF-b1),3212,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Auto-INDEX VALUE,3213,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) DRUG TEST, GENERAL TOXICOLOGY, (SP)",3214,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DRAW DATE 1,3215,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DRAW TIME 1,3216,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION.,3217,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DRAW DATE 2,3218,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DRAW TIME 2,3219,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMMENTS,3220,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GUIDANCE STATEMENTS,3221,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
REVIEWER:,3222,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GENERAL GUIDANCE,3223,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) METHOD,3224,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LIMITATIONS,3225,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) METHANOL,3226,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ETHANOL,3227,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ISOPROPANOL,3228,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ACETONE,3229,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LDL SMALL,3230,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LDL MEDIUM,3231,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 6 TG,3232,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 6 MMP,3233,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CHIKUNGUNYA VIRUS RNA, QL PCR",3234,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) UROPORPHYRIN I,3235,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) UROPORPHYRIN III,3236,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COPROPORPHYRIN I,3237,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COPROPORPHYRIN III,3238,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) ACETYL FENTANYL, QL, BLOOD",3239,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRET.-CELIAC,3240,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPR. SUMMARY (BRCA),3241,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BRCA1 SEQUENCING,3242,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BRCA1 SEQ INTERP,3243,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BRCA1 DEL/DUP,3244,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BRCA1 DEL/DUP INTERP,3245,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BRCA2 SEQUENCING,3246,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BRCA2 SEQ INTERP,3247,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BRCA2 DEL/DUP,3248,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BRCA2 DEL/DUP INTERP,3249,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMP. INTERP (BRCA),3250,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ADD. INFO. (BRCA),3251,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) FGF 23 (FIBROBLAST GROWTH FACTOR 23),3252,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)  GONADOTROPIN RELEASING HORMONE,3253,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) STATUS:,3254,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Ethyl Glucuronide (ETG),3255,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Ethyl Sulfate (ETS),3256,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) DACLATASVIR RESISTANCE,3257,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Desmethyltramadol,3258,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) JAK2 V617F MUTATION,3259,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MPL EXON 10 MUTATION,3260,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RESULT) INTERPRETATION,3261,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION (Factor V Leiden),3262,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
INTERPRETATION.,3263,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ENDOMYSIAL IGG,3264,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INTERPRETATION 2,3265,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) FIBROSIS SCORE,3266,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) VITAMIN D, 25-OH, TOTAL",3267,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BETA 1 GLOBULIN,3268,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BETA 2 GLOBULIN,3269,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TECHNICAL RESULTS,3270,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MUTATION FREQUENCY,3271,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MUTATION TYPE,3272,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EXON,3273,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NUCLEOTIDE CHANGE,3274,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
REFERENCE,3275,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HCV NS5a SUBTYPE,3276,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DACLATASVIR RESISTANCE,3277,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TISSUE IFA OBSERVATION(S),3278,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ASSAY DETAILS,3279,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ASSAY DETAIL,3280,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) VELPATASVIR RESISTANCE,3281,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SDMA,3282,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SOURCE 1,3283,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) eGFR-Cystatin C,3284,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SUMMARY INTERPRETATION-NeoPara,3285,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
INTERPR. RESULTS TABLE-NeoPara,3286,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
COMMENTS-NeoPara,3287,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Cigarette smoker,3288,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SPECIMEN SOURCE,3289,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SPECIMEN SOURCE,3290,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RESULT-FH Panel,3291,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LDLR CLASSIFICATION-FH Panel,3292,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) APOB CLASSIFICATION-FH Panel,3293,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PCSK9 CLASSIFICATION-FH Panel,3294,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CLINICAL INTERPRETATION-FH Panel,3295,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) VARIANT INTERPRETATION-FH Panel,3296,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
REVIEWER,3297,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) METHOD AND LIMITATION-FH Panel,3298,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ADDITIONAL INFORMATION-FH Panel,3299,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) RESOURCES-FH Panel,3300,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
INTERPRETATION-,3301,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ADMA,3302,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) LEVETIRACETAM, IMMUNOASSAY",3303,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
COMMENT,3304,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) OxLDL,3305,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EPA+DPA+DHA,3306,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ARACHIDONIC ACID/EPA  RATIO,3307,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) OMEGA-6/OMEGA-3 RATIO,3308,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) OMEGA-3 TOTAL,3309,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EPA,3310,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DPA,3311,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DHA,3312,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) OMEGA-6 TOTAL,3313,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ARACHIDONIC ACID,3314,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LINOLEIC ACID,3315,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TMAO (TRIMETHYLAMINE N OXIDE),3316,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TEST METHOD,3317,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HISTOCOMPATIBILITY LABORATORY INFORMATION,3318,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) A-1,3319,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) A-2,3320,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) A1 EQUIVALENT,3321,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) A2 EQUIVALENT,3322,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) REPORTABLE COMMENTS,3323,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) INSULIN RESISTANCE SCORE,3324,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)SPECIMEN SOURCE,3325,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GENES/LOCI TESTED:,3326,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) 12q15,3327,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABCB1,3328,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ABCG2,3329,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ADRA2A,3330,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ALDH2,3331,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ANKK1,3332,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) BDNF,3333,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) C11orf65,3334,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CEP72,3335,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COMT,3336,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CYP1A2,3337,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CYP2C8,3338,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CYP4F2,3339,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DBH,3340,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) DRD2,3341,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) F5,3342,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GRIK1,3343,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GRIK4,3344,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) GRIN2B,3345,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HTR2A,3346,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) HTR2C,3347,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NUDT15,3348,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) OPRM1,3349,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SLC6A4,3350,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SCL47A2,3351,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) UGT2B15,3352,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SIGNATURE,3353,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) METHOD AND LIMITATIONS,3354,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
REPORTING ID,3355,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
QUANTTB-NIL,3356,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
QUANTTB-MITOGEN-NIL,3357,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
QUANTTB-TB1-NIL,3358,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
QUANTTB-TB2-NIL,3359,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) QUANTIFERON(R)-TB GOLD PLUS, 4T, INCUBATED",3360,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NIL,3361,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) MITOGEN-NIL,3362,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TB1-NIL,3363,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TB2-NIL,3364,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) ANTI-MULLERIAN HORMONE (AMH), FEMALE",3365,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) T-SPOT.TB,3366,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PANEL A SPOT COUNT CORRECTED FOR NEG CONTROL,3367,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PANEL B SPOT COUNT CORRECTED FOR NEG CONTROL,3368,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
NEGATIVE CONTROL,3369,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) POSITIVE CONTROL,3370,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) PHOSPHATIDYLETHANOL, BLOOD",3371,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) LDL P,3372,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TG/HDL C,3373,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)LDL CHOLESTEROL,3374,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)HDL CHOLESTEROL,3375,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)TRIGLYCERIDES,3376,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES)CHOLESTEROL, TOTAL",3377,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) NON-HDL CHOLESTEROL,3378,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) CHOL/HDL C,3379,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Marijuana Comments,3380,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Tramadol Comments,3381,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) COENZYME Q10,3382,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
INTERPRETATION,3383,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) MUMPS VIRUS AB (IGG), DIAGNOSTIC",3384,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Opiates Screen,3385,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Norbuprenorphine Confirm.,3386,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Norfentanyl Confirm.,3387,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Tapentadol Screen,3388,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Tramadol Screen,3389,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) MEASLES(RUBEOLA)VIRUS, QL REALTIME PCR,NP/THROAT",3390,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Buprenorphine Comments,3391,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Fentanyl Comments,3392,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SOURCE:,3393,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PATIENT SYMPTOMATIC?,3394,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) TECHNICAL RESULTS,3395,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Pregnancy Result of IVF,3396,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) FLT3 ITD ALLELIC RATIO,3397,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) FLT3 TKD ALLELIC RATIO,3398,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) - SOURCE,3399,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) BK VIRUS DNA, QN REAL TIME PCR",3400,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) CHROMOGRANIN A, LC/MS/MS",3401,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) SARS COV 2 AB (IGG) SPIKE, SEMI QN",3402,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RES) SARS COV 2 AB, TOTAL SPIKE SEMI QN",3403,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SOURCE-,3404,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) ADENOVIRUS,3405,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) M BAND,3406,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) EGFR,3407,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"(RESULT) GALACTOSE ALPHA 1,3 GALACTOSE IGE",3408,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PEth 16:0/18:1 (POPEth),3409,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PEth 16:0/18:2 (PLPEth),3410,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PEth Comments,3411,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) PATHOLOGIST,3412,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Burr Cells,3413,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Calcium Carbonate Crystals,3414,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Calcium Phosphate Crystals,3415,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Clue Cells,3416,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Cellular Cast,3417,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Coronavirus Antibody IgG,3418,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Coronavirus Antibody IgM,3419,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Elliptocytes,3420,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) FENa Calculation,3421,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Final Report-Micro,3422,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Giardia,3423,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Hyphae Yeast,3424,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Influenza A H1-2009,3425,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES)Influenza A H1-2009,3426,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Leucine Crystals,3427,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC-MN Cells #,3428,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Anion Gap,3429,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Blood Urea Nitrogen (BUN),3430,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Chloride,3431,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Creatinine,3432,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Glucose,3433,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Potassium,3434,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Plasma Cell,3435,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Platelet Clumps,3436,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(result) BFC-PMN #,3437,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Sodium,3438,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PHLEB-Post Blood Pressure,3439,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PHLEB-Post Heart Rate,3440,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PHLEB-Pre-Blood Pressure,3441,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PHLEB-Pre-Heart Rate,3442,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PHLEB-Pre-Temperature,3443,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Total CO2,3444,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MD-Smudge Cells,3445,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Stomatocytes,3446,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PHLEB-Total Volume Removed,3447,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Tyrosine Crystals,3448,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Unclassified Crystals,3449,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UA WBC Clumps,3450,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Advanced Lipid Panel, Cardio IQ",3451,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Blood Cultures x2[Package],3452,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Bartonella henselae AB (IgG, IgM) w Reflx",3453,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Blood TYpe ABO and RH[Package],3454,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HF Blood TYpe ABO and RH[Package],3455,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
RespPanel4 FLUB,3456,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
BRCA Panel Plus,3457,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
B Cell CD-20 markers[Package],3458,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Beta 2 Glycoprotein AB (IgG, IgA, IgM)",3459,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Body Fluid Analysis- Alamosa[Package],3460,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Blastomyces AB Panel CF, ID",3461,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Brucella AB (IgG, IgM) w Rflx to Agglut.",3462,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Calcium/Creat Ratio,3463,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Culture, Aerobic & Anaerobic",3464,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
GFR,3465,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Cardiolipin AB (IgG, IgM)",3466,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Cardiolipin AB (IgA, IgG, IgM)",3467,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
CardioIQ Insulin Resistance w Score,3468,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Cdiff ToxB PCR in house,3469,CDM,300,RC,,,outpatient,,,76.41,57.31,,68.77,90,,,percent of total billed charges,90% of total billed charges,71.06,93,,,percent of total billed charges,93% of total billed charges,29.04,38,,,percent of total billed charges,38% of total billed charges,29.04,38,,,percent of total billed charges,38% of total billed charges,64.95,85,,,percent of total billed charges,85% of total billed charges,29.04,38,,,percent of total billed charges,38% of total billed charges,62.2,81.4,,,percent of total billed charges,81.4% of total billed charges,68.77,90,,,percent of total billed charges,90% of total billed charges,68.77,90,,,percent of total billed charges,90% of total billed charges,29.04,38,,,percent of total billed charges,38% of total billed charges,29.04,38,,,percent of total billed charges,38% of total billed charges,29.04,38,,,percent of total billed charges,38% of total billed charges,57.31,75,,,percent of total billed charges,75% of total billed charges,64.95,85,,,percent of total billed charges,85% of total billed charges,29.04,71.06,
C. difficile Toxin B PCR [Package],3470,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HLA Typing Celiac Disease,3471,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Celiac Disease Panel comprehensive,3472,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Cortisol, Free, Second Void Urine",3473,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Culture, Fungus (Hair, Skin, Nail)",3474,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Chikungunya AB (IgG, IgM), Rflx Titer",3475,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"CHLAMYDIA/GC RNA, TMA",3476,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Chronic Urticaria Panel 2 (Comp),3477,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Cortisol, Saliva, 2 Samples",3478,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
CMV AB Pro IgG and IgM,3479,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Carbon Monoxide Co-Ox[Package],3480,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Coccidioides AB ID, Serum",3481,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Coccidioides AB (IgG, IgM) Imm. w/Rflx",3482,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Resppanel4 SARS CoV,3483,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Coxsackie A AB, Serum",3484,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
CrossMatch[Package],3485,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Cortisol, Serum, 2 Spec",3486,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
CSF PCR panel - SLVH,3487,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Chlamydia/GC Profile,3488,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Culture, Fungus (not Hair, Skin, Blood)",3489,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Dengue Virus RNA Qual. RT PCR,3491,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Desmoglein AB (1 and 3),3492,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Diptheria and Tetanus Antitoxoids,3493,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Drug Test, General Toxicology, Serum",3494,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Epstein-Barr AB Panel,3495,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Egg Component Panel,3496,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Ehrlichia AB (IgG, IgM)",3497,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Encephalitis AB Eval w Rflx to Titer and Blot,3498,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Eosinophil count[Package],3499,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Order) Eosinophil Count - Blood,3500,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Familial Hypercholest. (FH) Panel,3507,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
FENA,3508,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
FISH DUP 22q11.2,3509,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"FISH, B-Cell Chronic Lymphocytic Leukemia Panel",3510,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Influenza A,3511,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Influenza B,3512,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
FLEXITEST1,3513,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
FLEXITEST2,3514,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
FLEXITEST3,3515,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Food Allergy Profile,3516,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Fungal Panel 3, Immunodiffusion",3517,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Food Specific IgG Allergy Panel (Adult),3518,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Hepatitis C ab (medicare screening only),3520,CDM,300,RC,G0472,HCPCS,outpatient,,,165.92,124.44,,149.33,90,,,percent of total billed charges,90% of total billed charges,154.31,93,,,percent of total billed charges,93% of total billed charges,63.05,38,,,percent of total billed charges,38% of total billed charges,63.05,38,,,percent of total billed charges,38% of total billed charges,141.03,85,,,percent of total billed charges,85% of total billed charges,63.05,38,,,percent of total billed charges,38% of total billed charges,135.06,81.4,,,percent of total billed charges,81.4% of total billed charges,149.33,90,,,percent of total billed charges,90% of total billed charges,149.33,90,,,percent of total billed charges,90% of total billed charges,63.05,38,,,percent of total billed charges,38% of total billed charges,63.05,38,,,percent of total billed charges,38% of total billed charges,63.05,38,,,percent of total billed charges,38% of total billed charges,124.44,75,,,percent of total billed charges,75% of total billed charges,141.03,85,,,percent of total billed charges,85% of total billed charges,63.05,154.31,
COVID-19 specimen collection - acute,3521,CDM,300,RC,G2023,HCPCS,outpatient,,,37.88,28.41,,34.09,90,,,percent of total billed charges,90% of total billed charges,35.23,93,,,percent of total billed charges,93% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,30.83,81.4,,,percent of total billed charges,81.4% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,28.41,75,,,percent of total billed charges,75% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,35.23,
COVID-19 specimen collection - acute,3522,CDM,300,RC,G2023,HCPCS,outpatient,,,37.88,28.41,,34.09,90,,,percent of total billed charges,90% of total billed charges,35.23,93,,,percent of total billed charges,93% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,30.83,81.4,,,percent of total billed charges,81.4% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,28.41,75,,,percent of total billed charges,75% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,35.23,
"GAD-65, IA-2 & INSULIN AUTOANTIBODY",3523,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Alpha-Galactose Profile,3524,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Campylobacter,3525,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Enterotoxigenic E. coli,3526,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Shiga-like toxin-prod. E. coli,3527,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
E. coli O157,3528,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Shigella/Enteroinvasive E. coli,3529,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Cryptosporium GI PCR,3530,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Cyclospora cayetanensis,3531,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Entamoeba histolytica,3532,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Giardia lamblia-GI PCR,3533,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Adenovirus F40/41,3534,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Astrovirus,3535,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
C diff toxin A/B (GI PCR),3536,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Norovirus GI/GII,3537,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
*Rotavirus A,3538,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Sapovirus (I, II, IV & V)",3539,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Stool Consistency,3540,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Plesiomonas shigelloides,3541,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Salmonella,3542,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Vibrio,3543,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Vibrio cholerae,3544,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Yersinia enterocolitica,3545,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Enteroaggregative E. coli,3546,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Enteropathogenic E. coli,3547,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Hanta Virus AB Profile (IgG, IgM)",3548,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Autoimmune Hepatitis Panel,3549,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Hepatitis Be Panel,3550,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Hepatitis E AB (IgG, IgM)",3551,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HISTO AB Panel,3552,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"HLA-DRB1, DQB1, Intermed. Res.",3553,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Heavy Metals Panel (Blood),3554,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Heavy Metal Panel (U),3555,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HSV Type 1 and 2 DNA Qual RT PCR,3556,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SureSwab Herpes Simplex Virus 1 & 2,3557,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Hydrocodone Metabolite Random Urine,3558,CDM,300,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Hypersensitivity Pneumonitis,3559,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Inflam Bowel Disease Diff Panel,3560,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
IBSdetex[Package],3561,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Order) IBS Detex,3562,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Immunofixation & Immunoglobulin, Serum",3563,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
IgG Subclasses Panel,3564,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Influenza A & B AB, Serum",3565,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Immunoglobulin Panel (IgA, IgG, IgM)",3566,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Iron & TIBC,3567,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Cortrosyn  (ACTH),3568,CDM,300,RC,,,outpatient,,,126.35,94.76,,113.72,90,,,percent of total billed charges,90% of total billed charges,117.51,93,,,percent of total billed charges,93% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,107.4,85,,,percent of total billed charges,85% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,102.85,81.4,,,percent of total billed charges,81.4% of total billed charges,113.72,90,,,percent of total billed charges,90% of total billed charges,113.72,90,,,percent of total billed charges,90% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,94.76,75,,,percent of total billed charges,75% of total billed charges,107.4,85,,,percent of total billed charges,85% of total billed charges,48.01,117.51,
Rh0(D)immune glob Rhophylac,3569,CDM,250,RC,,,outpatient,,,201.54,151.16,,181.39,90,,,percent of total billed charges,90% of total billed charges,187.43,93,,,percent of total billed charges,93% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,171.31,85,,,percent of total billed charges,85% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,164.05,81.4,,,percent of total billed charges,81.4% of total billed charges,181.39,90,,,percent of total billed charges,90% of total billed charges,181.39,90,,,percent of total billed charges,90% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,76.59,38,,,percent of total billed charges,38% of total billed charges,151.16,75,,,percent of total billed charges,75% of total billed charges,171.31,85,,,percent of total billed charges,85% of total billed charges,76.59,187.43,
"Kappa/Lambda Light Chains, Free w/Ratio",3570,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Kappa/Lamda Light Chains, Random Urine",3571,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Lyme Disease AB (IgG, IgM) Immunoblot",3572,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Lactate Dehydrogenase (LD) Isoenzyme Panel,3573,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Leukemia/Lymphoma Evaluation,3574,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Lipoprotein Fractionation Ultracentrifugation,3575,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Lipoprotein Fract. NMR w Lipid Panel,3576,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Lynch Syndrome Panel,3577,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Lupus Anticoagulant Eval w/Reflex,3578,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Lymphocyte Subset Panel 1,3579,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Myeloma Detection Panel, Basic",3580,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MENINGITIS PCR panel[Package],3581,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Myasthenia Gravis Panel 2 w Rflx MuSK,3582,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Anaerobic bacteria MIC,3583,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Order) Anaerobic Bacteria MIC,3584,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MICROALBUMIN W/CREAT,3585,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Methylmalonic Acid and Homocysteine,3586,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MMR IgG Panel,3587,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Monkeypox Virus, QL, PCR",3588,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Metabolic Risk Panel,3589,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Measles AB Panel,3590,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Mumps IGG and IGM Panel,3591,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Mercury, Random Urine",3592,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Vaginal Panel Molecular[Package],3593,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Myasthenia Gravis Panel 2,3594,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Myco Avium-Intracellulare DNA PCR,3595,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Mycoplasma Pneum AB (IgG, IgM)",3596,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Mycoplasma/Ureaplasma Panel,3597,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Myositis Assess+Jo1 AB,3598,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Myositis AssessR,3599,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Myositis Specific 11 AB Panel,3600,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
NAFLD Fibrosis Score,3601,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
NeoEncephalitis Paraneoplastic Eval.,3602,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Autoimmune Neurology AB Comp,3603,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"NF1 Sequencing, Deletion/Duplication",3604,CDM,300,RC,,,outpatient,,,473.38,355.04,,426.04,90,,,percent of total billed charges,90% of total billed charges,440.24,93,,,percent of total billed charges,93% of total billed charges,179.88,38,,,percent of total billed charges,38% of total billed charges,179.88,38,,,percent of total billed charges,38% of total billed charges,402.37,85,,,percent of total billed charges,85% of total billed charges,179.88,38,,,percent of total billed charges,38% of total billed charges,385.33,81.4,,,percent of total billed charges,81.4% of total billed charges,426.04,90,,,percent of total billed charges,90% of total billed charges,426.04,90,,,percent of total billed charges,90% of total billed charges,179.88,38,,,percent of total billed charges,38% of total billed charges,179.88,38,,,percent of total billed charges,38% of total billed charges,179.88,38,,,percent of total billed charges,38% of total billed charges,355.04,75,,,percent of total billed charges,75% of total billed charges,402.37,85,,,percent of total billed charges,85% of total billed charges,179.88,440.24,
"Salmonella/Shigella Cult, Campy & Shiga Toxin w Rflx",3605,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Organic Acids, Qual Urine",3606,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Opiate metabolites Screen w/confirmation,3607,CDM,300,RC,,,outpatient,,,90.22,67.67,,81.2,90,,,percent of total billed charges,90% of total billed charges,83.9,93,,,percent of total billed charges,93% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,73.44,81.4,,,percent of total billed charges,81.4% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,67.67,75,,,percent of total billed charges,75% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,83.9,
Organic Acids Quant. Urine,3608,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
O&P w Giardia ag [Package],3609,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Order) Ova_Parasite w/Giardia,3610,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Platelets pheresed, leuko reduced",3611,CDM,390,RC,,,outpatient,,,900.94,675.71,,810.85,90,,,percent of total billed charges,90% of total billed charges,837.87,93,,,percent of total billed charges,93% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,765.8,85,,,percent of total billed charges,85% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,733.37,81.4,,,percent of total billed charges,81.4% of total billed charges,810.85,90,,,percent of total billed charges,90% of total billed charges,810.85,90,,,percent of total billed charges,90% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,675.71,75,,,percent of total billed charges,75% of total billed charges,765.8,85,,,percent of total billed charges,85% of total billed charges,342.36,837.87,
"Parvovirus B19 AB (IgG, IgM)",3612,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Pathology  Review-lab results,3613,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Pre-biologic/biosimilar Screen Panel,3614,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Peanut Component Panel,3615,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Protein C+S Functional,3616,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Phospahtidyethanoleamine AB (IgA, IgG, IgM)",3617,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Phosphatidylethanolamine Antibodies,3618,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Phospholipase A2 Recept AB Panel,3619,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Prolactin Dilution Study,3620,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PNH with FLAER,3621,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Paraneoplastic AB Eval, CSF",3622,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Paraneoplastic Antibody Eval w Reflx,3623,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Polio 1,3 AB Neutralization",3624,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"14-3-3 Protein, CSF (Prion Disease)",3625,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Urine Protein w/Creatinine, random",3626,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Protein, Total & Electro w/IFE (Serum)",3627,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Protein Electro & Free K/L Light Chains, Serum",3628,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Potassium, Random Urine w Creatinine",3629,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PSA Free and Total,3630,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Protein, Total and Electrophoresis",3631,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Protein Electrophoresis and Immunofixation, 24 Hr Urine",3632,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Q FEVER (Coxiella burnetii) AB (IgG, IgM) w/rflx",3633,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
RA Diag Ident RA2,3634,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Buprenorphine Screen,3635,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Fentanyl Screen.,3636,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Heroin Metabolite Screen,3637,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Methadone Screen,3638,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Methorphan Screen,3639,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) Mitragynine Screen,3640,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Respiratory Allergy Profile XI,3641,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Respiratory PCR PANEL [Package],3642,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Respiratory PCR PANEL 2.1 [Package],3643,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Absolute Reticulocytes,3644,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Reticulocyte %,3645,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"RICKETTSIA AB, IGG,IGM w/rflx",3646,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Resp Panel4 RSV,3647,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Rubella ab Diag (IgG, IgM)",3648,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(RES) SARS-CoV-2,3649,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SOY COMPONENT PANEL,3650,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Allergy Shellfish Panel,3651,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
SLE Disease Activity Panel,3652,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"SureSwab Advanced Vaginitis, TMA",3653,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"SureSwab Advanced Vaginitis Plus, TMA",3654,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
STIs Increased Risk Panel,3655,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Stinging Insect Allergy Panel 13,3656,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Stone Risk Profile,3657,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Strep Pneumo AB IgG 23 serotypes,3658,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Testosterone-Free & Total,3659,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Thalassimis and HGBopathy Comp,3660,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"**DO NOT THYROID ANTIBODY ATA, TPO[Panel]",3661,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
THYROID PANEL,3662,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Thyroid Antibody ATA TPO,3663,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Thyroglobulin Panel (TG),3664,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Tick-Borne Disease AB Panel,3665,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Colorado Tick Fever AB Panel IFA,3666,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Tree Nut Allergy Panel,3667,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
ER Trauma Lab Panel,3668,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Transferrin, Carbohydrate-deficient",3669,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
TSH w HAMA Treatment,3670,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
COVID-19 (Sar-COV-2) QUEST,3671,CDM,300,RC,U0002,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,100.66,
"Calcium, Random Urine with Creatinine",3672,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Protein Electroph, urine random UPEP",3673,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Protein Electrophoresis, 24 hr urine (UPEP)",3674,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"PROTEIN, TOTAL, 24 HR (U) W/CREATININE",3675,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UroRisk Diagnostic Stone Profile (24 hr.),3676,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Valproic Acid, Total & Free",3677,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Von Willebrand Comp Panel,3678,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
HSV 1/2 IgG w Rflx to HSV-2 Inhib.,3679,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Venous Thrombosis Hypercoag Panel w Rflx,3680,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Venous Thrombosis Panel,3681,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"Varicella Zoster Virus AB (IgG, IgM)",3682,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"West Nile Virus AB (IgG, IgM), CSF",3683,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"West Nile AB (IgG, IgM)",3684,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
** DO NOT USE OLD URINE DRUG SCREEN,3685,CDM,300,RC,X8030,HCPCS,outpatient,,,260.13,195.1,,234.12,90,,,percent of total billed charges,90% of total billed charges,241.92,93,,,percent of total billed charges,93% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,211.75,81.4,,,percent of total billed charges,81.4% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,195.1,75,,,percent of total billed charges,75% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,241.92,
** DO NOT USE OLD URINE DRUG SCREEN,3686,CDM,300,RC,X8030,HCPCS,outpatient,,,260.13,195.1,,234.12,90,,,percent of total billed charges,90% of total billed charges,241.92,93,,,percent of total billed charges,93% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,211.75,81.4,,,percent of total billed charges,81.4% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,195.1,75,,,percent of total billed charges,75% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,241.92,
Chlamydia Culture[Package],3687,CDM,300,RC,87110,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
(Order) Chlamydia Culture,3688,CDM,300,RC,87110,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Crossmatch x2[Package],3689,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Crossmatch x3[Package],3690,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Crossmatch x4[Package],3691,CDM,300,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
MRI Temporomandibular Jts,3694,CDM,610,RC,70336,HCPCS,outpatient,,,2097.49,1573.12,,1887.74,90,,,percent of total billed charges,90% of total billed charges,1950.67,93,,,percent of total billed charges,93% of total billed charges,797.05,38,,,percent of total billed charges,38% of total billed charges,797.05,38,,,percent of total billed charges,38% of total billed charges,1782.87,85,,,percent of total billed charges,85% of total billed charges,797.05,38,,,percent of total billed charges,38% of total billed charges,1707.36,81.4,,,percent of total billed charges,81.4% of total billed charges,1887.74,90,,,percent of total billed charges,90% of total billed charges,1887.74,90,,,percent of total billed charges,90% of total billed charges,797.05,38,,,percent of total billed charges,38% of total billed charges,797.05,38,,,percent of total billed charges,38% of total billed charges,797.05,38,,,percent of total billed charges,38% of total billed charges,1573.12,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,797.05,1950.67,
"MRI Face, Neck or Orbits w/o contrast",3695,CDM,610,RC,70540,HCPCS,outpatient,,,2658.76,1994.07,,2392.88,90,,,percent of total billed charges,90% of total billed charges,2472.65,93,,,percent of total billed charges,93% of total billed charges,1010.33,38,,,percent of total billed charges,38% of total billed charges,1010.33,38,,,percent of total billed charges,38% of total billed charges,2259.95,85,,,percent of total billed charges,85% of total billed charges,1010.33,38,,,percent of total billed charges,38% of total billed charges,2164.23,81.4,,,percent of total billed charges,81.4% of total billed charges,2392.88,90,,,percent of total billed charges,90% of total billed charges,2392.88,90,,,percent of total billed charges,90% of total billed charges,1010.33,38,,,percent of total billed charges,38% of total billed charges,1010.33,38,,,percent of total billed charges,38% of total billed charges,1010.33,38,,,percent of total billed charges,38% of total billed charges,1994.07,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1010.33,2472.65,
"MRI Face, Neck or Orbits w/ contrast",3696,CDM,610,RC,70542,HCPCS,outpatient,,,2957.54,2218.16,,2661.79,90,,,percent of total billed charges,90% of total billed charges,2750.51,93,,,percent of total billed charges,93% of total billed charges,1123.87,38,,,percent of total billed charges,38% of total billed charges,1123.87,38,,,percent of total billed charges,38% of total billed charges,2513.91,85,,,percent of total billed charges,85% of total billed charges,1123.87,38,,,percent of total billed charges,38% of total billed charges,2407.44,81.4,,,percent of total billed charges,81.4% of total billed charges,2661.79,90,,,percent of total billed charges,90% of total billed charges,2661.79,90,,,percent of total billed charges,90% of total billed charges,1123.87,38,,,percent of total billed charges,38% of total billed charges,1123.87,38,,,percent of total billed charges,38% of total billed charges,1123.87,38,,,percent of total billed charges,38% of total billed charges,2218.16,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1123.87,2750.51,
"MRI Face, Neck or Orbits w, w/o contrast",3697,CDM,610,RC,70543,HCPCS,outpatient,,,4591,3443.25,,4131.9,90,,,percent of total billed charges,90% of total billed charges,4269.63,93,,,percent of total billed charges,93% of total billed charges,1744.58,38,,,percent of total billed charges,38% of total billed charges,1744.58,38,,,percent of total billed charges,38% of total billed charges,3902.35,85,,,percent of total billed charges,85% of total billed charges,1744.58,38,,,percent of total billed charges,38% of total billed charges,3737.07,81.4,,,percent of total billed charges,81.4% of total billed charges,4131.9,90,,,percent of total billed charges,90% of total billed charges,4131.9,90,,,percent of total billed charges,90% of total billed charges,1744.58,38,,,percent of total billed charges,38% of total billed charges,1744.58,38,,,percent of total billed charges,38% of total billed charges,1744.58,38,,,percent of total billed charges,38% of total billed charges,3443.25,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4269.63,
MRI MRA Head w/o contrast,3698,CDM,610,RC,70544,HCPCS,outpatient,,,3018.51,2263.88,,2716.66,90,,,percent of total billed charges,90% of total billed charges,2807.21,93,,,percent of total billed charges,93% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,2565.73,85,,,percent of total billed charges,85% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,2457.07,81.4,,,percent of total billed charges,81.4% of total billed charges,2716.66,90,,,percent of total billed charges,90% of total billed charges,2716.66,90,,,percent of total billed charges,90% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,2263.88,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1147.03,2807.21,
MRI MRA Head w/wo contrast,3699,CDM,610,RC,70545,HCPCS,outpatient,,,3517.67,2638.25,,3165.9,90,,,percent of total billed charges,90% of total billed charges,3271.43,93,,,percent of total billed charges,93% of total billed charges,1336.71,38,,,percent of total billed charges,38% of total billed charges,1336.71,38,,,percent of total billed charges,38% of total billed charges,2990.02,85,,,percent of total billed charges,85% of total billed charges,1336.71,38,,,percent of total billed charges,38% of total billed charges,2863.38,81.4,,,percent of total billed charges,81.4% of total billed charges,3165.9,90,,,percent of total billed charges,90% of total billed charges,3165.9,90,,,percent of total billed charges,90% of total billed charges,1336.71,38,,,percent of total billed charges,38% of total billed charges,1336.71,38,,,percent of total billed charges,38% of total billed charges,1336.71,38,,,percent of total billed charges,38% of total billed charges,2638.25,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1336.71,3271.43,
MRI MRA Neck w/o contrast,3700,CDM,610,RC,70547,HCPCS,outpatient,,,2689.22,2016.92,,2420.3,90,,,percent of total billed charges,90% of total billed charges,2500.97,93,,,percent of total billed charges,93% of total billed charges,1021.9,38,,,percent of total billed charges,38% of total billed charges,1021.9,38,,,percent of total billed charges,38% of total billed charges,2285.84,85,,,percent of total billed charges,85% of total billed charges,1021.9,38,,,percent of total billed charges,38% of total billed charges,2189.03,81.4,,,percent of total billed charges,81.4% of total billed charges,2420.3,90,,,percent of total billed charges,90% of total billed charges,2420.3,90,,,percent of total billed charges,90% of total billed charges,1021.9,38,,,percent of total billed charges,38% of total billed charges,1021.9,38,,,percent of total billed charges,38% of total billed charges,1021.9,38,,,percent of total billed charges,38% of total billed charges,2016.92,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1021.9,2500.97,
MRI MRA Neck w/contrast,3701,CDM,610,RC,70548,HCPCS,outpatient,,,3280.96,2460.72,,2952.86,90,,,percent of total billed charges,90% of total billed charges,3051.29,93,,,percent of total billed charges,93% of total billed charges,1246.76,38,,,percent of total billed charges,38% of total billed charges,1246.76,38,,,percent of total billed charges,38% of total billed charges,2788.82,85,,,percent of total billed charges,85% of total billed charges,1246.76,38,,,percent of total billed charges,38% of total billed charges,2670.7,81.4,,,percent of total billed charges,81.4% of total billed charges,2952.86,90,,,percent of total billed charges,90% of total billed charges,2952.86,90,,,percent of total billed charges,90% of total billed charges,1246.76,38,,,percent of total billed charges,38% of total billed charges,1246.76,38,,,percent of total billed charges,38% of total billed charges,1246.76,38,,,percent of total billed charges,38% of total billed charges,2460.72,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1246.76,3051.29,
MRI MRA Neck w/wo contrast,3702,CDM,610,RC,70549,HCPCS,outpatient,,,4112.91,3084.68,,3701.62,90,,,percent of total billed charges,90% of total billed charges,3825.01,93,,,percent of total billed charges,93% of total billed charges,1562.91,38,,,percent of total billed charges,38% of total billed charges,1562.91,38,,,percent of total billed charges,38% of total billed charges,3495.97,85,,,percent of total billed charges,85% of total billed charges,1562.91,38,,,percent of total billed charges,38% of total billed charges,3347.91,81.4,,,percent of total billed charges,81.4% of total billed charges,3701.62,90,,,percent of total billed charges,90% of total billed charges,3701.62,90,,,percent of total billed charges,90% of total billed charges,1562.91,38,,,percent of total billed charges,38% of total billed charges,1562.91,38,,,percent of total billed charges,38% of total billed charges,1562.91,38,,,percent of total billed charges,38% of total billed charges,3084.68,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1562.91,3825.01,
MRI Brain w/o contrast,3703,CDM,610,RC,70551,HCPCS,outpatient,,,3148.58,2361.44,,2833.72,90,,,percent of total billed charges,90% of total billed charges,2928.18,93,,,percent of total billed charges,93% of total billed charges,1196.46,38,,,percent of total billed charges,38% of total billed charges,1196.46,38,,,percent of total billed charges,38% of total billed charges,2676.29,85,,,percent of total billed charges,85% of total billed charges,1196.46,38,,,percent of total billed charges,38% of total billed charges,2562.94,81.4,,,percent of total billed charges,81.4% of total billed charges,2833.72,90,,,percent of total billed charges,90% of total billed charges,2833.72,90,,,percent of total billed charges,90% of total billed charges,1196.46,38,,,percent of total billed charges,38% of total billed charges,1196.46,38,,,percent of total billed charges,38% of total billed charges,1196.46,38,,,percent of total billed charges,38% of total billed charges,2361.44,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1196.46,2928.18,
MRI Brain w/o contrast+ ambulance SLVH,3704,CDM,610,RC,70551,HCPCS,outpatient,,,5189.52,3892.14,,4670.57,90,,,percent of total billed charges,90% of total billed charges,4826.25,93,,,percent of total billed charges,93% of total billed charges,1972.02,38,,,percent of total billed charges,38% of total billed charges,1972.02,38,,,percent of total billed charges,38% of total billed charges,4411.09,85,,,percent of total billed charges,85% of total billed charges,1972.02,38,,,percent of total billed charges,38% of total billed charges,4224.27,81.4,,,percent of total billed charges,81.4% of total billed charges,4670.57,90,,,percent of total billed charges,90% of total billed charges,4670.57,90,,,percent of total billed charges,90% of total billed charges,1972.02,38,,,percent of total billed charges,38% of total billed charges,1972.02,38,,,percent of total billed charges,38% of total billed charges,1972.02,38,,,percent of total billed charges,38% of total billed charges,3892.14,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4826.25,
MRI Brain w/ contrast,3705,CDM,610,RC,70552,HCPCS,outpatient,,,3531.73,2648.8,,3178.56,90,,,percent of total billed charges,90% of total billed charges,3284.51,93,,,percent of total billed charges,93% of total billed charges,1342.06,38,,,percent of total billed charges,38% of total billed charges,1342.06,38,,,percent of total billed charges,38% of total billed charges,3001.97,85,,,percent of total billed charges,85% of total billed charges,1342.06,38,,,percent of total billed charges,38% of total billed charges,2874.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3178.56,90,,,percent of total billed charges,90% of total billed charges,3178.56,90,,,percent of total billed charges,90% of total billed charges,1342.06,38,,,percent of total billed charges,38% of total billed charges,1342.06,38,,,percent of total billed charges,38% of total billed charges,1342.06,38,,,percent of total billed charges,38% of total billed charges,2648.8,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1342.06,3284.51,
"MRI Brain w, w/o contrast",3706,CDM,610,RC,70553,HCPCS,outpatient,,,4660.16,3495.12,,4194.14,90,,,percent of total billed charges,90% of total billed charges,4333.95,93,,,percent of total billed charges,93% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3961.14,85,,,percent of total billed charges,85% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3793.37,81.4,,,percent of total billed charges,81.4% of total billed charges,4194.14,90,,,percent of total billed charges,90% of total billed charges,4194.14,90,,,percent of total billed charges,90% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3495.12,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4333.95,
MRI Chest w/o contrast,3707,CDM,610,RC,71550,HCPCS,outpatient,,,2548.6,1911.45,,2293.74,90,,,percent of total billed charges,90% of total billed charges,2370.2,93,,,percent of total billed charges,93% of total billed charges,968.47,38,,,percent of total billed charges,38% of total billed charges,968.47,38,,,percent of total billed charges,38% of total billed charges,2166.31,85,,,percent of total billed charges,85% of total billed charges,968.47,38,,,percent of total billed charges,38% of total billed charges,2074.56,81.4,,,percent of total billed charges,81.4% of total billed charges,2293.74,90,,,percent of total billed charges,90% of total billed charges,2293.74,90,,,percent of total billed charges,90% of total billed charges,968.47,38,,,percent of total billed charges,38% of total billed charges,968.47,38,,,percent of total billed charges,38% of total billed charges,968.47,38,,,percent of total billed charges,38% of total billed charges,1911.45,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,968.47,2370.2,
MRI Chest w/ contrast,3708,CDM,610,RC,71551,HCPCS,outpatient,,,2843.91,2132.93,,2559.52,90,,,percent of total billed charges,90% of total billed charges,2644.84,93,,,percent of total billed charges,93% of total billed charges,1080.69,38,,,percent of total billed charges,38% of total billed charges,1080.69,38,,,percent of total billed charges,38% of total billed charges,2417.32,85,,,percent of total billed charges,85% of total billed charges,1080.69,38,,,percent of total billed charges,38% of total billed charges,2314.94,81.4,,,percent of total billed charges,81.4% of total billed charges,2559.52,90,,,percent of total billed charges,90% of total billed charges,2559.52,90,,,percent of total billed charges,90% of total billed charges,1080.69,38,,,percent of total billed charges,38% of total billed charges,1080.69,38,,,percent of total billed charges,38% of total billed charges,1080.69,38,,,percent of total billed charges,38% of total billed charges,2132.93,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1080.69,2644.84,
"MRI Chest w, w/o contrast",3709,CDM,610,RC,71552,HCPCS,outpatient,,,4571.09,3428.32,,4113.98,90,,,percent of total billed charges,90% of total billed charges,4251.11,93,,,percent of total billed charges,93% of total billed charges,1737.01,38,,,percent of total billed charges,38% of total billed charges,1737.01,38,,,percent of total billed charges,38% of total billed charges,3885.43,85,,,percent of total billed charges,85% of total billed charges,1737.01,38,,,percent of total billed charges,38% of total billed charges,3720.87,81.4,,,percent of total billed charges,81.4% of total billed charges,4113.98,90,,,percent of total billed charges,90% of total billed charges,4113.98,90,,,percent of total billed charges,90% of total billed charges,1737.01,38,,,percent of total billed charges,38% of total billed charges,1737.01,38,,,percent of total billed charges,38% of total billed charges,1737.01,38,,,percent of total billed charges,38% of total billed charges,3428.32,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4251.11,
MRI C-Spine w/o contrast,3710,CDM,610,RC,72141,HCPCS,outpatient,,,2692.73,2019.55,,2423.46,90,,,percent of total billed charges,90% of total billed charges,2504.24,93,,,percent of total billed charges,93% of total billed charges,1023.24,38,,,percent of total billed charges,38% of total billed charges,1023.24,38,,,percent of total billed charges,38% of total billed charges,2288.82,85,,,percent of total billed charges,85% of total billed charges,1023.24,38,,,percent of total billed charges,38% of total billed charges,2191.88,81.4,,,percent of total billed charges,81.4% of total billed charges,2423.46,90,,,percent of total billed charges,90% of total billed charges,2423.46,90,,,percent of total billed charges,90% of total billed charges,1023.24,38,,,percent of total billed charges,38% of total billed charges,1023.24,38,,,percent of total billed charges,38% of total billed charges,1023.24,38,,,percent of total billed charges,38% of total billed charges,2019.55,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1023.24,2504.24,
MRI C-Spine w/ contrast,3711,CDM,610,RC,72142,HCPCS,outpatient,,,3128.63,2346.47,,2815.77,90,,,percent of total billed charges,90% of total billed charges,2909.63,93,,,percent of total billed charges,93% of total billed charges,1188.88,38,,,percent of total billed charges,38% of total billed charges,1188.88,38,,,percent of total billed charges,38% of total billed charges,2659.34,85,,,percent of total billed charges,85% of total billed charges,1188.88,38,,,percent of total billed charges,38% of total billed charges,2546.7,81.4,,,percent of total billed charges,81.4% of total billed charges,2815.77,90,,,percent of total billed charges,90% of total billed charges,2815.77,90,,,percent of total billed charges,90% of total billed charges,1188.88,38,,,percent of total billed charges,38% of total billed charges,1188.88,38,,,percent of total billed charges,38% of total billed charges,1188.88,38,,,percent of total billed charges,38% of total billed charges,2346.47,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1188.88,2909.63,
MRI T-Spine w/o contrast,3712,CDM,610,RC,72146,HCPCS,outpatient,,,2682.19,2011.64,,2413.97,90,,,percent of total billed charges,90% of total billed charges,2494.44,93,,,percent of total billed charges,93% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,2279.86,85,,,percent of total billed charges,85% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,2183.3,81.4,,,percent of total billed charges,81.4% of total billed charges,2413.97,90,,,percent of total billed charges,90% of total billed charges,2413.97,90,,,percent of total billed charges,90% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,2011.64,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1019.23,2494.44,
MRI T-Spine w/ contrast,3713,CDM,610,RC,72147,HCPCS,outpatient,,,3223.56,2417.67,,2901.2,90,,,percent of total billed charges,90% of total billed charges,2997.91,93,,,percent of total billed charges,93% of total billed charges,1224.95,38,,,percent of total billed charges,38% of total billed charges,1224.95,38,,,percent of total billed charges,38% of total billed charges,2740.03,85,,,percent of total billed charges,85% of total billed charges,1224.95,38,,,percent of total billed charges,38% of total billed charges,2623.98,81.4,,,percent of total billed charges,81.4% of total billed charges,2901.2,90,,,percent of total billed charges,90% of total billed charges,2901.2,90,,,percent of total billed charges,90% of total billed charges,1224.95,38,,,percent of total billed charges,38% of total billed charges,1224.95,38,,,percent of total billed charges,38% of total billed charges,1224.95,38,,,percent of total billed charges,38% of total billed charges,2417.67,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1224.95,2997.91,
MRI L-Spine w/o contrast,3714,CDM,610,RC,72148,HCPCS,outpatient,,,2682.19,2011.64,,2413.97,90,,,percent of total billed charges,90% of total billed charges,2494.44,93,,,percent of total billed charges,93% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,2279.86,85,,,percent of total billed charges,85% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,2183.3,81.4,,,percent of total billed charges,81.4% of total billed charges,2413.97,90,,,percent of total billed charges,90% of total billed charges,2413.97,90,,,percent of total billed charges,90% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,1019.23,38,,,percent of total billed charges,38% of total billed charges,2011.64,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1019.23,2494.44,
MRI L-Spine w/ contrast,3715,CDM,610,RC,72149,HCPCS,outpatient,,,3201.28,2400.96,,2881.15,90,,,percent of total billed charges,90% of total billed charges,2977.19,93,,,percent of total billed charges,93% of total billed charges,1216.49,38,,,percent of total billed charges,38% of total billed charges,1216.49,38,,,percent of total billed charges,38% of total billed charges,2721.09,85,,,percent of total billed charges,85% of total billed charges,1216.49,38,,,percent of total billed charges,38% of total billed charges,2605.84,81.4,,,percent of total billed charges,81.4% of total billed charges,2881.15,90,,,percent of total billed charges,90% of total billed charges,2881.15,90,,,percent of total billed charges,90% of total billed charges,1216.49,38,,,percent of total billed charges,38% of total billed charges,1216.49,38,,,percent of total billed charges,38% of total billed charges,1216.49,38,,,percent of total billed charges,38% of total billed charges,2400.96,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1216.49,2977.19,
"MRI C-Spine w, w/o contrast",3716,CDM,610,RC,72156,HCPCS,outpatient,,,4660.16,3495.12,,4194.14,90,,,percent of total billed charges,90% of total billed charges,4333.95,93,,,percent of total billed charges,93% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3961.14,85,,,percent of total billed charges,85% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3793.37,81.4,,,percent of total billed charges,81.4% of total billed charges,4194.14,90,,,percent of total billed charges,90% of total billed charges,4194.14,90,,,percent of total billed charges,90% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3495.12,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4333.95,
"MRI T-Spine w, w/o contrast",3717,CDM,610,RC,72157,HCPCS,outpatient,,,4660.16,3495.12,,4194.14,90,,,percent of total billed charges,90% of total billed charges,4333.95,93,,,percent of total billed charges,93% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3961.14,85,,,percent of total billed charges,85% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3793.37,81.4,,,percent of total billed charges,81.4% of total billed charges,4194.14,90,,,percent of total billed charges,90% of total billed charges,4194.14,90,,,percent of total billed charges,90% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3495.12,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4333.95,
"MRI L-Spine w, w/o contrast",3718,CDM,610,RC,72158,HCPCS,outpatient,,,4660.16,3495.12,,4194.14,90,,,percent of total billed charges,90% of total billed charges,4333.95,93,,,percent of total billed charges,93% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3961.14,85,,,percent of total billed charges,85% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3793.37,81.4,,,percent of total billed charges,81.4% of total billed charges,4194.14,90,,,percent of total billed charges,90% of total billed charges,4194.14,90,,,percent of total billed charges,90% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,1770.86,38,,,percent of total billed charges,38% of total billed charges,3495.12,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4333.95,
"MRI L spine w/wo, with AMB to Ala",3719,CDM,610,RC,72158,HCPCS,outpatient,,,7051.73,5288.8,,6346.56,90,,,percent of total billed charges,90% of total billed charges,6558.11,93,,,percent of total billed charges,93% of total billed charges,2679.66,38,,,percent of total billed charges,38% of total billed charges,2679.66,38,,,percent of total billed charges,38% of total billed charges,5993.97,85,,,percent of total billed charges,85% of total billed charges,2679.66,38,,,percent of total billed charges,38% of total billed charges,5740.11,81.4,,,percent of total billed charges,81.4% of total billed charges,6346.56,90,,,percent of total billed charges,90% of total billed charges,6346.56,90,,,percent of total billed charges,90% of total billed charges,2679.66,38,,,percent of total billed charges,38% of total billed charges,2679.66,38,,,percent of total billed charges,38% of total billed charges,2679.66,38,,,percent of total billed charges,38% of total billed charges,5288.8,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,6558.11,
MRI Pelvis w/o contrast,3720,CDM,610,RC,72195,HCPCS,outpatient,,,2669.31,2001.98,,2402.38,90,,,percent of total billed charges,90% of total billed charges,2482.46,93,,,percent of total billed charges,93% of total billed charges,1014.34,38,,,percent of total billed charges,38% of total billed charges,1014.34,38,,,percent of total billed charges,38% of total billed charges,2268.91,85,,,percent of total billed charges,85% of total billed charges,1014.34,38,,,percent of total billed charges,38% of total billed charges,2172.82,81.4,,,percent of total billed charges,81.4% of total billed charges,2402.38,90,,,percent of total billed charges,90% of total billed charges,2402.38,90,,,percent of total billed charges,90% of total billed charges,1014.34,38,,,percent of total billed charges,38% of total billed charges,1014.34,38,,,percent of total billed charges,38% of total billed charges,1014.34,38,,,percent of total billed charges,38% of total billed charges,2001.98,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1014.34,2482.46,
MRI Pelvis w/ contrast,3721,CDM,610,RC,72196,HCPCS,outpatient,,,3080.59,2310.44,,2772.53,90,,,percent of total billed charges,90% of total billed charges,2864.95,93,,,percent of total billed charges,93% of total billed charges,1170.62,38,,,percent of total billed charges,38% of total billed charges,1170.62,38,,,percent of total billed charges,38% of total billed charges,2618.5,85,,,percent of total billed charges,85% of total billed charges,1170.62,38,,,percent of total billed charges,38% of total billed charges,2507.6,81.4,,,percent of total billed charges,81.4% of total billed charges,2772.53,90,,,percent of total billed charges,90% of total billed charges,2772.53,90,,,percent of total billed charges,90% of total billed charges,1170.62,38,,,percent of total billed charges,38% of total billed charges,1170.62,38,,,percent of total billed charges,38% of total billed charges,1170.62,38,,,percent of total billed charges,38% of total billed charges,2310.44,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1170.62,2864.95,
"MRI Pelvis w, w/o contrast",3722,CDM,610,RC,72197,HCPCS,outpatient,,,4602.73,3452.05,,4142.46,90,,,percent of total billed charges,90% of total billed charges,4280.54,93,,,percent of total billed charges,93% of total billed charges,1749.04,38,,,percent of total billed charges,38% of total billed charges,1749.04,38,,,percent of total billed charges,38% of total billed charges,3912.32,85,,,percent of total billed charges,85% of total billed charges,1749.04,38,,,percent of total billed charges,38% of total billed charges,3746.62,81.4,,,percent of total billed charges,81.4% of total billed charges,4142.46,90,,,percent of total billed charges,90% of total billed charges,4142.46,90,,,percent of total billed charges,90% of total billed charges,1749.04,38,,,percent of total billed charges,38% of total billed charges,1749.04,38,,,percent of total billed charges,38% of total billed charges,1749.04,38,,,percent of total billed charges,38% of total billed charges,3452.05,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4280.54,
MRI Upper Extrem Other Than JT,3723,CDM,610,RC,73218,HCPCS,outpatient,,,1933.43,1450.07,,1740.09,90,,,percent of total billed charges,90% of total billed charges,1798.09,93,,,percent of total billed charges,93% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,1643.42,85,,,percent of total billed charges,85% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,1573.81,81.4,,,percent of total billed charges,81.4% of total billed charges,1740.09,90,,,percent of total billed charges,90% of total billed charges,1740.09,90,,,percent of total billed charges,90% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,1450.07,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,734.7,1798.09,
MRI Bi-lateral Upper Extem Other Than JT,3724,CDM,610,RC,73218,HCPCS,outpatient,,,3866.86,2900.15,,3480.17,90,,,percent of total billed charges,90% of total billed charges,3596.18,93,,,percent of total billed charges,93% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3286.83,85,,,percent of total billed charges,85% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3147.62,81.4,,,percent of total billed charges,81.4% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,2900.15,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1469.41,3596.18,
MRI Bi-lateral Upper Extem Other Than JT,3725,CDM,610,RC,73218,HCPCS,outpatient,,,3866.86,2900.15,,3480.17,90,,,percent of total billed charges,90% of total billed charges,3596.18,93,,,percent of total billed charges,93% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3286.83,85,,,percent of total billed charges,85% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3147.62,81.4,,,percent of total billed charges,81.4% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,2900.15,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1469.41,3596.18,
MRI Bi-lateral Upper Extem Other Than JT,3726,CDM,610,RC,73218,HCPCS,outpatient,,,3866.86,2900.15,,3480.17,90,,,percent of total billed charges,90% of total billed charges,3596.18,93,,,percent of total billed charges,93% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3286.83,85,,,percent of total billed charges,85% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3147.62,81.4,,,percent of total billed charges,81.4% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,2900.15,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1469.41,3596.18,
MRI Upper Ext; w/wo contrast,3727,CDM,610,RC,73220,HCPCS,outpatient,,,3358.3,2518.73,,3022.47,90,,,percent of total billed charges,90% of total billed charges,3123.22,93,,,percent of total billed charges,93% of total billed charges,1276.15,38,,,percent of total billed charges,38% of total billed charges,1276.15,38,,,percent of total billed charges,38% of total billed charges,2854.56,85,,,percent of total billed charges,85% of total billed charges,1276.15,38,,,percent of total billed charges,38% of total billed charges,2733.66,81.4,,,percent of total billed charges,81.4% of total billed charges,3022.47,90,,,percent of total billed charges,90% of total billed charges,3022.47,90,,,percent of total billed charges,90% of total billed charges,1276.15,38,,,percent of total billed charges,38% of total billed charges,1276.15,38,,,percent of total billed charges,38% of total billed charges,1276.15,38,,,percent of total billed charges,38% of total billed charges,2518.73,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1276.15,3123.22,
"MRI Upper Ext jt. wo (Shoulder, Elbow, Wrist)",3728,CDM,610,RC,73221,HCPCS,outpatient,,,1933.43,1450.07,,1740.09,90,,,percent of total billed charges,90% of total billed charges,1798.09,93,,,percent of total billed charges,93% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,1643.42,85,,,percent of total billed charges,85% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,1573.81,81.4,,,percent of total billed charges,81.4% of total billed charges,1740.09,90,,,percent of total billed charges,90% of total billed charges,1740.09,90,,,percent of total billed charges,90% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,734.7,38,,,percent of total billed charges,38% of total billed charges,1450.07,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,734.7,1798.09,
MRI Bi-lateral Upper Ext w/o contrast,3729,CDM,610,RC,73221,HCPCS,outpatient,,,3866.86,2900.15,,3480.17,90,,,percent of total billed charges,90% of total billed charges,3596.18,93,,,percent of total billed charges,93% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3286.83,85,,,percent of total billed charges,85% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3147.62,81.4,,,percent of total billed charges,81.4% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,2900.15,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1469.41,3596.18,
MRI Bi-lateral Upper Ext w/o contrast,3730,CDM,610,RC,73221,HCPCS,outpatient,,,3866.86,2900.15,,3480.17,90,,,percent of total billed charges,90% of total billed charges,3596.18,93,,,percent of total billed charges,93% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3286.83,85,,,percent of total billed charges,85% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3147.62,81.4,,,percent of total billed charges,81.4% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,2900.15,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1469.41,3596.18,
MRI Bi-lateral Upper Ext w/o contrast,3731,CDM,610,RC,73221,HCPCS,outpatient,,,3866.86,2900.15,,3480.17,90,,,percent of total billed charges,90% of total billed charges,3596.18,93,,,percent of total billed charges,93% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3286.83,85,,,percent of total billed charges,85% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,3147.62,81.4,,,percent of total billed charges,81.4% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,3480.17,90,,,percent of total billed charges,90% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,1469.41,38,,,percent of total billed charges,38% of total billed charges,2900.15,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1469.41,3596.18,
"MRI Upper Extrem jt. (Shoulder, Elbow, Wrist w/cont)",3732,CDM,610,RC,73222,HCPCS,outpatient,,,1933.23,1449.92,,1739.91,90,,,percent of total billed charges,90% of total billed charges,1797.9,93,,,percent of total billed charges,93% of total billed charges,734.63,38,,,percent of total billed charges,38% of total billed charges,734.63,38,,,percent of total billed charges,38% of total billed charges,1643.25,85,,,percent of total billed charges,85% of total billed charges,734.63,38,,,percent of total billed charges,38% of total billed charges,1573.65,81.4,,,percent of total billed charges,81.4% of total billed charges,1739.91,90,,,percent of total billed charges,90% of total billed charges,1739.91,90,,,percent of total billed charges,90% of total billed charges,734.63,38,,,percent of total billed charges,38% of total billed charges,734.63,38,,,percent of total billed charges,38% of total billed charges,734.63,38,,,percent of total billed charges,38% of total billed charges,1449.92,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,734.63,1797.9,
"MRI Upper Extrem jt (Shoulder, Elbow, Wrist w/wo cont)",3733,CDM,610,RC,73223,HCPCS,outpatient,,,2067.63,1550.72,,1860.87,90,,,percent of total billed charges,90% of total billed charges,1922.9,93,,,percent of total billed charges,93% of total billed charges,785.7,38,,,percent of total billed charges,38% of total billed charges,785.7,38,,,percent of total billed charges,38% of total billed charges,1757.49,85,,,percent of total billed charges,85% of total billed charges,785.7,38,,,percent of total billed charges,38% of total billed charges,1683.05,81.4,,,percent of total billed charges,81.4% of total billed charges,1860.87,90,,,percent of total billed charges,90% of total billed charges,1860.87,90,,,percent of total billed charges,90% of total billed charges,785.7,38,,,percent of total billed charges,38% of total billed charges,785.7,38,,,percent of total billed charges,38% of total billed charges,785.7,38,,,percent of total billed charges,38% of total billed charges,1550.72,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,785.7,1922.9,
"MRI Lower Ext., w/o contrast",3734,CDM,610,RC,73718,HCPCS,outpatient,,,2643.53,1982.65,,2379.18,90,,,percent of total billed charges,90% of total billed charges,2458.48,93,,,percent of total billed charges,93% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,2247,85,,,percent of total billed charges,85% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,2151.83,81.4,,,percent of total billed charges,81.4% of total billed charges,2379.18,90,,,percent of total billed charges,90% of total billed charges,2379.18,90,,,percent of total billed charges,90% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,1004.54,38,,,percent of total billed charges,38% of total billed charges,1982.65,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1004.54,2458.48,
"MRI Bi-lateral Lower Ext, wo contrast",3735,CDM,610,RC,73718,HCPCS,outpatient,,,5287.03,3965.27,,4758.33,90,,,percent of total billed charges,90% of total billed charges,4916.94,93,,,percent of total billed charges,93% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,4493.98,85,,,percent of total billed charges,85% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,4303.64,81.4,,,percent of total billed charges,81.4% of total billed charges,4758.33,90,,,percent of total billed charges,90% of total billed charges,4758.33,90,,,percent of total billed charges,90% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,3965.27,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4916.94,
"MRI Bi-lateral Lower Ext, wo contrast",3736,CDM,610,RC,73718,HCPCS,outpatient,,,5287.03,3965.27,,4758.33,90,,,percent of total billed charges,90% of total billed charges,4916.94,93,,,percent of total billed charges,93% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,4493.98,85,,,percent of total billed charges,85% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,4303.64,81.4,,,percent of total billed charges,81.4% of total billed charges,4758.33,90,,,percent of total billed charges,90% of total billed charges,4758.33,90,,,percent of total billed charges,90% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,3965.27,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4916.94,
"MRI Bi-lateral Lower Ext, wo contrast",3737,CDM,610,RC,73718,HCPCS,outpatient,,,5287.03,3965.27,,4758.33,90,,,percent of total billed charges,90% of total billed charges,4916.94,93,,,percent of total billed charges,93% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,4493.98,85,,,percent of total billed charges,85% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,4303.64,81.4,,,percent of total billed charges,81.4% of total billed charges,4758.33,90,,,percent of total billed charges,90% of total billed charges,4758.33,90,,,percent of total billed charges,90% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,2009.07,38,,,percent of total billed charges,38% of total billed charges,3965.27,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,4916.94,
MRI Lower Ext; Other/Than Jt. w/wo contrast,3738,CDM,610,RC,73720,HCPCS,outpatient,,,4291.05,3218.29,,3861.95,90,,,percent of total billed charges,90% of total billed charges,3990.68,93,,,percent of total billed charges,93% of total billed charges,1630.6,38,,,percent of total billed charges,38% of total billed charges,1630.6,38,,,percent of total billed charges,38% of total billed charges,3647.39,85,,,percent of total billed charges,85% of total billed charges,1630.6,38,,,percent of total billed charges,38% of total billed charges,3492.91,81.4,,,percent of total billed charges,81.4% of total billed charges,3861.95,90,,,percent of total billed charges,90% of total billed charges,3861.95,90,,,percent of total billed charges,90% of total billed charges,1630.6,38,,,percent of total billed charges,38% of total billed charges,1630.6,38,,,percent of total billed charges,38% of total billed charges,1630.6,38,,,percent of total billed charges,38% of total billed charges,3218.29,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,3990.68,
"MRI Lower Extremity jt. (Knee, Hip, Ankle wo)",3739,CDM,610,RC,73721,HCPCS,outpatient,,,3078.25,2308.69,,2770.43,90,,,percent of total billed charges,90% of total billed charges,2862.77,93,,,percent of total billed charges,93% of total billed charges,1169.74,38,,,percent of total billed charges,38% of total billed charges,1169.74,38,,,percent of total billed charges,38% of total billed charges,2616.51,85,,,percent of total billed charges,85% of total billed charges,1169.74,38,,,percent of total billed charges,38% of total billed charges,2505.7,81.4,,,percent of total billed charges,81.4% of total billed charges,2770.43,90,,,percent of total billed charges,90% of total billed charges,2770.43,90,,,percent of total billed charges,90% of total billed charges,1169.74,38,,,percent of total billed charges,38% of total billed charges,1169.74,38,,,percent of total billed charges,38% of total billed charges,1169.74,38,,,percent of total billed charges,38% of total billed charges,2308.69,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1169.74,2862.77,
MRI Bi-lateral KNEE w contrast,3740,CDM,610,RC,73721,HCPCS,outpatient,,,6156.51,4617.38,,5540.86,90,,,percent of total billed charges,90% of total billed charges,5725.55,93,,,percent of total billed charges,93% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,5233.03,85,,,percent of total billed charges,85% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,5011.4,81.4,,,percent of total billed charges,81.4% of total billed charges,5540.86,90,,,percent of total billed charges,90% of total billed charges,5540.86,90,,,percent of total billed charges,90% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,4617.38,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,5725.55,
MRI Bi-lateral KNEE w contrast,3741,CDM,610,RC,73721,HCPCS,outpatient,,,6156.51,4617.38,,5540.86,90,,,percent of total billed charges,90% of total billed charges,5725.55,93,,,percent of total billed charges,93% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,5233.03,85,,,percent of total billed charges,85% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,5011.4,81.4,,,percent of total billed charges,81.4% of total billed charges,5540.86,90,,,percent of total billed charges,90% of total billed charges,5540.86,90,,,percent of total billed charges,90% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,4617.38,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,5725.55,
MRI Bi-lateral KNEE w contrast,3742,CDM,610,RC,73721,HCPCS,outpatient,,,6156.51,4617.38,,5540.86,90,,,percent of total billed charges,90% of total billed charges,5725.55,93,,,percent of total billed charges,93% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,5233.03,85,,,percent of total billed charges,85% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,5011.4,81.4,,,percent of total billed charges,81.4% of total billed charges,5540.86,90,,,percent of total billed charges,90% of total billed charges,5540.86,90,,,percent of total billed charges,90% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,2339.47,38,,,percent of total billed charges,38% of total billed charges,4617.38,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,5725.55,
"MRI Lower Extrem jt., (Hip, Knee, Ankle w/cont)",3743,CDM,610,RC,73722,HCPCS,outpatient,,,3101.45,2326.09,,2791.31,90,,,percent of total billed charges,90% of total billed charges,2884.35,93,,,percent of total billed charges,93% of total billed charges,1178.55,38,,,percent of total billed charges,38% of total billed charges,1178.55,38,,,percent of total billed charges,38% of total billed charges,2636.23,85,,,percent of total billed charges,85% of total billed charges,1178.55,38,,,percent of total billed charges,38% of total billed charges,2524.58,81.4,,,percent of total billed charges,81.4% of total billed charges,2791.31,90,,,percent of total billed charges,90% of total billed charges,2791.31,90,,,percent of total billed charges,90% of total billed charges,1178.55,38,,,percent of total billed charges,38% of total billed charges,1178.55,38,,,percent of total billed charges,38% of total billed charges,1178.55,38,,,percent of total billed charges,38% of total billed charges,2326.09,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1178.55,2884.35,
"MRI Lower Extrem jt. (Hip, Knee, Ankle w/wo cont)",3744,CDM,610,RC,73723,HCPCS,outpatient,,,3216.33,2412.25,,2894.7,90,,,percent of total billed charges,90% of total billed charges,2991.19,93,,,percent of total billed charges,93% of total billed charges,1222.21,38,,,percent of total billed charges,38% of total billed charges,1222.21,38,,,percent of total billed charges,38% of total billed charges,2733.88,85,,,percent of total billed charges,85% of total billed charges,1222.21,38,,,percent of total billed charges,38% of total billed charges,2618.09,81.4,,,percent of total billed charges,81.4% of total billed charges,2894.7,90,,,percent of total billed charges,90% of total billed charges,2894.7,90,,,percent of total billed charges,90% of total billed charges,1222.21,38,,,percent of total billed charges,38% of total billed charges,1222.21,38,,,percent of total billed charges,38% of total billed charges,1222.21,38,,,percent of total billed charges,38% of total billed charges,2412.25,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1222.21,2991.19,
MRI Abd w/o contrast,3745,CDM,610,RC,74181,HCPCS,outpatient,,,3224.72,2418.54,,2902.25,90,,,percent of total billed charges,90% of total billed charges,2998.99,93,,,percent of total billed charges,93% of total billed charges,1225.39,38,,,percent of total billed charges,38% of total billed charges,1225.39,38,,,percent of total billed charges,38% of total billed charges,2741.01,85,,,percent of total billed charges,85% of total billed charges,1225.39,38,,,percent of total billed charges,38% of total billed charges,2624.92,81.4,,,percent of total billed charges,81.4% of total billed charges,2902.25,90,,,percent of total billed charges,90% of total billed charges,2902.25,90,,,percent of total billed charges,90% of total billed charges,1225.39,38,,,percent of total billed charges,38% of total billed charges,1225.39,38,,,percent of total billed charges,38% of total billed charges,1225.39,38,,,percent of total billed charges,38% of total billed charges,2418.54,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1225.39,2998.99,
MRCP w Amb to SLVH,3746,CDM,610,RC,74181,HCPCS,outpatient,,,5410.31,4057.73,,4869.28,90,,,percent of total billed charges,90% of total billed charges,5031.59,93,,,percent of total billed charges,93% of total billed charges,2055.92,38,,,percent of total billed charges,38% of total billed charges,2055.92,38,,,percent of total billed charges,38% of total billed charges,4598.76,85,,,percent of total billed charges,85% of total billed charges,2055.92,38,,,percent of total billed charges,38% of total billed charges,4403.99,81.4,,,percent of total billed charges,81.4% of total billed charges,4869.28,90,,,percent of total billed charges,90% of total billed charges,4869.28,90,,,percent of total billed charges,90% of total billed charges,2055.92,38,,,percent of total billed charges,38% of total billed charges,2055.92,38,,,percent of total billed charges,38% of total billed charges,2055.92,38,,,percent of total billed charges,38% of total billed charges,4057.73,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,5031.59,
MRCP - Alamosa,3747,CDM,610,RC,74181,HCPCS,outpatient,,,2618.4,1963.8,,2356.56,90,,,percent of total billed charges,90% of total billed charges,2435.11,93,,,percent of total billed charges,93% of total billed charges,994.99,38,,,percent of total billed charges,38% of total billed charges,994.99,38,,,percent of total billed charges,38% of total billed charges,2225.64,85,,,percent of total billed charges,85% of total billed charges,994.99,38,,,percent of total billed charges,38% of total billed charges,2131.38,81.4,,,percent of total billed charges,81.4% of total billed charges,2356.56,90,,,percent of total billed charges,90% of total billed charges,2356.56,90,,,percent of total billed charges,90% of total billed charges,994.99,38,,,percent of total billed charges,38% of total billed charges,994.99,38,,,percent of total billed charges,38% of total billed charges,994.99,38,,,percent of total billed charges,38% of total billed charges,1963.8,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,994.99,2435.11,
MRI Abd w/ contrast,3748,CDM,610,RC,74182,HCPCS,outpatient,,,3461.43,2596.07,,3115.29,90,,,percent of total billed charges,90% of total billed charges,3219.13,93,,,percent of total billed charges,93% of total billed charges,1315.34,38,,,percent of total billed charges,38% of total billed charges,1315.34,38,,,percent of total billed charges,38% of total billed charges,2942.22,85,,,percent of total billed charges,85% of total billed charges,1315.34,38,,,percent of total billed charges,38% of total billed charges,2817.6,81.4,,,percent of total billed charges,81.4% of total billed charges,3115.29,90,,,percent of total billed charges,90% of total billed charges,3115.29,90,,,percent of total billed charges,90% of total billed charges,1315.34,38,,,percent of total billed charges,38% of total billed charges,1315.34,38,,,percent of total billed charges,38% of total billed charges,1315.34,38,,,percent of total billed charges,38% of total billed charges,2596.07,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1315.34,3219.13,
"MRI Abd w, w/o contrast",3749,CDM,610,RC,74183,HCPCS,outpatient,,,4299.26,3224.45,,3869.33,90,,,percent of total billed charges,90% of total billed charges,3998.31,93,,,percent of total billed charges,93% of total billed charges,1633.72,38,,,percent of total billed charges,38% of total billed charges,1633.72,38,,,percent of total billed charges,38% of total billed charges,3654.37,85,,,percent of total billed charges,85% of total billed charges,1633.72,38,,,percent of total billed charges,38% of total billed charges,3499.6,81.4,,,percent of total billed charges,81.4% of total billed charges,3869.33,90,,,percent of total billed charges,90% of total billed charges,3869.33,90,,,percent of total billed charges,90% of total billed charges,1633.72,38,,,percent of total billed charges,38% of total billed charges,1633.72,38,,,percent of total billed charges,38% of total billed charges,1633.72,38,,,percent of total billed charges,38% of total billed charges,3224.45,75,,,percent of total billed charges,75% of total billed charges,1613,100,,,case rate,100% of UHC case rate,1613,3998.31,
Code Status,3754,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
NG Tube insertion,3758,CDM,761,RC,43752,HCPCS,outpatient,,,208.57,156.43,,187.71,90,,,percent of total billed charges,90% of total billed charges,193.97,93,,,percent of total billed charges,93% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,79.26,38,,,percent of total billed charges,38% of total billed charges,169.78,81.4,,,percent of total billed charges,81.4% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,156.43,75,,,percent of total billed charges,75% of total billed charges,177.28,85,,,percent of total billed charges,85% of total billed charges,79.26,193.97,
Observation initial -mod /hr facility,3759,CDM,762,RC,99222,HCPCS,outpatient,,,79.07,59.3,,71.16,90,,,percent of total billed charges,90% of total billed charges,73.54,93,,,percent of total billed charges,93% of total billed charges,30.05,38,,,percent of total billed charges,38% of total billed charges,30.05,38,,,percent of total billed charges,38% of total billed charges,67.21,85,,,percent of total billed charges,85% of total billed charges,30.05,38,,,percent of total billed charges,38% of total billed charges,64.36,81.4,,,percent of total billed charges,81.4% of total billed charges,71.16,90,,,percent of total billed charges,90% of total billed charges,71.16,90,,,percent of total billed charges,90% of total billed charges,30.05,38,,,percent of total billed charges,38% of total billed charges,30.05,38,,,percent of total billed charges,38% of total billed charges,30.05,38,,,percent of total billed charges,38% of total billed charges,59.3,75,,,percent of total billed charges,75% of total billed charges,67.21,85,,,percent of total billed charges,85% of total billed charges,30.05,73.54,
Same day IP admit/discharge -low PRO,3760,CDM,987,RC,99234,HCPCS,outpatient,,,356.21,267.16,,174.79,130,,,fee schedule,130% of fee schedule,174.79,130,,,fee schedule,130% of fee schedule,99.3,100,,,fee schedule,Pays 100% Medicare OPPS,99.3,100,,,fee schedule,Pays 100% Medicare OPPS,162.46,119,,,fee schedule,119% of fee schedule,99.3,100,,,fee schedule,Pays 100% Medicare OPPS,99.3,100,,,fee schedule,100% of fee schedule,320.59,90,,,percent of total billed charges,90% of total billed charges,99.3,100,,,fee schedule,Pays 100% Medicare OPPS,99.3,100,,,fee schedule,Pays 100% Medicare OPPS,99.3,100,,,fee schedule,Pays 100% Medicare OPPS,99.3,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,99.3,100,,,fee schedule,100% of fee schedule,99.3,320.59,
Discharge OBS Care >30,3761,CDM,987,RC,99239,HCPCS,outpatient,,,172.71,129.53,,138.05,130,,,fee schedule,130% of fee schedule,138.05,130,,,fee schedule,130% of fee schedule,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,130.63,119,,,fee schedule,119% of fee schedule,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,100% of fee schedule,155.44,90,,,percent of total billed charges,90% of total billed charges,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,179.75,100,,,fee schedule,100% of fee schedule,115.88,100,,,fee schedule,100% of fee schedule,115.88,179.75,
Observation facility mod per hr,3762,CDM,762,RC,G0378,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
Observation facility mod per hr,3763,CDM,762,RC,G0378,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
Observation facility mod per hr,3764,CDM,762,RC,G0378,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
OT eval-low,3766,CDM,434,RC,95165,HCPCS,outpatient,,,157.66,118.25,,141.89,90,,,percent of total billed charges,90% of total billed charges,146.62,93,,,percent of total billed charges,93% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,128.34,81.4,,,percent of total billed charges,81.4% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,118.25,75,,,percent of total billed charges,75% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,146.62,
OT evaluation,3767,CDM,430,RC,97003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
OT evaluation,3768,CDM,430,RC,97003,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
OT therapeutic exercises,3769,CDM,430,RC,97110,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
OT Neuromuscular Re-ed,3770,CDM,434,RC,97112,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
OT Manual,3771,CDM,430,RC,97140,HCPCS,outpatient,,,64.44,48.33,,58,90,,,percent of total billed charges,90% of total billed charges,59.93,93,,,percent of total billed charges,93% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,52.45,81.4,,,percent of total billed charges,81.4% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,48.33,75,,,percent of total billed charges,75% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,59.93,
OT Eval-mod,3772,CDM,434,RC,97166,HCPCS,outpatient,,,180.18,135.14,,162.16,90,,,percent of total billed charges,90% of total billed charges,167.57,93,,,percent of total billed charges,93% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,153.15,85,,,percent of total billed charges,85% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,146.67,81.4,,,percent of total billed charges,81.4% of total billed charges,162.16,90,,,percent of total billed charges,90% of total billed charges,162.16,90,,,percent of total billed charges,90% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,68.47,38,,,percent of total billed charges,38% of total billed charges,135.14,75,,,percent of total billed charges,75% of total billed charges,153.15,85,,,percent of total billed charges,85% of total billed charges,68.47,167.57,
OT eval -high,3773,CDM,434,RC,97167,HCPCS,outpatient,,,185.81,139.36,,167.23,90,,,percent of total billed charges,90% of total billed charges,172.8,93,,,percent of total billed charges,93% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,157.94,85,,,percent of total billed charges,85% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,151.25,81.4,,,percent of total billed charges,81.4% of total billed charges,167.23,90,,,percent of total billed charges,90% of total billed charges,167.23,90,,,percent of total billed charges,90% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,70.61,38,,,percent of total billed charges,38% of total billed charges,139.36,75,,,percent of total billed charges,75% of total billed charges,157.94,85,,,percent of total billed charges,85% of total billed charges,70.61,172.8,
OT re-evaluation,3774,CDM,434,RC,97168,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
OT TherapeuticActivities,3775,CDM,430,RC,97530,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
OT TherapeuticActivities,3776,CDM,430,RC,97530,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
CARDIAC REHABILIATION-OP,3777,CDM,943,RC,93798,HCPCS,outpatient,,,82.8,62.1,,74.52,90,,,percent of total billed charges,90% of total billed charges,77,93,,,percent of total billed charges,93% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,70.38,85,,,percent of total billed charges,85% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,67.4,81.4,,,percent of total billed charges,81.4% of total billed charges,74.52,90,,,percent of total billed charges,90% of total billed charges,74.52,90,,,percent of total billed charges,90% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,31.46,38,,,percent of total billed charges,38% of total billed charges,62.1,75,,,percent of total billed charges,75% of total billed charges,70.38,85,,,percent of total billed charges,85% of total billed charges,31.46,77,
6-minute walk test,3778,CDM,482,RC,94618,HCPCS,outpatient,,,189.42,142.07,,170.48,90,,,percent of total billed charges,90% of total billed charges,176.16,93,,,percent of total billed charges,93% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,161.01,85,,,percent of total billed charges,85% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,154.19,81.4,,,percent of total billed charges,81.4% of total billed charges,170.48,90,,,percent of total billed charges,90% of total billed charges,170.48,90,,,percent of total billed charges,90% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,71.98,38,,,percent of total billed charges,38% of total billed charges,142.07,75,,,percent of total billed charges,75% of total billed charges,161.01,85,,,percent of total billed charges,85% of total billed charges,71.98,176.16,
GER consult EXT,3780,CDM,988,RC,99214,HCPCS,outpatient,,,255,191.25,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,229.5,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,229.5,
GER CONSULT EXT+,3781,CDM,988,RC,99215,HCPCS,outpatient,,,341.7,256.28,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,307.53,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,307.53,
GER prolonged serv no contact,3782,CDM,988,RC,99358,HCPCS,outpatient,,,345.78,259.34,,142.14,130,,,fee schedule,130% of fee schedule,142.14,130,,,fee schedule,130% of fee schedule,91.42,100,,,fee schedule,Pays 100% Medicare OPPS,91.42,100,,,fee schedule,Pays 100% Medicare OPPS,136.05,119,,,fee schedule,119% of fee schedule,91.42,100,,,fee schedule,Pays 100% Medicare OPPS,91.42,100,,,fee schedule,100% of fee schedule,311.2,90,,,percent of total billed charges,90% of total billed charges,91.42,100,,,fee schedule,Pays 100% Medicare OPPS,91.42,100,,,fee schedule,Pays 100% Medicare OPPS,91.42,100,,,fee schedule,Pays 100% Medicare OPPS,91.42,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,91.42,100,,,fee schedule,100% of fee schedule,91.42,311.2,
"GER ASSMT care plan, cog imp",3783,CDM,988,RC,99483,HCPCS,outpatient,,,552.84,414.63,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,195.79,100,,,fee schedule,Pays 100% Medicare OPPS,195.79,100,,,fee schedule,Pays 100% Medicare OPPS,220.95,119,,,fee schedule,119% of fee schedule,195.79,100,,,fee schedule,Pays 100% Medicare OPPS,195.79,100,,,fee schedule,100% of fee schedule,497.56,90,,,percent of total billed charges,90% of total billed charges,195.79,100,,,fee schedule,Pays 100% Medicare OPPS,195.79,100,,,fee schedule,Pays 100% Medicare OPPS,195.79,100,,,fee schedule,Pays 100% Medicare OPPS,195.79,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,195.79,100,,,fee schedule,100% of fee schedule,195.79,497.56,
GER ADV CARE Plan 1st 30,3784,CDM,988,RC,99497,HCPCS,outpatient,,,153,114.75,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,96.31,119,,,fee schedule,119% of fee schedule,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,100% of fee schedule,137.7,90,,,percent of total billed charges,90% of total billed charges,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,76.2,100,,,fee schedule,100% of fee schedule,76.2,137.7,
GER ADV CARE Plan 1st 30,3785,CDM,988,RC,99497,HCPCS,outpatient,,,153,114.75,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,96.31,119,,,fee schedule,119% of fee schedule,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,100% of fee schedule,137.7,90,,,percent of total billed charges,90% of total billed charges,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,76.2,100,,,fee schedule,100% of fee schedule,76.2,137.7,
GER Adv Care plan addt 30min,3786,CDM,988,RC,99498,HCPCS,outpatient,,,127.5,95.63,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,90.68,119,,,fee schedule,119% of fee schedule,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,100% of fee schedule,114.75,90,,,percent of total billed charges,90% of total billed charges,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,72.08,100,,,fee schedule,100% of fee schedule,72.08,114.75,
GER Adv Care plan addt 30min,3787,CDM,988,RC,99498,HCPCS,outpatient,,,127.5,95.63,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,90.68,119,,,fee schedule,119% of fee schedule,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,100% of fee schedule,114.75,90,,,percent of total billed charges,90% of total billed charges,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,72.08,100,,,fee schedule,100% of fee schedule,72.08,114.75,
GER Annual Wellness V,3788,CDM,988,RC,G0438,HCPCS,outpatient,,,336.6,252.45,,212.04,130,,,fee schedule,130% of fee schedule,212.04,130,,,fee schedule,130% of fee schedule,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,208.33,119,,,fee schedule,119% of fee schedule,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,100% of fee schedule,302.94,90,,,percent of total billed charges,90% of total billed charges,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,169.19,100,,,fee schedule,100% of fee schedule,169.19,302.94,
GER Annual Wellness V,3789,CDM,988,RC,G0438,HCPCS,outpatient,,,336.6,252.45,,212.04,130,,,fee schedule,130% of fee schedule,212.04,130,,,fee schedule,130% of fee schedule,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,208.33,119,,,fee schedule,119% of fee schedule,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,100% of fee schedule,302.94,90,,,percent of total billed charges,90% of total billed charges,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,169.19,100,,,fee schedule,100% of fee schedule,169.19,302.94,
GER AWV-subs,3790,CDM,988,RC,G0439,HCPCS,outpatient,,,265.2,198.9,,141.82,130,,,fee schedule,130% of fee schedule,141.82,130,,,fee schedule,130% of fee schedule,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,141.55,119,,,fee schedule,119% of fee schedule,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,100% of fee schedule,238.68,90,,,percent of total billed charges,90% of total billed charges,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,132.67,100,,,fee schedule,100% of fee schedule,132.67,238.68,
GER AWV-subs,3791,CDM,988,RC,G0439,HCPCS,outpatient,,,265.2,198.9,,141.82,130,,,fee schedule,130% of fee schedule,141.82,130,,,fee schedule,130% of fee schedule,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,141.55,119,,,fee schedule,119% of fee schedule,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,100% of fee schedule,238.68,90,,,percent of total billed charges,90% of total billed charges,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,132.67,100,,,fee schedule,100% of fee schedule,132.67,238.68,
GER depression annual screening Medicare,3792,CDM,988,RC,G0444,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,11.66,119,,,fee schedule,119% of fee schedule,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,9.24,100,,,fee schedule,100% of fee schedule,9.24,36.72,
GER depression annual screening Medicare,3793,CDM,988,RC,G0444,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,11.66,119,,,fee schedule,119% of fee schedule,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,9.24,100,,,fee schedule,100% of fee schedule,9.24,36.72,
WND I&D Abcess Simple FAC,3794,CDM,761,RC,10060,HCPCS,outpatient,,,263.65,197.74,,237.29,90,,,percent of total billed charges,90% of total billed charges,245.19,93,,,percent of total billed charges,93% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,100.19,38,,,percent of total billed charges,38% of total billed charges,214.61,81.4,,,percent of total billed charges,81.4% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,197.74,75,,,percent of total billed charges,75% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,245.19,
WND I&D multi/complex-Fac,3795,CDM,761,RC,10061,HCPCS,outpatient,,,438.24,328.68,,394.42,90,,,percent of total billed charges,90% of total billed charges,407.56,93,,,percent of total billed charges,93% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,166.53,38,,,percent of total billed charges,38% of total billed charges,356.73,81.4,,,percent of total billed charges,81.4% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,328.68,75,,,percent of total billed charges,75% of total billed charges,372.5,85,,,percent of total billed charges,85% of total billed charges,166.53,407.56,
WND Drain pilonidal cyst-simple FAC,3796,CDM,761,RC,10080,HCPCS,outpatient,,,698.22,523.67,,628.4,90,,,percent of total billed charges,90% of total billed charges,649.34,93,,,percent of total billed charges,93% of total billed charges,265.32,38,,,percent of total billed charges,38% of total billed charges,265.32,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,265.32,38,,,percent of total billed charges,38% of total billed charges,568.35,81.4,,,percent of total billed charges,81.4% of total billed charges,628.4,90,,,percent of total billed charges,90% of total billed charges,628.4,90,,,percent of total billed charges,90% of total billed charges,265.32,38,,,percent of total billed charges,38% of total billed charges,265.32,38,,,percent of total billed charges,38% of total billed charges,265.32,38,,,percent of total billed charges,38% of total billed charges,523.67,75,,,percent of total billed charges,75% of total billed charges,593.49,85,,,percent of total billed charges,85% of total billed charges,265.32,649.34,
WND FB remove/incision-PRO,3797,CDM,982,RC,10120,HCPCS,outpatient,,,115.92,86.94,,122.29,130,,,fee schedule,130% of fee schedule,122.29,130,,,fee schedule,130% of fee schedule,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,127.98,119,,,fee schedule,119% of fee schedule,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,100% of fee schedule,104.33,90,,,percent of total billed charges,90% of total billed charges,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,108.4,100,,,fee schedule,100% of fee schedule,71.86,127.98,
WND FB remove/incision-FAC,3798,CDM,761,RC,10120,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,154.02,
WND I&D hematoma/fluid-Fac,3799,CDM,761,RC,10140,HCPCS,outpatient,,,2057.64,1543.23,,1851.88,90,,,percent of total billed charges,90% of total billed charges,1913.61,93,,,percent of total billed charges,93% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,781.9,38,,,percent of total billed charges,38% of total billed charges,1674.92,81.4,,,percent of total billed charges,81.4% of total billed charges,1851.88,90,,,percent of total billed charges,90% of total billed charges,1851.88,90,,,percent of total billed charges,90% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,781.9,38,,,percent of total billed charges,38% of total billed charges,1543.23,75,,,percent of total billed charges,75% of total billed charges,1748.99,85,,,percent of total billed charges,85% of total billed charges,781.9,1913.61,
WND Punct. drainage-FAC,3800,CDM,761,RC,10160,HCPCS,outpatient,,,274.79,206.09,,247.31,90,,,percent of total billed charges,90% of total billed charges,255.55,93,,,percent of total billed charges,93% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,104.42,38,,,percent of total billed charges,38% of total billed charges,223.68,81.4,,,percent of total billed charges,81.4% of total billed charges,247.31,90,,,percent of total billed charges,90% of total billed charges,247.31,90,,,percent of total billed charges,90% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,206.09,75,,,percent of total billed charges,75% of total billed charges,233.57,85,,,percent of total billed charges,85% of total billed charges,104.42,255.55,
WND Deb infected skin-FAC,3801,CDM,761,RC,11000,HCPCS,outpatient,,,337.84,253.38,,304.06,90,,,percent of total billed charges,90% of total billed charges,314.19,93,,,percent of total billed charges,93% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,128.38,38,,,percent of total billed charges,38% of total billed charges,275,81.4,,,percent of total billed charges,81.4% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,253.38,75,,,percent of total billed charges,75% of total billed charges,287.16,85,,,percent of total billed charges,85% of total billed charges,128.38,314.19,
WND Deb sq tissue 20 cm2/< FAC,3802,CDM,761,RC,11042,HCPCS,outpatient,,,405.41,304.06,,364.87,90,,,percent of total billed charges,90% of total billed charges,377.03,93,,,percent of total billed charges,93% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,154.06,38,,,percent of total billed charges,38% of total billed charges,330,81.4,,,percent of total billed charges,81.4% of total billed charges,364.87,90,,,percent of total billed charges,90% of total billed charges,364.87,90,,,percent of total billed charges,90% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,304.06,75,,,percent of total billed charges,75% of total billed charges,344.6,85,,,percent of total billed charges,85% of total billed charges,154.06,377.03,
Debridement - Skin 20 Sq cm or< PRO,3803,CDM,982,RC,11042,HCPCS,outpatient,,,406.06,304.55,,67.16,130,,,fee schedule,130% of fee schedule,67.16,130,,,fee schedule,130% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,75.54,119,,,fee schedule,119% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,100% of fee schedule,365.45,90,,,percent of total billed charges,90% of total billed charges,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,60.41,100,,,fee schedule,100% of fee schedule,60.41,365.45,
Debridement - Skin 20 Sq cm or< PRO,3804,CDM,982,RC,11042,HCPCS,outpatient,,,406.06,304.55,,67.16,130,,,fee schedule,130% of fee schedule,67.16,130,,,fee schedule,130% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,75.54,119,,,fee schedule,119% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,100% of fee schedule,365.45,90,,,percent of total billed charges,90% of total billed charges,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,60.41,100,,,fee schedule,100% of fee schedule,60.41,365.45,
Debridement - Skin 20 Sq cm or< PRO,3805,CDM,982,RC,11042,HCPCS,outpatient,,,406.06,304.55,,67.16,130,,,fee schedule,130% of fee schedule,67.16,130,,,fee schedule,130% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,75.54,119,,,fee schedule,119% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,100% of fee schedule,365.45,90,,,percent of total billed charges,90% of total billed charges,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,60.41,100,,,fee schedule,100% of fee schedule,60.41,365.45,
Debridement - Skin 20 Sq cm or< PRO,3806,CDM,982,RC,11042,HCPCS,outpatient,,,406.06,304.55,,67.16,130,,,fee schedule,130% of fee schedule,67.16,130,,,fee schedule,130% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,75.54,119,,,fee schedule,119% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,100% of fee schedule,365.45,90,,,percent of total billed charges,90% of total billed charges,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,60.41,100,,,fee schedule,100% of fee schedule,60.41,365.45,
Debridement - Skin 20 Sq cm or< PRO,3807,CDM,982,RC,11042,HCPCS,outpatient,,,406.06,304.55,,67.16,130,,,fee schedule,130% of fee schedule,67.16,130,,,fee schedule,130% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,75.54,119,,,fee schedule,119% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,100% of fee schedule,365.45,90,,,percent of total billed charges,90% of total billed charges,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,60.41,100,,,fee schedule,100% of fee schedule,60.41,365.45,
"WND Deb Mus/fascia <20cm2,-FAC",3808,CDM,761,RC,11043,HCPCS,outpatient,,,506.77,380.08,,456.09,90,,,percent of total billed charges,90% of total billed charges,471.3,93,,,percent of total billed charges,93% of total billed charges,192.57,38,,,percent of total billed charges,38% of total billed charges,192.57,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,192.57,38,,,percent of total billed charges,38% of total billed charges,412.51,81.4,,,percent of total billed charges,81.4% of total billed charges,456.09,90,,,percent of total billed charges,90% of total billed charges,456.09,90,,,percent of total billed charges,90% of total billed charges,192.57,38,,,percent of total billed charges,38% of total billed charges,192.57,38,,,percent of total billed charges,38% of total billed charges,192.57,38,,,percent of total billed charges,38% of total billed charges,380.08,75,,,percent of total billed charges,75% of total billed charges,430.75,85,,,percent of total billed charges,85% of total billed charges,192.57,471.3,
WND Deb Bone <20cm/<-FAC,3809,CDM,761,RC,11044,HCPCS,outpatient,,,1013.54,760.16,,912.19,90,,,percent of total billed charges,90% of total billed charges,942.59,93,,,percent of total billed charges,93% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,385.15,38,,,percent of total billed charges,38% of total billed charges,825.02,81.4,,,percent of total billed charges,81.4% of total billed charges,912.19,90,,,percent of total billed charges,90% of total billed charges,912.19,90,,,percent of total billed charges,90% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,760.16,75,,,percent of total billed charges,75% of total billed charges,861.51,85,,,percent of total billed charges,85% of total billed charges,385.15,942.59,
WND Deb subq add on 20 sq cm FAC,3810,CDM,761,RC,11045,HCPCS,outpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,21.82,38,,,percent of total billed charges,38% of total billed charges,46.75,81.4,,,percent of total billed charges,81.4% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.07,75,,,percent of total billed charges,75% of total billed charges,48.82,85,,,percent of total billed charges,85% of total billed charges,21.82,53.41,
WND Deb mus/fascia add-on FAC,3811,CDM,761,RC,11046,HCPCS,outpatient,,,551.83,413.87,,496.65,90,,,percent of total billed charges,90% of total billed charges,513.2,93,,,percent of total billed charges,93% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,209.7,38,,,percent of total billed charges,38% of total billed charges,449.19,81.4,,,percent of total billed charges,81.4% of total billed charges,496.65,90,,,percent of total billed charges,90% of total billed charges,496.65,90,,,percent of total billed charges,90% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,209.7,38,,,percent of total billed charges,38% of total billed charges,413.87,75,,,percent of total billed charges,75% of total billed charges,469.06,85,,,percent of total billed charges,85% of total billed charges,209.7,513.2,
WND Deb bone add-on FAC,3812,CDM,761,RC,11047,HCPCS,outpatient,,,1520.32,1140.24,,1368.29,90,,,percent of total billed charges,90% of total billed charges,1413.9,93,,,percent of total billed charges,93% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,577.72,38,,,percent of total billed charges,38% of total billed charges,1237.54,81.4,,,percent of total billed charges,81.4% of total billed charges,1368.29,90,,,percent of total billed charges,90% of total billed charges,1368.29,90,,,percent of total billed charges,90% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,577.72,38,,,percent of total billed charges,38% of total billed charges,1140.24,75,,,percent of total billed charges,75% of total billed charges,1292.27,85,,,percent of total billed charges,85% of total billed charges,577.72,1413.9,
WND Trim skin lesion FAC,3813,CDM,761,RC,11055,HCPCS,outpatient,,,35.15,26.36,,31.64,90,,,percent of total billed charges,90% of total billed charges,32.69,93,,,percent of total billed charges,93% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,13.36,38,,,percent of total billed charges,38% of total billed charges,28.61,81.4,,,percent of total billed charges,81.4% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,26.36,75,,,percent of total billed charges,75% of total billed charges,29.88,85,,,percent of total billed charges,85% of total billed charges,13.36,32.69,
WND Trim skin.Lesion; 2-4-FAC,3814,CDM,761,RC,11056,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
WND BIOPSY-tangential (scrape) FAC,3815,CDM,761,RC,11102,HCPCS,outpatient,,,220.81,165.61,,198.73,90,,,percent of total billed charges,90% of total billed charges,205.35,93,,,percent of total billed charges,93% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,83.91,38,,,percent of total billed charges,38% of total billed charges,179.74,81.4,,,percent of total billed charges,81.4% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,165.61,75,,,percent of total billed charges,75% of total billed charges,187.69,85,,,percent of total billed charges,85% of total billed charges,83.91,205.35,
WND Biopsy tangential ea add FAC,3816,CDM,761,RC,11103,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,51.34,
WND Biopsy Punch-Fac,3817,CDM,761,RC,11104,HCPCS,outpatient,,,242.9,182.18,,218.61,90,,,percent of total billed charges,90% of total billed charges,225.9,93,,,percent of total billed charges,93% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,92.3,38,,,percent of total billed charges,38% of total billed charges,197.72,81.4,,,percent of total billed charges,81.4% of total billed charges,218.61,90,,,percent of total billed charges,90% of total billed charges,218.61,90,,,percent of total billed charges,90% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,182.18,75,,,percent of total billed charges,75% of total billed charges,206.47,85,,,percent of total billed charges,85% of total billed charges,92.3,225.9,
WND Biopsy punch each add Fac,3818,CDM,761,RC,11105,HCPCS,outpatient,,,88.32,66.24,,79.49,90,,,percent of total billed charges,90% of total billed charges,82.14,93,,,percent of total billed charges,93% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,33.56,38,,,percent of total billed charges,38% of total billed charges,71.89,81.4,,,percent of total billed charges,81.4% of total billed charges,79.49,90,,,percent of total billed charges,90% of total billed charges,79.49,90,,,percent of total billed charges,90% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,66.24,75,,,percent of total billed charges,75% of total billed charges,75.07,85,,,percent of total billed charges,85% of total billed charges,33.56,82.14,
WND Biopsy Incisional Facility,3819,CDM,761,RC,11106,HCPCS,outpatient,,,331.22,248.42,,298.1,90,,,percent of total billed charges,90% of total billed charges,308.03,93,,,percent of total billed charges,93% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,125.86,38,,,percent of total billed charges,38% of total billed charges,269.61,81.4,,,percent of total billed charges,81.4% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,248.42,75,,,percent of total billed charges,75% of total billed charges,281.54,85,,,percent of total billed charges,85% of total billed charges,125.86,308.03,
WND Biopsy incisional ea add FAC,3820,CDM,761,RC,11107,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,154.02,
"WND Shave-Benign, Skin Tags1-15-FAC",3821,CDM,761,RC,11200,HCPCS,outpatient,,,135.15,101.36,,121.64,90,,,percent of total billed charges,90% of total billed charges,125.69,93,,,percent of total billed charges,93% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,51.36,38,,,percent of total billed charges,38% of total billed charges,110.01,81.4,,,percent of total billed charges,81.4% of total billed charges,121.64,90,,,percent of total billed charges,90% of total billed charges,121.64,90,,,percent of total billed charges,90% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,101.36,75,,,percent of total billed charges,75% of total billed charges,114.88,85,,,percent of total billed charges,85% of total billed charges,51.36,125.69,
"WND Shave, B9;Each Additional 10 FAC",3822,CDM,761,RC,11201,HCPCS,outpatient,,,28.15,21.11,,25.34,90,,,percent of total billed charges,90% of total billed charges,26.18,93,,,percent of total billed charges,93% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,10.7,38,,,percent of total billed charges,38% of total billed charges,22.91,81.4,,,percent of total billed charges,81.4% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,21.11,75,,,percent of total billed charges,75% of total billed charges,23.93,85,,,percent of total billed charges,85% of total billed charges,10.7,26.18,
"WND Excise B9 (tr,a,l) Lesion .5cm-<,-FAC",3823,CDM,761,RC,11400,HCPCS,outpatient,,,495.53,371.65,,445.98,90,,,percent of total billed charges,90% of total billed charges,460.84,93,,,percent of total billed charges,93% of total billed charges,188.3,38,,,percent of total billed charges,38% of total billed charges,188.3,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,188.3,38,,,percent of total billed charges,38% of total billed charges,403.36,81.4,,,percent of total billed charges,81.4% of total billed charges,445.98,90,,,percent of total billed charges,90% of total billed charges,445.98,90,,,percent of total billed charges,90% of total billed charges,188.3,38,,,percent of total billed charges,38% of total billed charges,188.3,38,,,percent of total billed charges,38% of total billed charges,188.3,38,,,percent of total billed charges,38% of total billed charges,371.65,75,,,percent of total billed charges,75% of total billed charges,421.2,85,,,percent of total billed charges,85% of total billed charges,188.3,460.84,
"WND Excise B9(tr,a,l) Lesion .6 to 1cm-FAC",3824,CDM,761,RC,11401,HCPCS,outpatient,,,270.28,202.71,,243.25,90,,,percent of total billed charges,90% of total billed charges,251.36,93,,,percent of total billed charges,93% of total billed charges,102.71,38,,,percent of total billed charges,38% of total billed charges,102.71,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,102.71,38,,,percent of total billed charges,38% of total billed charges,220.01,81.4,,,percent of total billed charges,81.4% of total billed charges,243.25,90,,,percent of total billed charges,90% of total billed charges,243.25,90,,,percent of total billed charges,90% of total billed charges,102.71,38,,,percent of total billed charges,38% of total billed charges,102.71,38,,,percent of total billed charges,38% of total billed charges,102.71,38,,,percent of total billed charges,38% of total billed charges,202.71,75,,,percent of total billed charges,75% of total billed charges,229.74,85,,,percent of total billed charges,85% of total billed charges,102.71,251.36,
"WND Excise B9(tr,a,l) 1 to 2cm-FAC",3825,CDM,761,RC,11402,HCPCS,outpatient,,,337.84,253.38,,304.06,90,,,percent of total billed charges,90% of total billed charges,314.19,93,,,percent of total billed charges,93% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,128.38,38,,,percent of total billed charges,38% of total billed charges,275,81.4,,,percent of total billed charges,81.4% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,253.38,75,,,percent of total billed charges,75% of total billed charges,287.16,85,,,percent of total billed charges,85% of total billed charges,128.38,314.19,
"WND Excise B9(tr,a,l)2.1-3cm-FAC",3826,CDM,761,RC,11403,HCPCS,outpatient,,,450.46,337.85,,405.41,90,,,percent of total billed charges,90% of total billed charges,418.93,93,,,percent of total billed charges,93% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,171.17,38,,,percent of total billed charges,38% of total billed charges,366.67,81.4,,,percent of total billed charges,81.4% of total billed charges,405.41,90,,,percent of total billed charges,90% of total billed charges,405.41,90,,,percent of total billed charges,90% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,337.85,75,,,percent of total billed charges,75% of total billed charges,382.89,85,,,percent of total billed charges,85% of total billed charges,171.17,418.93,
"WND Excise B9(tr,a,l)3.1-4cm-FAC",3827,CDM,761,RC,11404,HCPCS,outpatient,,,900.94,675.71,,810.85,90,,,percent of total billed charges,90% of total billed charges,837.87,93,,,percent of total billed charges,93% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,342.36,38,,,percent of total billed charges,38% of total billed charges,733.37,81.4,,,percent of total billed charges,81.4% of total billed charges,810.85,90,,,percent of total billed charges,90% of total billed charges,810.85,90,,,percent of total billed charges,90% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,342.36,38,,,percent of total billed charges,38% of total billed charges,675.71,75,,,percent of total billed charges,75% of total billed charges,765.8,85,,,percent of total billed charges,85% of total billed charges,342.36,837.87,
"WND Excise B9(tr,a,l)>4.0cm-FAC",3828,CDM,761,RC,11406,HCPCS,outpatient,,,1126.16,844.62,,1013.54,90,,,percent of total billed charges,90% of total billed charges,1047.33,93,,,percent of total billed charges,93% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,427.94,38,,,percent of total billed charges,38% of total billed charges,916.69,81.4,,,percent of total billed charges,81.4% of total billed charges,1013.54,90,,,percent of total billed charges,90% of total billed charges,1013.54,90,,,percent of total billed charges,90% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,844.62,75,,,percent of total billed charges,75% of total billed charges,957.24,85,,,percent of total billed charges,85% of total billed charges,427.94,1047.33,
"WND Excise B9(sc,n,ha,fe,g);.5cm or<-FAC",3829,CDM,761,RC,11420,HCPCS,outpatient,,,157.66,118.25,,141.89,90,,,percent of total billed charges,90% of total billed charges,146.62,93,,,percent of total billed charges,93% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,59.91,38,,,percent of total billed charges,38% of total billed charges,128.34,81.4,,,percent of total billed charges,81.4% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,141.89,90,,,percent of total billed charges,90% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,59.91,38,,,percent of total billed charges,38% of total billed charges,118.25,75,,,percent of total billed charges,75% of total billed charges,134.01,85,,,percent of total billed charges,85% of total billed charges,59.91,146.62,
"WND Excise B9(sc,n,ha,fe,g) .6 to 1.cm-FAC",3830,CDM,761,RC,11421,HCPCS,outpatient,,,225.23,168.92,,202.71,90,,,percent of total billed charges,90% of total billed charges,209.46,93,,,percent of total billed charges,93% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,85.59,38,,,percent of total billed charges,38% of total billed charges,183.34,81.4,,,percent of total billed charges,81.4% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,168.92,75,,,percent of total billed charges,75% of total billed charges,191.45,85,,,percent of total billed charges,85% of total billed charges,85.59,209.46,
"WND Exc B9(head,neck,ext, gen) 1.1-2cm Fac",3831,CDM,761,RC,11422,HCPCS,outpatient,,,563.07,422.3,,506.76,90,,,percent of total billed charges,90% of total billed charges,523.66,93,,,percent of total billed charges,93% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,213.97,38,,,percent of total billed charges,38% of total billed charges,458.34,81.4,,,percent of total billed charges,81.4% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,422.3,75,,,percent of total billed charges,75% of total billed charges,478.61,85,,,percent of total billed charges,85% of total billed charges,213.97,523.66,
"WND Exc B9(sc,n,ha,fe,g) 2.1 to 3cm-FAC",3832,CDM,761,RC,11423,HCPCS,outpatient,,,1126.16,844.62,,1013.54,90,,,percent of total billed charges,90% of total billed charges,1047.33,93,,,percent of total billed charges,93% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,427.94,38,,,percent of total billed charges,38% of total billed charges,916.69,81.4,,,percent of total billed charges,81.4% of total billed charges,1013.54,90,,,percent of total billed charges,90% of total billed charges,1013.54,90,,,percent of total billed charges,90% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,427.94,38,,,percent of total billed charges,38% of total billed charges,844.62,75,,,percent of total billed charges,75% of total billed charges,957.24,85,,,percent of total billed charges,85% of total billed charges,427.94,1047.33,
"WND Exc B9(sc,n,ha,fe,g)3.1-4cm FAC",3833,CDM,761,RC,11424,HCPCS,outpatient,,,1351.4,1013.55,,1216.26,90,,,percent of total billed charges,90% of total billed charges,1256.8,93,,,percent of total billed charges,93% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,513.53,38,,,percent of total billed charges,38% of total billed charges,1100.04,81.4,,,percent of total billed charges,81.4% of total billed charges,1216.26,90,,,percent of total billed charges,90% of total billed charges,1216.26,90,,,percent of total billed charges,90% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,513.53,38,,,percent of total billed charges,38% of total billed charges,1013.55,75,,,percent of total billed charges,75% of total billed charges,1148.69,85,,,percent of total billed charges,85% of total billed charges,513.53,1256.8,
WND Excis B9 Face .5cm/<-FAC,3834,CDM,761,RC,11440,HCPCS,outpatient,,,168.92,126.69,,152.03,90,,,percent of total billed charges,90% of total billed charges,157.1,93,,,percent of total billed charges,93% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,64.19,38,,,percent of total billed charges,38% of total billed charges,137.5,81.4,,,percent of total billed charges,81.4% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,126.69,75,,,percent of total billed charges,75% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,157.1,
WND Excis B9(Face);0.6-1.cm-FAC,3835,CDM,761,RC,11441,HCPCS,outpatient,,,225.23,168.92,,202.71,90,,,percent of total billed charges,90% of total billed charges,209.46,93,,,percent of total billed charges,93% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,85.59,38,,,percent of total billed charges,38% of total billed charges,183.34,81.4,,,percent of total billed charges,81.4% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,168.92,75,,,percent of total billed charges,75% of total billed charges,191.45,85,,,percent of total billed charges,85% of total billed charges,85.59,209.46,
WND Excis B9(Face);1.1-2cm-FAC,3836,CDM,761,RC,11442,HCPCS,outpatient,,,247.76,185.82,,222.98,90,,,percent of total billed charges,90% of total billed charges,230.42,93,,,percent of total billed charges,93% of total billed charges,94.15,38,,,percent of total billed charges,38% of total billed charges,94.15,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,94.15,38,,,percent of total billed charges,38% of total billed charges,201.68,81.4,,,percent of total billed charges,81.4% of total billed charges,222.98,90,,,percent of total billed charges,90% of total billed charges,222.98,90,,,percent of total billed charges,90% of total billed charges,94.15,38,,,percent of total billed charges,38% of total billed charges,94.15,38,,,percent of total billed charges,38% of total billed charges,94.15,38,,,percent of total billed charges,38% of total billed charges,185.82,75,,,percent of total billed charges,75% of total billed charges,210.6,85,,,percent of total billed charges,85% of total billed charges,94.15,230.42,
WND Excis B9(Face);2.1-3cm-FAC,3837,CDM,761,RC,11443,HCPCS,outpatient,,,848.97,636.73,,764.07,90,,,percent of total billed charges,90% of total billed charges,789.54,93,,,percent of total billed charges,93% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,322.61,38,,,percent of total billed charges,38% of total billed charges,691.06,81.4,,,percent of total billed charges,81.4% of total billed charges,764.07,90,,,percent of total billed charges,90% of total billed charges,764.07,90,,,percent of total billed charges,90% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,322.61,38,,,percent of total billed charges,38% of total billed charges,636.73,75,,,percent of total billed charges,75% of total billed charges,721.62,85,,,percent of total billed charges,85% of total billed charges,322.61,789.54,
"WND Excision,Mal(tr,a,l);2.1-3.0cm-FAC",3838,CDM,761,RC,11603,HCPCS,outpatient,,,876.76,657.57,,789.08,90,,,percent of total billed charges,90% of total billed charges,815.39,93,,,percent of total billed charges,93% of total billed charges,333.17,38,,,percent of total billed charges,38% of total billed charges,333.17,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,333.17,38,,,percent of total billed charges,38% of total billed charges,713.68,81.4,,,percent of total billed charges,81.4% of total billed charges,789.08,90,,,percent of total billed charges,90% of total billed charges,789.08,90,,,percent of total billed charges,90% of total billed charges,333.17,38,,,percent of total billed charges,38% of total billed charges,333.17,38,,,percent of total billed charges,38% of total billed charges,333.17,38,,,percent of total billed charges,38% of total billed charges,657.57,75,,,percent of total billed charges,75% of total billed charges,745.25,85,,,percent of total billed charges,85% of total billed charges,333.17,815.39,
"WND Lesion Rmv malig(tr,ar,le) Fac",3839,CDM,761,RC,11604,HCPCS,outpatient,,,1104.08,828.06,,993.67,90,,,percent of total billed charges,90% of total billed charges,1026.79,93,,,percent of total billed charges,93% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,419.55,38,,,percent of total billed charges,38% of total billed charges,898.72,81.4,,,percent of total billed charges,81.4% of total billed charges,993.67,90,,,percent of total billed charges,90% of total billed charges,993.67,90,,,percent of total billed charges,90% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,828.06,75,,,percent of total billed charges,75% of total billed charges,938.47,85,,,percent of total billed charges,85% of total billed charges,419.55,1026.79,
"WND Lesion Rmv malig(tr,ar,le) PRO",3840,CDM,982,RC,11604,HCPCS,outpatient,,,552.03,414.02,,289,130,,,fee schedule,130% of fee schedule,289,130,,,fee schedule,130% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,264.75,119,,,fee schedule,119% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,100% of fee schedule,496.83,90,,,percent of total billed charges,90% of total billed charges,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,216.44,100,,,fee schedule,100% of fee schedule,201.21,496.83,
WND Debrid Nail 1-5-FAC,3841,CDM,761,RC,11720,HCPCS,outpatient,,,22.52,16.89,,20.27,90,,,percent of total billed charges,90% of total billed charges,20.94,93,,,percent of total billed charges,93% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,8.56,38,,,percent of total billed charges,38% of total billed charges,18.33,81.4,,,percent of total billed charges,81.4% of total billed charges,20.27,90,,,percent of total billed charges,90% of total billed charges,20.27,90,,,percent of total billed charges,90% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,16.89,75,,,percent of total billed charges,75% of total billed charges,19.14,85,,,percent of total billed charges,85% of total billed charges,8.56,20.94,
WND Debride Nail 6 or <-FAC,3842,CDM,761,RC,11721,HCPCS,outpatient,,,28.15,21.11,,25.34,90,,,percent of total billed charges,90% of total billed charges,26.18,93,,,percent of total billed charges,93% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,10.7,38,,,percent of total billed charges,38% of total billed charges,22.91,81.4,,,percent of total billed charges,81.4% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,21.11,75,,,percent of total billed charges,75% of total billed charges,23.93,85,,,percent of total billed charges,85% of total billed charges,10.7,26.18,
WND Removal of Nail plate-FAC,3843,CDM,761,RC,11730,HCPCS,outpatient,,,67.56,50.67,,60.8,90,,,percent of total billed charges,90% of total billed charges,62.83,93,,,percent of total billed charges,93% of total billed charges,25.67,38,,,percent of total billed charges,38% of total billed charges,25.67,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,25.67,38,,,percent of total billed charges,38% of total billed charges,54.99,81.4,,,percent of total billed charges,81.4% of total billed charges,60.8,90,,,percent of total billed charges,90% of total billed charges,60.8,90,,,percent of total billed charges,90% of total billed charges,25.67,38,,,percent of total billed charges,38% of total billed charges,25.67,38,,,percent of total billed charges,38% of total billed charges,25.67,38,,,percent of total billed charges,38% of total billed charges,50.67,75,,,percent of total billed charges,75% of total billed charges,57.43,85,,,percent of total billed charges,85% of total billed charges,25.67,62.83,
WND Removal of Nail plate add-on FAC,3844,CDM,761,RC,11732,HCPCS,outpatient,,,22.52,16.89,,20.27,90,,,percent of total billed charges,90% of total billed charges,20.94,93,,,percent of total billed charges,93% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,8.56,38,,,percent of total billed charges,38% of total billed charges,18.33,81.4,,,percent of total billed charges,81.4% of total billed charges,20.27,90,,,percent of total billed charges,90% of total billed charges,20.27,90,,,percent of total billed charges,90% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,8.56,38,,,percent of total billed charges,38% of total billed charges,16.89,75,,,percent of total billed charges,75% of total billed charges,19.14,85,,,percent of total billed charges,85% of total billed charges,8.56,20.94,
WND Drain blood from under nail-FAC,3845,CDM,761,RC,11740,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
WND Removal of nail bed-FAC,3846,CDM,761,RC,11750,HCPCS,outpatient,,,135.15,101.36,,121.64,90,,,percent of total billed charges,90% of total billed charges,125.69,93,,,percent of total billed charges,93% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,51.36,38,,,percent of total billed charges,38% of total billed charges,110.01,81.4,,,percent of total billed charges,81.4% of total billed charges,121.64,90,,,percent of total billed charges,90% of total billed charges,121.64,90,,,percent of total billed charges,90% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,101.36,75,,,percent of total billed charges,75% of total billed charges,114.88,85,,,percent of total billed charges,85% of total billed charges,51.36,125.69,
WND Repair of Nail Bed-FAC,3847,CDM,761,RC,11760,HCPCS,outpatient,,,168.92,126.69,,152.03,90,,,percent of total billed charges,90% of total billed charges,157.1,93,,,percent of total billed charges,93% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,64.19,38,,,percent of total billed charges,38% of total billed charges,137.5,81.4,,,percent of total billed charges,81.4% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,126.69,75,,,percent of total billed charges,75% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,157.1,
WND Excision of nail fold toe-FAC,3848,CDM,761,RC,11765,HCPCS,outpatient,,,84.46,63.35,,76.01,90,,,percent of total billed charges,90% of total billed charges,78.55,93,,,percent of total billed charges,93% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,32.09,38,,,percent of total billed charges,38% of total billed charges,68.75,81.4,,,percent of total billed charges,81.4% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,63.35,75,,,percent of total billed charges,75% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,78.55,
WND Debrid. Nail;Wedge Exc.of Skin;Fold-FAC,3849,CDM,761,RC,12001,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,104.73,
WND Lac Repair-Supf.Nonface;2.6-7.5 cm-FAC,3850,CDM,761,RC,12002,HCPCS,outpatient,,,144.13,108.1,,129.72,90,,,percent of total billed charges,90% of total billed charges,134.04,93,,,percent of total billed charges,93% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,54.77,38,,,percent of total billed charges,38% of total billed charges,117.32,81.4,,,percent of total billed charges,81.4% of total billed charges,129.72,90,,,percent of total billed charges,90% of total billed charges,129.72,90,,,percent of total billed charges,90% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,108.1,75,,,percent of total billed charges,75% of total billed charges,122.51,85,,,percent of total billed charges,85% of total billed charges,54.77,134.04,
WND Closure wound dehis simp-FAC,3851,CDM,761,RC,12020,HCPCS,outpatient,,,185.14,138.86,,166.63,90,,,percent of total billed charges,90% of total billed charges,172.18,93,,,percent of total billed charges,93% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,70.35,38,,,percent of total billed charges,38% of total billed charges,150.7,81.4,,,percent of total billed charges,81.4% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,138.86,75,,,percent of total billed charges,75% of total billed charges,157.37,85,,,percent of total billed charges,85% of total billed charges,70.35,172.18,
WND Closure of wound dehis w/pack-FAC,3852,CDM,761,RC,12021,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
WND Lac Repair-Intermed. Nonface;2.5cm or < FAC,3853,CDM,761,RC,12031,HCPCS,outpatient,,,197.07,147.8,,177.36,90,,,percent of total billed charges,90% of total billed charges,183.28,93,,,percent of total billed charges,93% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,74.89,38,,,percent of total billed charges,38% of total billed charges,160.41,81.4,,,percent of total billed charges,81.4% of total billed charges,177.36,90,,,percent of total billed charges,90% of total billed charges,177.36,90,,,percent of total billed charges,90% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,147.8,75,,,percent of total billed charges,75% of total billed charges,167.51,85,,,percent of total billed charges,85% of total billed charges,74.89,183.28,
WND Lac Repair Intermed. Nonface;2.6-7.5cm FAC,3854,CDM,761,RC,12032,HCPCS,outpatient,,,225.23,168.92,,202.71,90,,,percent of total billed charges,90% of total billed charges,209.46,93,,,percent of total billed charges,93% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,85.59,38,,,percent of total billed charges,38% of total billed charges,183.34,81.4,,,percent of total billed charges,81.4% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,168.92,75,,,percent of total billed charges,75% of total billed charges,191.45,85,,,percent of total billed charges,85% of total billed charges,85.59,209.46,
WND Lac Repair Intermed. Nonface;7.6-12.5cm FAC,3855,CDM,761,RC,12034,HCPCS,outpatient,,,253.39,190.04,,228.05,90,,,percent of total billed charges,90% of total billed charges,235.65,93,,,percent of total billed charges,93% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,96.29,38,,,percent of total billed charges,38% of total billed charges,206.26,81.4,,,percent of total billed charges,81.4% of total billed charges,228.05,90,,,percent of total billed charges,90% of total billed charges,228.05,90,,,percent of total billed charges,90% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,190.04,75,,,percent of total billed charges,75% of total billed charges,215.38,85,,,percent of total billed charges,85% of total billed charges,96.29,235.65,
WND Lac Repair Intermed. Nonface;12.6-20.0cm FAC,3856,CDM,761,RC,12035,HCPCS,outpatient,,,281.54,211.16,,253.39,90,,,percent of total billed charges,90% of total billed charges,261.83,93,,,percent of total billed charges,93% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,106.99,38,,,percent of total billed charges,38% of total billed charges,229.17,81.4,,,percent of total billed charges,81.4% of total billed charges,253.39,90,,,percent of total billed charges,90% of total billed charges,253.39,90,,,percent of total billed charges,90% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,211.16,75,,,percent of total billed charges,75% of total billed charges,239.31,85,,,percent of total billed charges,85% of total billed charges,106.99,261.83,
WND Lac Repair Intermed Nonface;20.1-30cm FAC,3857,CDM,761,RC,12036,HCPCS,outpatient,,,309.69,232.27,,278.72,90,,,percent of total billed charges,90% of total billed charges,288.01,93,,,percent of total billed charges,93% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,117.68,38,,,percent of total billed charges,38% of total billed charges,252.09,81.4,,,percent of total billed charges,81.4% of total billed charges,278.72,90,,,percent of total billed charges,90% of total billed charges,278.72,90,,,percent of total billed charges,90% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,232.27,75,,,percent of total billed charges,75% of total billed charges,263.24,85,,,percent of total billed charges,85% of total billed charges,117.68,288.01,
WND Lac Repair- Intermed Nonface< 30.0cm FAC,3858,CDM,761,RC,12037,HCPCS,outpatient,,,394.16,295.62,,354.74,90,,,percent of total billed charges,90% of total billed charges,366.57,93,,,percent of total billed charges,93% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,149.78,38,,,percent of total billed charges,38% of total billed charges,320.85,81.4,,,percent of total billed charges,81.4% of total billed charges,354.74,90,,,percent of total billed charges,90% of total billed charges,354.74,90,,,percent of total billed charges,90% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,295.62,75,,,percent of total billed charges,75% of total billed charges,335.04,85,,,percent of total billed charges,85% of total billed charges,149.78,366.57,
WND Lac Repair-Intermed. Head/Face;2.6-7.5 FAC,3859,CDM,761,RC,12042,HCPCS,outpatient,,,197.07,147.8,,177.36,90,,,percent of total billed charges,90% of total billed charges,183.28,93,,,percent of total billed charges,93% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,74.89,38,,,percent of total billed charges,38% of total billed charges,160.41,81.4,,,percent of total billed charges,81.4% of total billed charges,177.36,90,,,percent of total billed charges,90% of total billed charges,177.36,90,,,percent of total billed charges,90% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,74.89,38,,,percent of total billed charges,38% of total billed charges,147.8,75,,,percent of total billed charges,75% of total billed charges,167.51,85,,,percent of total billed charges,85% of total billed charges,74.89,183.28,
WND Lac Repair Intermed Head/Face7.6-12.5cm FAC,3860,CDM,761,RC,12044,HCPCS,outpatient,,,225.23,168.92,,202.71,90,,,percent of total billed charges,90% of total billed charges,209.46,93,,,percent of total billed charges,93% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,85.59,38,,,percent of total billed charges,38% of total billed charges,183.34,81.4,,,percent of total billed charges,81.4% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,168.92,75,,,percent of total billed charges,75% of total billed charges,191.45,85,,,percent of total billed charges,85% of total billed charges,85.59,209.46,
WND Lac Repair Intermed Head/Face12.6-20cm FAC,3861,CDM,761,RC,12045,HCPCS,outpatient,,,281.54,211.16,,253.39,90,,,percent of total billed charges,90% of total billed charges,261.83,93,,,percent of total billed charges,93% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,106.99,38,,,percent of total billed charges,38% of total billed charges,229.17,81.4,,,percent of total billed charges,81.4% of total billed charges,253.39,90,,,percent of total billed charges,90% of total billed charges,253.39,90,,,percent of total billed charges,90% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,211.16,75,,,percent of total billed charges,75% of total billed charges,239.31,85,,,percent of total billed charges,85% of total billed charges,106.99,261.83,
WND Lac Repair-Intermed Head/Face;20.1-30 FAC,3862,CDM,761,RC,12046,HCPCS,outpatient,,,309.69,232.27,,278.72,90,,,percent of total billed charges,90% of total billed charges,288.01,93,,,percent of total billed charges,93% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,117.68,38,,,percent of total billed charges,38% of total billed charges,252.09,81.4,,,percent of total billed charges,81.4% of total billed charges,278.72,90,,,percent of total billed charges,90% of total billed charges,278.72,90,,,percent of total billed charges,90% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,232.27,75,,,percent of total billed charges,75% of total billed charges,263.24,85,,,percent of total billed charges,85% of total billed charges,117.68,288.01,
WND Lac Repair-Intermed. Head/Face;< 30.0cm FAC,3863,CDM,761,RC,12047,HCPCS,outpatient,,,563.07,422.3,,506.76,90,,,percent of total billed charges,90% of total billed charges,523.66,93,,,percent of total billed charges,93% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,213.97,38,,,percent of total billed charges,38% of total billed charges,458.34,81.4,,,percent of total billed charges,81.4% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,506.76,90,,,percent of total billed charges,90% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,213.97,38,,,percent of total billed charges,38% of total billed charges,422.3,75,,,percent of total billed charges,75% of total billed charges,478.61,85,,,percent of total billed charges,85% of total billed charges,213.97,523.66,
WND Lac Repair Intermed Face;2.5cm/<FAC,3864,CDM,761,RC,12051,HCPCS,outpatient,,,140.77,105.58,,126.69,90,,,percent of total billed charges,90% of total billed charges,130.92,93,,,percent of total billed charges,93% of total billed charges,53.49,38,,,percent of total billed charges,38% of total billed charges,53.49,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,53.49,38,,,percent of total billed charges,38% of total billed charges,114.59,81.4,,,percent of total billed charges,81.4% of total billed charges,126.69,90,,,percent of total billed charges,90% of total billed charges,126.69,90,,,percent of total billed charges,90% of total billed charges,53.49,38,,,percent of total billed charges,38% of total billed charges,53.49,38,,,percent of total billed charges,38% of total billed charges,53.49,38,,,percent of total billed charges,38% of total billed charges,105.58,75,,,percent of total billed charges,75% of total billed charges,119.65,85,,,percent of total billed charges,85% of total billed charges,53.49,130.92,
WND Lac Repair-Intermed Face;2.6-5cm FAC,3865,CDM,761,RC,12052,HCPCS,outpatient,,,225.23,168.92,,202.71,90,,,percent of total billed charges,90% of total billed charges,209.46,93,,,percent of total billed charges,93% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,85.59,38,,,percent of total billed charges,38% of total billed charges,183.34,81.4,,,percent of total billed charges,81.4% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,168.92,75,,,percent of total billed charges,75% of total billed charges,191.45,85,,,percent of total billed charges,85% of total billed charges,85.59,209.46,
WND Lac Repair  Intermed Face;5.1-7.5cm FAC,3866,CDM,761,RC,12053,HCPCS,outpatient,,,253.39,190.04,,228.05,90,,,percent of total billed charges,90% of total billed charges,235.65,93,,,percent of total billed charges,93% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,96.29,38,,,percent of total billed charges,38% of total billed charges,206.26,81.4,,,percent of total billed charges,81.4% of total billed charges,228.05,90,,,percent of total billed charges,90% of total billed charges,228.05,90,,,percent of total billed charges,90% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,96.29,38,,,percent of total billed charges,38% of total billed charges,190.04,75,,,percent of total billed charges,75% of total billed charges,215.38,85,,,percent of total billed charges,85% of total billed charges,96.29,235.65,
WND Lac Repair Intermed Face 7.6-12.5cm FAC,3867,CDM,761,RC,12054,HCPCS,outpatient,,,281.54,211.16,,253.39,90,,,percent of total billed charges,90% of total billed charges,261.83,93,,,percent of total billed charges,93% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,106.99,38,,,percent of total billed charges,38% of total billed charges,229.17,81.4,,,percent of total billed charges,81.4% of total billed charges,253.39,90,,,percent of total billed charges,90% of total billed charges,253.39,90,,,percent of total billed charges,90% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,211.16,75,,,percent of total billed charges,75% of total billed charges,239.31,85,,,percent of total billed charges,85% of total billed charges,106.99,261.83,
WND Lac Repair Intermed Face 12.6-20cm FAC,3868,CDM,761,RC,12055,HCPCS,outpatient,,,309.69,232.27,,278.72,90,,,percent of total billed charges,90% of total billed charges,288.01,93,,,percent of total billed charges,93% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,117.68,38,,,percent of total billed charges,38% of total billed charges,252.09,81.4,,,percent of total billed charges,81.4% of total billed charges,278.72,90,,,percent of total billed charges,90% of total billed charges,278.72,90,,,percent of total billed charges,90% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,232.27,75,,,percent of total billed charges,75% of total billed charges,263.24,85,,,percent of total billed charges,85% of total billed charges,117.68,288.01,
WND Lac Repair Intermed. Face;20.1-30cm-FAC,3869,CDM,761,RC,12056,HCPCS,outpatient,,,309.69,232.27,,278.72,90,,,percent of total billed charges,90% of total billed charges,288.01,93,,,percent of total billed charges,93% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,117.68,38,,,percent of total billed charges,38% of total billed charges,252.09,81.4,,,percent of total billed charges,81.4% of total billed charges,278.72,90,,,percent of total billed charges,90% of total billed charges,278.72,90,,,percent of total billed charges,90% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,117.68,38,,,percent of total billed charges,38% of total billed charges,232.27,75,,,percent of total billed charges,75% of total billed charges,263.24,85,,,percent of total billed charges,85% of total billed charges,117.68,288.01,
Skin Graft app trnk/arm/leg up to 100sq cm fac,3870,CDM,360,RC,15271,HCPCS,outpatient,,,3202.93,2402.2,,2882.64,90,,,percent of total billed charges,90% of total billed charges,2978.72,93,,,percent of total billed charges,93% of total billed charges,1217.11,38,,,percent of total billed charges,38% of total billed charges,1217.11,38,,,percent of total billed charges,38% of total billed charges,2722.49,85,,,percent of total billed charges,85% of total billed charges,1217.11,38,,,percent of total billed charges,38% of total billed charges,2607.19,81.4,,,percent of total billed charges,81.4% of total billed charges,2882.64,90,,,percent of total billed charges,90% of total billed charges,2882.64,90,,,percent of total billed charges,90% of total billed charges,1217.11,38,,,percent of total billed charges,38% of total billed charges,1217.11,38,,,percent of total billed charges,38% of total billed charges,1217.11,38,,,percent of total billed charges,38% of total billed charges,2402.2,75,,,percent of total billed charges,75% of total billed charges,2722.49,85,,,percent of total billed charges,85% of total billed charges,1217.11,2978.72,
"WND APPLICATION OF SKIN SUBSTITUE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS - FAC",3871,CDM,761,RC,15275,HCPCS,outpatient,,,324.73,243.55,,292.26,90,,,percent of total billed charges,90% of total billed charges,302,93,,,percent of total billed charges,93% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,123.4,38,,,percent of total billed charges,38% of total billed charges,264.33,81.4,,,percent of total billed charges,81.4% of total billed charges,292.26,90,,,percent of total billed charges,90% of total billed charges,292.26,90,,,percent of total billed charges,90% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,123.4,38,,,percent of total billed charges,38% of total billed charges,243.55,75,,,percent of total billed charges,75% of total billed charges,276.02,85,,,percent of total billed charges,85% of total billed charges,123.4,302,
WND Burn init Trmt-FAC,3872,CDM,761,RC,16000,HCPCS,outpatient,,,78.85,59.14,,70.97,90,,,percent of total billed charges,90% of total billed charges,73.33,93,,,percent of total billed charges,93% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,29.96,38,,,percent of total billed charges,38% of total billed charges,64.18,81.4,,,percent of total billed charges,81.4% of total billed charges,70.97,90,,,percent of total billed charges,90% of total billed charges,70.97,90,,,percent of total billed charges,90% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,59.14,75,,,percent of total billed charges,75% of total billed charges,67.02,85,,,percent of total billed charges,85% of total billed charges,29.96,73.33,
"WND Burn, Debride <5%-FAC",3873,CDM,761,RC,16020,HCPCS,outpatient,,,135.15,101.36,,121.64,90,,,percent of total billed charges,90% of total billed charges,125.69,93,,,percent of total billed charges,93% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,51.36,38,,,percent of total billed charges,38% of total billed charges,110.01,81.4,,,percent of total billed charges,81.4% of total billed charges,121.64,90,,,percent of total billed charges,90% of total billed charges,121.64,90,,,percent of total billed charges,90% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,51.36,38,,,percent of total billed charges,38% of total billed charges,101.36,75,,,percent of total billed charges,75% of total billed charges,114.88,85,,,percent of total billed charges,85% of total billed charges,51.36,125.69,
WND Burn Debride 5%-10% (med.) - FAC,3874,CDM,761,RC,16025,HCPCS,outpatient,,,281.54,211.16,,253.39,90,,,percent of total billed charges,90% of total billed charges,261.83,93,,,percent of total billed charges,93% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,106.99,38,,,percent of total billed charges,38% of total billed charges,229.17,81.4,,,percent of total billed charges,81.4% of total billed charges,253.39,90,,,percent of total billed charges,90% of total billed charges,253.39,90,,,percent of total billed charges,90% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,106.99,38,,,percent of total billed charges,38% of total billed charges,211.16,75,,,percent of total billed charges,75% of total billed charges,239.31,85,,,percent of total billed charges,85% of total billed charges,106.99,261.83,
WND Burn; Large> 10%-FAC,3875,CDM,761,RC,16030,HCPCS,outpatient,,,337.84,253.38,,304.06,90,,,percent of total billed charges,90% of total billed charges,314.19,93,,,percent of total billed charges,93% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,128.38,38,,,percent of total billed charges,38% of total billed charges,275,81.4,,,percent of total billed charges,81.4% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,253.38,75,,,percent of total billed charges,75% of total billed charges,287.16,85,,,percent of total billed charges,85% of total billed charges,128.38,314.19,
WND Cryo-1st Lesion-FAC,3876,CDM,761,RC,17000,HCPCS,outpatient,,,73.21,54.91,,65.89,90,,,percent of total billed charges,90% of total billed charges,68.09,93,,,percent of total billed charges,93% of total billed charges,27.82,38,,,percent of total billed charges,38% of total billed charges,27.82,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,27.82,38,,,percent of total billed charges,38% of total billed charges,59.59,81.4,,,percent of total billed charges,81.4% of total billed charges,65.89,90,,,percent of total billed charges,90% of total billed charges,65.89,90,,,percent of total billed charges,90% of total billed charges,27.82,38,,,percent of total billed charges,38% of total billed charges,27.82,38,,,percent of total billed charges,38% of total billed charges,27.82,38,,,percent of total billed charges,38% of total billed charges,54.91,75,,,percent of total billed charges,75% of total billed charges,62.23,85,,,percent of total billed charges,85% of total billed charges,27.82,68.09,
WND Cryo:2-14 Lesions-FAC,3877,CDM,761,RC,17003,HCPCS,outpatient,,,5.63,4.22,,5.07,90,,,percent of total billed charges,90% of total billed charges,5.24,93,,,percent of total billed charges,93% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,2.14,38,,,percent of total billed charges,38% of total billed charges,4.58,81.4,,,percent of total billed charges,81.4% of total billed charges,5.07,90,,,percent of total billed charges,90% of total billed charges,5.07,90,,,percent of total billed charges,90% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,4.22,75,,,percent of total billed charges,75% of total billed charges,4.79,85,,,percent of total billed charges,85% of total billed charges,2.14,5.24,
WND Cryo Lesions 15+-FAC,3878,CDM,761,RC,17004,HCPCS,outpatient,,,225.23,168.92,,202.71,90,,,percent of total billed charges,90% of total billed charges,209.46,93,,,percent of total billed charges,93% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,85.59,38,,,percent of total billed charges,38% of total billed charges,183.34,81.4,,,percent of total billed charges,81.4% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,202.71,90,,,percent of total billed charges,90% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,85.59,38,,,percent of total billed charges,38% of total billed charges,168.92,75,,,percent of total billed charges,75% of total billed charges,191.45,85,,,percent of total billed charges,85% of total billed charges,85.59,209.46,
WND Wart Removal;up to 14 Lesions-FAC,3879,CDM,761,RC,17110,HCPCS,outpatient,,,78.85,59.14,,70.97,90,,,percent of total billed charges,90% of total billed charges,73.33,93,,,percent of total billed charges,93% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,29.96,38,,,percent of total billed charges,38% of total billed charges,64.18,81.4,,,percent of total billed charges,81.4% of total billed charges,70.97,90,,,percent of total billed charges,90% of total billed charges,70.97,90,,,percent of total billed charges,90% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,29.96,38,,,percent of total billed charges,38% of total billed charges,59.14,75,,,percent of total billed charges,75% of total billed charges,67.02,85,,,percent of total billed charges,85% of total billed charges,29.96,73.33,
WND Chem. Cauterize of Gran Tissue-FAC,3880,CDM,761,RC,17250,HCPCS,outpatient,,,39.41,29.56,,35.47,90,,,percent of total billed charges,90% of total billed charges,36.65,93,,,percent of total billed charges,93% of total billed charges,14.98,38,,,percent of total billed charges,38% of total billed charges,14.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,14.98,38,,,percent of total billed charges,38% of total billed charges,32.08,81.4,,,percent of total billed charges,81.4% of total billed charges,35.47,90,,,percent of total billed charges,90% of total billed charges,35.47,90,,,percent of total billed charges,90% of total billed charges,14.98,38,,,percent of total billed charges,38% of total billed charges,14.98,38,,,percent of total billed charges,38% of total billed charges,14.98,38,,,percent of total billed charges,38% of total billed charges,29.56,75,,,percent of total billed charges,75% of total billed charges,33.5,85,,,percent of total billed charges,85% of total billed charges,14.98,36.65,
WND Apply rigid leg cast (TCC)PRO,3881,CDM,982,RC,29445,HCPCS,outpatient,,,247.76,185.82,,142.51,130,,,fee schedule,130% of fee schedule,142.51,130,,,fee schedule,130% of fee schedule,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,126.69,119,,,fee schedule,119% of fee schedule,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,100% of fee schedule,222.98,90,,,percent of total billed charges,90% of total billed charges,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,99.19,100,,,fee schedule,100% of fee schedule,99.19,222.98,
WND Apply rigid leg cast(TCC) FAC,3882,CDM,761,RC,29445,HCPCS,outpatient,,,450.46,337.85,,405.41,90,,,percent of total billed charges,90% of total billed charges,418.93,93,,,percent of total billed charges,93% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,171.17,38,,,percent of total billed charges,38% of total billed charges,366.67,81.4,,,percent of total billed charges,81.4% of total billed charges,405.41,90,,,percent of total billed charges,90% of total billed charges,405.41,90,,,percent of total billed charges,90% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,337.85,75,,,percent of total billed charges,75% of total billed charges,382.89,85,,,percent of total billed charges,85% of total billed charges,171.17,418.93,
WND Strapping - Unna Boot - FAC,3883,CDM,761,RC,29580,HCPCS,outpatient,,,84.46,63.35,,76.01,90,,,percent of total billed charges,90% of total billed charges,78.55,93,,,percent of total billed charges,93% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,32.09,38,,,percent of total billed charges,38% of total billed charges,68.75,81.4,,,percent of total billed charges,81.4% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,76.01,90,,,percent of total billed charges,90% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,32.09,38,,,percent of total billed charges,38% of total billed charges,63.35,75,,,percent of total billed charges,75% of total billed charges,71.79,85,,,percent of total billed charges,85% of total billed charges,32.09,78.55,
WND Strapping low extremity -FAC,3884,CDM,761,RC,29581,HCPCS,outpatient,,,171.88,128.91,,154.69,90,,,percent of total billed charges,90% of total billed charges,159.85,93,,,percent of total billed charges,93% of total billed charges,65.31,38,,,percent of total billed charges,38% of total billed charges,65.31,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,65.31,38,,,percent of total billed charges,38% of total billed charges,139.91,81.4,,,percent of total billed charges,81.4% of total billed charges,154.69,90,,,percent of total billed charges,90% of total billed charges,154.69,90,,,percent of total billed charges,90% of total billed charges,65.31,38,,,percent of total billed charges,38% of total billed charges,65.31,38,,,percent of total billed charges,38% of total billed charges,65.31,38,,,percent of total billed charges,38% of total billed charges,128.91,75,,,percent of total billed charges,75% of total billed charges,146.1,85,,,percent of total billed charges,85% of total billed charges,65.31,159.85,
WND Digital nerve block-Fac,3885,CDM,761,RC,64450,HCPCS,outpatient,,,883.27,662.45,,794.94,90,,,percent of total billed charges,90% of total billed charges,821.44,93,,,percent of total billed charges,93% of total billed charges,335.64,38,,,percent of total billed charges,38% of total billed charges,335.64,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,335.64,38,,,percent of total billed charges,38% of total billed charges,718.98,81.4,,,percent of total billed charges,81.4% of total billed charges,794.94,90,,,percent of total billed charges,90% of total billed charges,794.94,90,,,percent of total billed charges,90% of total billed charges,335.64,38,,,percent of total billed charges,38% of total billed charges,335.64,38,,,percent of total billed charges,38% of total billed charges,335.64,38,,,percent of total billed charges,38% of total billed charges,662.45,75,,,percent of total billed charges,75% of total billed charges,750.78,85,,,percent of total billed charges,85% of total billed charges,335.64,821.44,
WND-digital nerve block PRO,3886,CDM,982,RC,64450,HCPCS,outpatient,,,165.61,124.21,,91.05,130,,,fee schedule,130% of fee schedule,91.05,130,,,fee schedule,130% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,53,119,,,fee schedule,119% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,100% of fee schedule,149.05,90,,,percent of total billed charges,90% of total billed charges,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,42.29,100,,,fee schedule,100% of fee schedule,35.93,149.05,
PM chemodenervation - pro,3887,CDM,988,RC,64615,HCPCS,outpatient,,,75.78,56.84,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,75.78,100,,,fee schedule,Pays 100% Medicare OPPS,75.78,100,,,fee schedule,Pays 100% Medicare OPPS,90.18,119,,,fee schedule,119% of fee schedule,75.78,100,,,fee schedule,Pays 100% Medicare OPPS,75.78,100,,,fee schedule,100% of fee schedule,68.2,90,,,percent of total billed charges,90% of total billed charges,75.78,100,,,fee schedule,Pays 100% Medicare OPPS,75.78,100,,,fee schedule,Pays 100% Medicare OPPS,75.78,100,,,fee schedule,Pays 100% Medicare OPPS,75.78,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,75.78,100,,,fee schedule,100% of fee schedule,68.2,90.18,
WND FBR-Eyelid - FAC,3888,CDM,761,RC,67938,HCPCS,outpatient,,,602.48,451.86,,542.23,90,,,percent of total billed charges,90% of total billed charges,560.31,93,,,percent of total billed charges,93% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,228.94,38,,,percent of total billed charges,38% of total billed charges,490.42,81.4,,,percent of total billed charges,81.4% of total billed charges,542.23,90,,,percent of total billed charges,90% of total billed charges,542.23,90,,,percent of total billed charges,90% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,228.94,38,,,percent of total billed charges,38% of total billed charges,451.86,75,,,percent of total billed charges,75% of total billed charges,512.11,85,,,percent of total billed charges,85% of total billed charges,228.94,560.31,
"WND Remove impacted Cerumen, 1 or both-FAC",3889,CDM,761,RC,69210,HCPCS,outpatient,,,45.7,34.28,,41.13,90,,,percent of total billed charges,90% of total billed charges,42.5,93,,,percent of total billed charges,93% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,17.37,38,,,percent of total billed charges,38% of total billed charges,37.2,81.4,,,percent of total billed charges,81.4% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,34.28,75,,,percent of total billed charges,75% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,42.5,
WND ABI (Ankle-Brachial Index)-Fac,3890,CDM,920,RC,93922,HCPCS,outpatient,,,168.92,126.69,,152.03,90,,,percent of total billed charges,90% of total billed charges,157.1,93,,,percent of total billed charges,93% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,137.5,81.4,,,percent of total billed charges,81.4% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,126.69,75,,,percent of total billed charges,75% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,157.1,
ABI (Ankle-Brachial Index)-Pro,3891,CDM,921,RC,93922,HCPCS,outpatient,,,337.84,253.38,,304.06,90,,,percent of total billed charges,90% of total billed charges,314.19,93,,,percent of total billed charges,93% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,287.16,85,,,percent of total billed charges,85% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,275,81.4,,,percent of total billed charges,81.4% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,253.38,75,,,percent of total billed charges,75% of total billed charges,287.16,85,,,percent of total billed charges,85% of total billed charges,128.38,314.19,
ABI (Ankle-Brachial Index)-Fac,3892,CDM,920,RC,93922,HCPCS,outpatient,,,168.92,126.69,,152.03,90,,,percent of total billed charges,90% of total billed charges,157.1,93,,,percent of total billed charges,93% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,137.5,81.4,,,percent of total billed charges,81.4% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,126.69,75,,,percent of total billed charges,75% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,157.1,
WC remove devit tis 20cm< Pro,3893,CDM,982,RC,97597,HCPCS,outpatient,,,55.2,41.4,,31.37,130,,,fee schedule,130% of fee schedule,31.37,130,,,fee schedule,130% of fee schedule,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,70,100,,,case rate,100% of case rate,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,100% of fee schedule,49.68,90,,,percent of total billed charges,90% of total billed charges,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,35.67,100,,,fee schedule,100% of fee schedule,31.37,70,
WC remove devit tis 20cm< Pro,3894,CDM,982,RC,97597,HCPCS,outpatient,,,55.2,41.4,,31.37,130,,,fee schedule,130% of fee schedule,31.37,130,,,fee schedule,130% of fee schedule,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,70,100,,,case rate,100% of case rate,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,100% of fee schedule,49.68,90,,,percent of total billed charges,90% of total billed charges,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,35.67,100,,,fee schedule,100% of fee schedule,31.37,70,
WC remove devit tis 20cm< Fac,3895,CDM,761,RC,97597,HCPCS,outpatient,,,298.11,223.58,,268.3,90,,,percent of total billed charges,90% of total billed charges,277.24,93,,,percent of total billed charges,93% of total billed charges,113.28,38,,,percent of total billed charges,38% of total billed charges,113.28,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,113.28,38,,,percent of total billed charges,38% of total billed charges,242.66,81.4,,,percent of total billed charges,81.4% of total billed charges,268.3,90,,,percent of total billed charges,90% of total billed charges,268.3,90,,,percent of total billed charges,90% of total billed charges,113.28,38,,,percent of total billed charges,38% of total billed charges,113.28,38,,,percent of total billed charges,38% of total billed charges,113.28,38,,,percent of total billed charges,38% of total billed charges,223.58,75,,,percent of total billed charges,75% of total billed charges,253.39,85,,,percent of total billed charges,85% of total billed charges,113.28,277.24,
WND-Non-sel debridement w/o anes,3896,CDM,761,RC,97602,HCPCS,outpatient,,,176.65,132.49,,158.99,90,,,percent of total billed charges,90% of total billed charges,164.28,93,,,percent of total billed charges,93% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,67.13,38,,,percent of total billed charges,38% of total billed charges,143.79,81.4,,,percent of total billed charges,81.4% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,132.49,75,,,percent of total billed charges,75% of total billed charges,150.15,85,,,percent of total billed charges,85% of total billed charges,67.13,164.28,
WND Wound  NEW Min - FAC,3897,CDM,761,RC,99201,HCPCS,outpatient,,,42.17,31.63,,37.95,90,,,percent of total billed charges,90% of total billed charges,39.22,93,,,percent of total billed charges,93% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,16.02,38,,,percent of total billed charges,38% of total billed charges,34.33,81.4,,,percent of total billed charges,81.4% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,31.63,75,,,percent of total billed charges,75% of total billed charges,35.84,85,,,percent of total billed charges,85% of total billed charges,16.02,39.22,
WND Wound New  Brief-FAC,3898,CDM,761,RC,99202,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
WND Wound New Int-FAC,3899,CDM,761,RC,99203,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
WND Wound New Ext-FAC,3900,CDM,761,RC,99204,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
WND Wound New Ext+-FAC,3901,CDM,761,RC,99205,HCPCS,outpatient,,,153.5,115.13,,138.15,90,,,percent of total billed charges,90% of total billed charges,142.76,93,,,percent of total billed charges,93% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,58.33,38,,,percent of total billed charges,38% of total billed charges,124.95,81.4,,,percent of total billed charges,81.4% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,115.13,75,,,percent of total billed charges,75% of total billed charges,130.48,85,,,percent of total billed charges,85% of total billed charges,58.33,142.76,
WND Wound/Nurse visit FAC,3902,CDM,761,RC,99211,HCPCS,outpatient,,,28.15,21.11,,25.34,90,,,percent of total billed charges,90% of total billed charges,26.18,93,,,percent of total billed charges,93% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,10.7,38,,,percent of total billed charges,38% of total billed charges,22.91,81.4,,,percent of total billed charges,81.4% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,21.11,75,,,percent of total billed charges,75% of total billed charges,23.93,85,,,percent of total billed charges,85% of total billed charges,10.7,26.18,
WND Wound Visit Est. Brief-FAC,3903,CDM,761,RC,99212,HCPCS,outpatient,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
WND Wound Visit Est.Int FAC,3904,CDM,761,RC,99213,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
WND Wound Visit Est.ext-FAC,3905,CDM,761,RC,99214,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
WND Wound Visit Est.ext+FAC,3906,CDM,761,RC,99215,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
"HBOT,full body 30min",3907,CDM,413,RC,G0277,HCPCS,outpatient,,,110.4,82.8,,99.36,90,,,percent of total billed charges,90% of total billed charges,102.67,93,,,percent of total billed charges,93% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,89.87,81.4,,,percent of total billed charges,81.4% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,82.8,75,,,percent of total billed charges,75% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,102.67,
Closed Phalanx Fracture,3908,CDM,982,RC,26720,HCPCS,outpatient,,,473.4,355.05,,236.47,130,,,fee schedule,130% of fee schedule,236.47,130,,,fee schedule,130% of fee schedule,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,231.75,119,,,fee schedule,119% of fee schedule,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,100% of fee schedule,426.06,90,,,percent of total billed charges,90% of total billed charges,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,201.84,100,,,fee schedule,100% of fee schedule,71.86,426.06,
Rmv. Inf./Devit.Tissue;Partial Thick-FAC,3913,CDM,450,RC,11040,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Rmv. Inf./Devit.Tissue;Partial Thick-FAC,3914,CDM,450,RC,11040,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
EXC - paring or cutting benign lesion -single-FAC,3915,CDM,510,RC,11055,HCPCS,outpatient,,,35.15,26.36,,31.64,90,,,percent of total billed charges,90% of total billed charges,32.69,93,,,percent of total billed charges,93% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,13.36,38,,,percent of total billed charges,38% of total billed charges,28.61,81.4,,,percent of total billed charges,81.4% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,26.36,75,,,percent of total billed charges,75% of total billed charges,29.88,85,,,percent of total billed charges,85% of total billed charges,13.36,32.69,
WND Trim skin.Lesion; 2-4-G,3916,CDM,982,RC,11056,HCPCS,outpatient,,,123.04,92.28,,36.75,130,,,fee schedule,130% of fee schedule,36.75,130,,,fee schedule,130% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,119,,,fee schedule,119% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,100% of fee schedule,110.74,90,,,percent of total billed charges,90% of total billed charges,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,22.02,100,,,fee schedule,100% of fee schedule,22.02,110.74,
Biopsy tangential ea add FAC,3917,CDM,510,RC,11103,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,51.34,
Biopsy tangential ea add FAC,3918,CDM,510,RC,11103,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,51.34,
Biopsy Punch-Fac,3919,CDM,510,RC,11104,HCPCS,outpatient,,,242.9,182.18,,218.61,90,,,percent of total billed charges,90% of total billed charges,225.9,93,,,percent of total billed charges,93% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,92.3,38,,,percent of total billed charges,38% of total billed charges,197.72,81.4,,,percent of total billed charges,81.4% of total billed charges,218.61,90,,,percent of total billed charges,90% of total billed charges,218.61,90,,,percent of total billed charges,90% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,182.18,75,,,percent of total billed charges,75% of total billed charges,206.47,85,,,percent of total billed charges,85% of total billed charges,92.3,225.9,
Biopsy Punch-Fac,3920,CDM,510,RC,11104,HCPCS,outpatient,,,242.9,182.18,,218.61,90,,,percent of total billed charges,90% of total billed charges,225.9,93,,,percent of total billed charges,93% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,92.3,38,,,percent of total billed charges,38% of total billed charges,197.72,81.4,,,percent of total billed charges,81.4% of total billed charges,218.61,90,,,percent of total billed charges,90% of total billed charges,218.61,90,,,percent of total billed charges,90% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,182.18,75,,,percent of total billed charges,75% of total billed charges,206.47,85,,,percent of total billed charges,85% of total billed charges,92.3,225.9,
Biopsy Punch each add Pro,3921,CDM,983,RC,11105,HCPCS,outpatient,,,69.56,52.17,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,32.8,119,,,fee schedule,119% of fee schedule,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,100% of fee schedule,62.6,90,,,percent of total billed charges,90% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.84,100,,,fee schedule,100% of fee schedule,25.84,62.6,
Biopsy Punch each add Pro,3922,CDM,983,RC,11105,HCPCS,outpatient,,,69.56,52.17,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,32.8,119,,,fee schedule,119% of fee schedule,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,100% of fee schedule,62.6,90,,,percent of total billed charges,90% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.84,100,,,fee schedule,100% of fee schedule,25.84,62.6,
Biopsy punch each add Fac,3923,CDM,521,RC,11105,HCPCS,outpatient,,,88.32,66.24,,79.49,90,,,percent of total billed charges,90% of total billed charges,82.14,93,,,percent of total billed charges,93% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,75.07,85,,,percent of total billed charges,85% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,71.89,81.4,,,percent of total billed charges,81.4% of total billed charges,79.49,90,,,percent of total billed charges,90% of total billed charges,79.49,90,,,percent of total billed charges,90% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,66.24,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,33.56,82.14,
Biopsy punch each add Fac,3924,CDM,521,RC,11105,HCPCS,outpatient,,,88.32,66.24,,79.49,90,,,percent of total billed charges,90% of total billed charges,82.14,93,,,percent of total billed charges,93% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,75.07,85,,,percent of total billed charges,85% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,71.89,81.4,,,percent of total billed charges,81.4% of total billed charges,79.49,90,,,percent of total billed charges,90% of total billed charges,79.49,90,,,percent of total billed charges,90% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,66.24,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,33.56,82.14,
Biopsy Incisional Facility,3925,CDM,510,RC,11106,HCPCS,outpatient,,,331.22,248.42,,298.1,90,,,percent of total billed charges,90% of total billed charges,308.03,93,,,percent of total billed charges,93% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,125.86,38,,,percent of total billed charges,38% of total billed charges,269.61,81.4,,,percent of total billed charges,81.4% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,248.42,75,,,percent of total billed charges,75% of total billed charges,281.54,85,,,percent of total billed charges,85% of total billed charges,125.86,308.03,
Biopsy Incisional Facility,3926,CDM,510,RC,11106,HCPCS,outpatient,,,331.22,248.42,,298.1,90,,,percent of total billed charges,90% of total billed charges,308.03,93,,,percent of total billed charges,93% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,125.86,38,,,percent of total billed charges,38% of total billed charges,269.61,81.4,,,percent of total billed charges,81.4% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,248.42,75,,,percent of total billed charges,75% of total billed charges,281.54,85,,,percent of total billed charges,85% of total billed charges,125.86,308.03,
Biopsy incisional ea add FAC,3927,CDM,510,RC,11107,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,154.02,
Biopsy incisional ea add FAC,3928,CDM,510,RC,11107,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,154.02,
"Exc Benigh(head,neck,ext, gen) 1.1-2cm Fac",3929,CDM,510,RC,11422,HCPCS,outpatient,,,152.33,114.25,,137.1,90,,,percent of total billed charges,90% of total billed charges,141.67,93,,,percent of total billed charges,93% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,57.89,38,,,percent of total billed charges,38% of total billed charges,124,81.4,,,percent of total billed charges,81.4% of total billed charges,137.1,90,,,percent of total billed charges,90% of total billed charges,137.1,90,,,percent of total billed charges,90% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,114.25,75,,,percent of total billed charges,75% of total billed charges,129.48,85,,,percent of total billed charges,85% of total billed charges,57.89,141.67,
Lesion rem; malig head/face 3.1-4.0-T,3930,CDM,510,RC,11644,HCPCS,outpatient,,,355.05,266.29,,319.55,90,,,percent of total billed charges,90% of total billed charges,330.2,93,,,percent of total billed charges,93% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,134.92,38,,,percent of total billed charges,38% of total billed charges,289.01,81.4,,,percent of total billed charges,81.4% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,266.29,75,,,percent of total billed charges,75% of total billed charges,301.79,85,,,percent of total billed charges,85% of total billed charges,134.92,330.2,
"Asp./Inj joint; BILATERAL Inter.(w,el,an) FACILITY",3931,CDM,510,RC,20605,HCPCS,outpatient,,,192.17,144.13,,172.95,90,,,percent of total billed charges,90% of total billed charges,178.72,93,,,percent of total billed charges,93% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,73.02,38,,,percent of total billed charges,38% of total billed charges,156.43,81.4,,,percent of total billed charges,81.4% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,144.13,75,,,percent of total billed charges,75% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,178.72,
"Asp./Inj joint; BILATERAL Inter.(w,el,an) FACILITY",3932,CDM,510,RC,20605,HCPCS,outpatient,,,192.17,144.13,,172.95,90,,,percent of total billed charges,90% of total billed charges,178.72,93,,,percent of total billed charges,93% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,73.02,38,,,percent of total billed charges,38% of total billed charges,156.43,81.4,,,percent of total billed charges,81.4% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,144.13,75,,,percent of total billed charges,75% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,178.72,
"Asp./Inj Joint; Major(s,h,k) BILATERAL -Facility",3933,CDM,510,RC,20610,HCPCS,outpatient,,,208.57,156.43,,187.71,90,,,percent of total billed charges,90% of total billed charges,193.97,93,,,percent of total billed charges,93% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,79.26,38,,,percent of total billed charges,38% of total billed charges,169.78,81.4,,,percent of total billed charges,81.4% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,156.43,75,,,percent of total billed charges,75% of total billed charges,177.28,85,,,percent of total billed charges,85% of total billed charges,79.26,193.97,
"Asp./Inj Joint; Major(s,h,k) BILATERAL -Facility",3934,CDM,510,RC,20610,HCPCS,outpatient,,,208.57,156.43,,187.71,90,,,percent of total billed charges,90% of total billed charges,193.97,93,,,percent of total billed charges,93% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,79.26,38,,,percent of total billed charges,38% of total billed charges,169.78,81.4,,,percent of total billed charges,81.4% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,156.43,75,,,percent of total billed charges,75% of total billed charges,177.28,85,,,percent of total billed charges,85% of total billed charges,79.26,193.97,
"Asp./Inj Joint; Major(s,h,k) BILATERAL -Facility",3935,CDM,510,RC,20610,HCPCS,outpatient,,,208.57,156.43,,187.71,90,,,percent of total billed charges,90% of total billed charges,193.97,93,,,percent of total billed charges,93% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,79.26,38,,,percent of total billed charges,38% of total billed charges,169.78,81.4,,,percent of total billed charges,81.4% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,156.43,75,,,percent of total billed charges,75% of total billed charges,177.28,85,,,percent of total billed charges,85% of total billed charges,79.26,193.97,
FRX/Dislocation-Finger/Thumb; W manip-FAC,3936,CDM,510,RC,26755,HCPCS,outpatient,,,591.74,443.81,,532.57,90,,,percent of total billed charges,90% of total billed charges,550.32,93,,,percent of total billed charges,93% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,224.86,38,,,percent of total billed charges,38% of total billed charges,481.68,81.4,,,percent of total billed charges,81.4% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,443.81,75,,,percent of total billed charges,75% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,550.32,
FRX/Dislocation-Finger/Thumb; W manip-FAC,3937,CDM,510,RC,26755,HCPCS,outpatient,,,591.74,443.81,,532.57,90,,,percent of total billed charges,90% of total billed charges,550.32,93,,,percent of total billed charges,93% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,224.86,38,,,percent of total billed charges,38% of total billed charges,481.68,81.4,,,percent of total billed charges,81.4% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,443.81,75,,,percent of total billed charges,75% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,550.32,
Apply rigid leg (TCC) FAC,3938,CDM,510,RC,29445,HCPCS,outpatient,,,450.46,337.85,,405.41,90,,,percent of total billed charges,90% of total billed charges,418.93,93,,,percent of total billed charges,93% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,171.17,38,,,percent of total billed charges,38% of total billed charges,366.67,81.4,,,percent of total billed charges,81.4% of total billed charges,405.41,90,,,percent of total billed charges,90% of total billed charges,405.41,90,,,percent of total billed charges,90% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,171.17,38,,,percent of total billed charges,38% of total billed charges,337.85,75,,,percent of total billed charges,75% of total billed charges,382.89,85,,,percent of total billed charges,85% of total billed charges,171.17,418.93,
Apply strapping lower ext Multi-layer cast-FAC,3939,CDM,510,RC,29581,HCPCS,outpatient,,,172.24,129.18,,155.02,90,,,percent of total billed charges,90% of total billed charges,160.18,93,,,percent of total billed charges,93% of total billed charges,65.45,38,,,percent of total billed charges,38% of total billed charges,65.45,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,65.45,38,,,percent of total billed charges,38% of total billed charges,140.2,81.4,,,percent of total billed charges,81.4% of total billed charges,155.02,90,,,percent of total billed charges,90% of total billed charges,155.02,90,,,percent of total billed charges,90% of total billed charges,65.45,38,,,percent of total billed charges,38% of total billed charges,65.45,38,,,percent of total billed charges,38% of total billed charges,65.45,38,,,percent of total billed charges,38% of total billed charges,129.18,75,,,percent of total billed charges,75% of total billed charges,146.4,85,,,percent of total billed charges,85% of total billed charges,65.45,160.18,
Insertion of Cardiac monitor SQ,3940,CDM,761,RC,33285,HCPCS,outpatient,,,4329.73,3247.3,,3896.76,90,,,percent of total billed charges,90% of total billed charges,4026.65,93,,,percent of total billed charges,93% of total billed charges,1645.3,38,,,percent of total billed charges,38% of total billed charges,1645.3,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,1645.3,38,,,percent of total billed charges,38% of total billed charges,3524.4,81.4,,,percent of total billed charges,81.4% of total billed charges,3896.76,90,,,percent of total billed charges,90% of total billed charges,3896.76,90,,,percent of total billed charges,90% of total billed charges,1645.3,38,,,percent of total billed charges,38% of total billed charges,1645.3,38,,,percent of total billed charges,38% of total billed charges,1645.3,38,,,percent of total billed charges,38% of total billed charges,3247.3,75,,,percent of total billed charges,75% of total billed charges,3680.27,85,,,percent of total billed charges,85% of total billed charges,1645.3,4026.65,
Insertion of PICC line >5yrs,3941,CDM,761,RC,36569,HCPCS,outpatient,,,1154.21,865.66,,1038.79,90,,,percent of total billed charges,90% of total billed charges,1073.42,93,,,percent of total billed charges,93% of total billed charges,438.6,38,,,percent of total billed charges,38% of total billed charges,438.6,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,438.6,38,,,percent of total billed charges,38% of total billed charges,939.53,81.4,,,percent of total billed charges,81.4% of total billed charges,1038.79,90,,,percent of total billed charges,90% of total billed charges,1038.79,90,,,percent of total billed charges,90% of total billed charges,438.6,38,,,percent of total billed charges,38% of total billed charges,438.6,38,,,percent of total billed charges,38% of total billed charges,438.6,38,,,percent of total billed charges,38% of total billed charges,865.66,75,,,percent of total billed charges,75% of total billed charges,981.08,85,,,percent of total billed charges,85% of total billed charges,438.6,1073.42,
Remove impacted Cerumen w/o instru[Package],3942,CDM,524,RC,69209,HCPCS,outpatient,,,92.82,69.62,,83.54,90,,,percent of total billed charges,90% of total billed charges,86.32,93,,,percent of total billed charges,93% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,78.9,85,,,percent of total billed charges,85% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,75.56,81.4,,,percent of total billed charges,81.4% of total billed charges,83.54,90,,,percent of total billed charges,90% of total billed charges,83.54,90,,,percent of total billed charges,90% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,35.27,38,,,percent of total billed charges,38% of total billed charges,69.62,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,35.27,86.32,
Remove impacted Cerumen w/o instru-fac,3943,CDM,510,RC,69209,HCPCS,outpatient,,,58.01,43.51,,52.21,90,,,percent of total billed charges,90% of total billed charges,53.95,93,,,percent of total billed charges,93% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,22.04,38,,,percent of total billed charges,38% of total billed charges,47.22,81.4,,,percent of total billed charges,81.4% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,52.21,90,,,percent of total billed charges,90% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,22.04,38,,,percent of total billed charges,38% of total billed charges,43.51,75,,,percent of total billed charges,75% of total billed charges,49.31,85,,,percent of total billed charges,85% of total billed charges,22.04,53.95,
Clinic Admin- flu vaccine,3944,CDM,771,RC,90471,HCPCS,outpatient,,,35.7,26.78,,32.13,90,,,percent of total billed charges,90% of total billed charges,33.2,93,,,percent of total billed charges,93% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,29.06,81.4,,,percent of total billed charges,81.4% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,26.78,75,,,percent of total billed charges,75% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,33.2,
Clinic Admin- flu vaccine,3945,CDM,771,RC,90471,HCPCS,outpatient,,,35.7,26.78,,32.13,90,,,percent of total billed charges,90% of total billed charges,33.2,93,,,percent of total billed charges,93% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,29.06,81.4,,,percent of total billed charges,81.4% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,26.78,75,,,percent of total billed charges,75% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,33.2,
"Clinic IV therapy for Vit C, MAG",3946,CDM,510,RC,96367,HCPCS,outpatient,,,106.63,79.97,,95.97,90,,,percent of total billed charges,90% of total billed charges,99.17,93,,,percent of total billed charges,93% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,40.52,38,,,percent of total billed charges,38% of total billed charges,86.8,81.4,,,percent of total billed charges,81.4% of total billed charges,95.97,90,,,percent of total billed charges,90% of total billed charges,95.97,90,,,percent of total billed charges,90% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,79.97,75,,,percent of total billed charges,75% of total billed charges,90.64,85,,,percent of total billed charges,85% of total billed charges,40.52,99.17,
Port Flush,3947,CDM,761,RC,96523,HCPCS,outpatient,,,128.89,96.67,,116,90,,,percent of total billed charges,90% of total billed charges,119.87,93,,,percent of total billed charges,93% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,48.98,38,,,percent of total billed charges,38% of total billed charges,104.92,81.4,,,percent of total billed charges,81.4% of total billed charges,116,90,,,percent of total billed charges,90% of total billed charges,116,90,,,percent of total billed charges,90% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,48.98,38,,,percent of total billed charges,38% of total billed charges,96.67,75,,,percent of total billed charges,75% of total billed charges,109.56,85,,,percent of total billed charges,85% of total billed charges,48.98,119.87,
Office Visit New Min - FAC,3948,CDM,510,RC,99201,HCPCS,outpatient,,,42.17,31.63,,37.95,90,,,percent of total billed charges,90% of total billed charges,39.22,93,,,percent of total billed charges,93% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,16.02,38,,,percent of total billed charges,38% of total billed charges,34.33,81.4,,,percent of total billed charges,81.4% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,31.63,75,,,percent of total billed charges,75% of total billed charges,35.84,85,,,percent of total billed charges,85% of total billed charges,16.02,39.22,
Office Visit New Brief- FAC,3949,CDM,510,RC,99202,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
Office Visit New Int.-FAC,3950,CDM,510,RC,99203,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
Office Visit New Ext.-FAC,3951,CDM,510,RC,99204,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
Office Visit New Ext. +-FAC,3952,CDM,510,RC,99205,HCPCS,outpatient,,,153.5,115.13,,138.15,90,,,percent of total billed charges,90% of total billed charges,142.76,93,,,percent of total billed charges,93% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,58.33,38,,,percent of total billed charges,38% of total billed charges,124.95,81.4,,,percent of total billed charges,81.4% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,115.13,75,,,percent of total billed charges,75% of total billed charges,130.48,85,,,percent of total billed charges,85% of total billed charges,58.33,142.76,
Office Visit Est. Brief-FAC,3953,CDM,510,RC,99212,HCPCS,outpatient,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
Office Visit Est. Brief-FAC,3954,CDM,510,RC,99212,HCPCS,outpatient,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
Office Visit Est. Int.-FAC,3955,CDM,510,RC,99213,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
Office Visit Est. Ext.-FAC,3956,CDM,510,RC,99214,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
Office Visit Est. Ext. +-FAC,3957,CDM,510,RC,99215,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
OFFICE CONSULT-MINOR- 15 MIN-FAC,3958,CDM,510,RC,99241,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
OFFICE COUSULT-LOW-FAC 30 MIN,3959,CDM,510,RC,99242,HCPCS,outpatient,,,127.72,95.79,,114.95,90,,,percent of total billed charges,90% of total billed charges,118.78,93,,,percent of total billed charges,93% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,48.53,38,,,percent of total billed charges,38% of total billed charges,103.96,81.4,,,percent of total billed charges,81.4% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,95.79,75,,,percent of total billed charges,75% of total billed charges,108.56,85,,,percent of total billed charges,85% of total billed charges,48.53,118.78,
OFFICE CONSULT-MODERATE-40 MIN-FAC,3960,CDM,510,RC,99243,HCPCS,outpatient,,,125.38,94.04,,112.84,90,,,percent of total billed charges,90% of total billed charges,116.6,93,,,percent of total billed charges,93% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,47.64,38,,,percent of total billed charges,38% of total billed charges,102.06,81.4,,,percent of total billed charges,81.4% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,94.04,75,,,percent of total billed charges,75% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,116.6,
OFFICE CONSULT-MOD/HIGH-60 MIN-FAC,3961,CDM,510,RC,99244,HCPCS,outpatient,,,164.04,123.03,,147.64,90,,,percent of total billed charges,90% of total billed charges,152.56,93,,,percent of total billed charges,93% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,62.34,38,,,percent of total billed charges,38% of total billed charges,133.53,81.4,,,percent of total billed charges,81.4% of total billed charges,147.64,90,,,percent of total billed charges,90% of total billed charges,147.64,90,,,percent of total billed charges,90% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,123.03,75,,,percent of total billed charges,75% of total billed charges,139.43,85,,,percent of total billed charges,85% of total billed charges,62.34,152.56,
OFFICE CONSULT-HIGH-HIGH-80 MIN-FAC,3962,CDM,510,RC,99245,HCPCS,outpatient,,,172.25,129.19,,155.03,90,,,percent of total billed charges,90% of total billed charges,160.19,93,,,percent of total billed charges,93% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,65.46,38,,,percent of total billed charges,38% of total billed charges,140.21,81.4,,,percent of total billed charges,81.4% of total billed charges,155.03,90,,,percent of total billed charges,90% of total billed charges,155.03,90,,,percent of total billed charges,90% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,65.46,38,,,percent of total billed charges,38% of total billed charges,129.19,75,,,percent of total billed charges,75% of total billed charges,146.41,85,,,percent of total billed charges,85% of total billed charges,65.46,160.19,
PICC device,3963,CDM,278,RC,C1751,HCPCS,both,,,296.47,222.35,,266.82,90,,,percent of total billed charges,90% of total billed charges,275.72,93,,,percent of total billed charges,93% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,252,85,,,percent of total billed charges,85% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,241.33,81.4,,,percent of total billed charges,81.4% of total billed charges,266.82,90,,,percent of total billed charges,90% of total billed charges,266.82,90,,,percent of total billed charges,90% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,222.35,75,,,percent of total billed charges,75% of total billed charges,252,85,,,percent of total billed charges,85% of total billed charges,112.66,275.72,
BIOMONTOR III,3964,CDM,270,RC,C1764,HCPCS,outpatient,,,5953.37,4465.03,,5358.03,90,,,percent of total billed charges,90% of total billed charges,5536.63,93,,,percent of total billed charges,93% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,5060.36,85,,,percent of total billed charges,85% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,4846.04,81.4,,,percent of total billed charges,81.4% of total billed charges,5358.03,90,,,percent of total billed charges,90% of total billed charges,5358.03,90,,,percent of total billed charges,90% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,4465.03,75,,,percent of total billed charges,75% of total billed charges,5060.36,85,,,percent of total billed charges,85% of total billed charges,2262.28,5536.63,
PM INJ TRIGGER POINT 1/2 MUSCL FAC,3965,CDM,761,RC,20552,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
PM INJECT TRIGGER POINTS 3/> FAC,3966,CDM,761,RC,20553,HCPCS,outpatient,,,97.42,73.07,,87.68,90,,,percent of total billed charges,90% of total billed charges,90.6,93,,,percent of total billed charges,93% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,37.02,38,,,percent of total billed charges,38% of total billed charges,79.3,81.4,,,percent of total billed charges,81.4% of total billed charges,87.68,90,,,percent of total billed charges,90% of total billed charges,87.68,90,,,percent of total billed charges,90% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,73.07,75,,,percent of total billed charges,75% of total billed charges,82.81,85,,,percent of total billed charges,85% of total billed charges,37.02,90.6,
PM INJECT TRIGGER POINTS 3/> FAC,3967,CDM,761,RC,20553,HCPCS,outpatient,,,97.42,73.07,,87.68,90,,,percent of total billed charges,90% of total billed charges,90.6,93,,,percent of total billed charges,93% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,37.02,38,,,percent of total billed charges,38% of total billed charges,79.3,81.4,,,percent of total billed charges,81.4% of total billed charges,87.68,90,,,percent of total billed charges,90% of total billed charges,87.68,90,,,percent of total billed charges,90% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,37.02,38,,,percent of total billed charges,38% of total billed charges,73.07,75,,,percent of total billed charges,75% of total billed charges,82.81,85,,,percent of total billed charges,85% of total billed charges,37.02,90.6,
"PM Arthrocentesis, aspiration and/or injection, major joint or bursa FAC",3968,CDM,761,RC,20610,HCPCS,outpatient,,,269.28,201.96,,242.35,90,,,percent of total billed charges,90% of total billed charges,250.43,93,,,percent of total billed charges,93% of total billed charges,102.33,38,,,percent of total billed charges,38% of total billed charges,102.33,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,102.33,38,,,percent of total billed charges,38% of total billed charges,219.19,81.4,,,percent of total billed charges,81.4% of total billed charges,242.35,90,,,percent of total billed charges,90% of total billed charges,242.35,90,,,percent of total billed charges,90% of total billed charges,102.33,38,,,percent of total billed charges,38% of total billed charges,102.33,38,,,percent of total billed charges,38% of total billed charges,102.33,38,,,percent of total billed charges,38% of total billed charges,201.96,75,,,percent of total billed charges,75% of total billed charges,228.89,85,,,percent of total billed charges,85% of total billed charges,102.33,250.43,
PM N BLOCK INJ OCCIPITAL FAC,3969,CDM,761,RC,64405,HCPCS,outpatient,,,194.84,146.13,,175.36,90,,,percent of total billed charges,90% of total billed charges,181.2,93,,,percent of total billed charges,93% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,74.04,38,,,percent of total billed charges,38% of total billed charges,158.6,81.4,,,percent of total billed charges,81.4% of total billed charges,175.36,90,,,percent of total billed charges,90% of total billed charges,175.36,90,,,percent of total billed charges,90% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,74.04,38,,,percent of total billed charges,38% of total billed charges,146.13,75,,,percent of total billed charges,75% of total billed charges,165.61,85,,,percent of total billed charges,85% of total billed charges,74.04,181.2,
PM N BLOCK INJ INTERCOST SNG FAC,3970,CDM,761,RC,64420,HCPCS,outpatient,,,216.48,162.36,,194.83,90,,,percent of total billed charges,90% of total billed charges,201.33,93,,,percent of total billed charges,93% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,82.26,38,,,percent of total billed charges,38% of total billed charges,176.21,81.4,,,percent of total billed charges,81.4% of total billed charges,194.83,90,,,percent of total billed charges,90% of total billed charges,194.83,90,,,percent of total billed charges,90% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,82.26,38,,,percent of total billed charges,38% of total billed charges,162.36,75,,,percent of total billed charges,75% of total billed charges,184.01,85,,,percent of total billed charges,85% of total billed charges,82.26,201.33,
PM N BLOCK INJ INTERCOST MLT FAC,3971,CDM,761,RC,64421,HCPCS,outpatient,,,270.61,202.96,,243.55,90,,,percent of total billed charges,90% of total billed charges,251.67,93,,,percent of total billed charges,93% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,102.83,38,,,percent of total billed charges,38% of total billed charges,220.28,81.4,,,percent of total billed charges,81.4% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,202.96,75,,,percent of total billed charges,75% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,251.67,
PM OTHER PERIPHERAL NERVE BLOCK FAC,3972,CDM,761,RC,64450,HCPCS,outpatient,,,270.61,202.96,,243.55,90,,,percent of total billed charges,90% of total billed charges,251.67,93,,,percent of total billed charges,93% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,102.83,38,,,percent of total billed charges,38% of total billed charges,220.28,81.4,,,percent of total billed charges,81.4% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,243.55,90,,,percent of total billed charges,90% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,102.83,38,,,percent of total billed charges,38% of total billed charges,202.96,75,,,percent of total billed charges,75% of total billed charges,230.02,85,,,percent of total billed charges,85% of total billed charges,102.83,251.67,
PM chemodenervation - fac,3973,CDM,761,RC,64615,HCPCS,outpatient,,,54.12,40.59,,48.71,90,,,percent of total billed charges,90% of total billed charges,50.33,93,,,percent of total billed charges,93% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,20.57,38,,,percent of total billed charges,38% of total billed charges,44.05,81.4,,,percent of total billed charges,81.4% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,40.59,75,,,percent of total billed charges,75% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,50.33,
CONSULT BRIEF NEW FAC,3974,CDM,761,RC,99202,HCPCS,outpatient,,,64.94,48.71,,58.45,90,,,percent of total billed charges,90% of total billed charges,60.39,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,24.68,38,,,percent of total billed charges,38% of total billed charges,52.86,81.4,,,percent of total billed charges,81.4% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.71,75,,,percent of total billed charges,75% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,60.39,
CONSULT INT NEW FAC,3975,CDM,761,RC,99203,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,100.66,
CONSULT EXT NEW FAC,3976,CDM,761,RC,99204,HCPCS,outpatient,,,129.9,97.43,,116.91,90,,,percent of total billed charges,90% of total billed charges,120.81,93,,,percent of total billed charges,93% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,49.36,38,,,percent of total billed charges,38% of total billed charges,105.74,81.4,,,percent of total billed charges,81.4% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,97.43,75,,,percent of total billed charges,75% of total billed charges,110.42,85,,,percent of total billed charges,85% of total billed charges,49.36,120.81,
CONSULT BRIEF EST FAC,3977,CDM,761,RC,99212,HCPCS,outpatient,,,38.96,29.22,,35.06,90,,,percent of total billed charges,90% of total billed charges,36.23,93,,,percent of total billed charges,93% of total billed charges,14.8,38,,,percent of total billed charges,38% of total billed charges,14.8,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,14.8,38,,,percent of total billed charges,38% of total billed charges,31.71,81.4,,,percent of total billed charges,81.4% of total billed charges,35.06,90,,,percent of total billed charges,90% of total billed charges,35.06,90,,,percent of total billed charges,90% of total billed charges,14.8,38,,,percent of total billed charges,38% of total billed charges,14.8,38,,,percent of total billed charges,38% of total billed charges,14.8,38,,,percent of total billed charges,38% of total billed charges,29.22,75,,,percent of total billed charges,75% of total billed charges,33.12,85,,,percent of total billed charges,85% of total billed charges,14.8,36.23,
CONSULT INT EST FAC,3978,CDM,761,RC,99213,HCPCS,outpatient,,,48.72,36.54,,43.85,90,,,percent of total billed charges,90% of total billed charges,45.31,93,,,percent of total billed charges,93% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.51,38,,,percent of total billed charges,38% of total billed charges,39.66,81.4,,,percent of total billed charges,81.4% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,36.54,75,,,percent of total billed charges,75% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,45.31,
CONSULT EXT EST FAC,3979,CDM,761,RC,99214,HCPCS,outpatient,,,54.12,40.59,,48.71,90,,,percent of total billed charges,90% of total billed charges,50.33,93,,,percent of total billed charges,93% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,20.57,38,,,percent of total billed charges,38% of total billed charges,44.05,81.4,,,percent of total billed charges,81.4% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,40.59,75,,,percent of total billed charges,75% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,50.33,
CONSULT EXT+ EST FAC,3980,CDM,761,RC,99215,HCPCS,outpatient,,,59.53,44.65,,53.58,90,,,percent of total billed charges,90% of total billed charges,55.36,93,,,percent of total billed charges,93% of total billed charges,22.62,38,,,percent of total billed charges,38% of total billed charges,22.62,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,22.62,38,,,percent of total billed charges,38% of total billed charges,48.46,81.4,,,percent of total billed charges,81.4% of total billed charges,53.58,90,,,percent of total billed charges,90% of total billed charges,53.58,90,,,percent of total billed charges,90% of total billed charges,22.62,38,,,percent of total billed charges,38% of total billed charges,22.62,38,,,percent of total billed charges,38% of total billed charges,22.62,38,,,percent of total billed charges,38% of total billed charges,44.65,75,,,percent of total billed charges,75% of total billed charges,50.6,85,,,percent of total billed charges,85% of total billed charges,22.62,55.36,
Telephone E&M 5 - 10 min,3981,CDM,988,RC,99441,HCPCS,outpatient,,,54.12,40.59,,16.46,130,,,fee schedule,130% of fee schedule,16.46,130,,,fee schedule,130% of fee schedule,35.23,100,,,fee schedule,Pays 100% Medicare OPPS,35.23,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.23,100,,,fee schedule,Pays 100% Medicare OPPS,35.23,100,,,fee schedule,100% of fee schedule,48.71,90,,,percent of total billed charges,90% of total billed charges,35.23,100,,,fee schedule,Pays 100% Medicare OPPS,35.23,100,,,fee schedule,Pays 100% Medicare OPPS,35.23,100,,,fee schedule,Pays 100% Medicare OPPS,35.23,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,35.23,100,,,fee schedule,100% of fee schedule,16.46,48.71,
SI joint fusion access tool kit,3982,CDM,271,RC,,,outpatient,,,1224,918,,1101.6,90,,,percent of total billed charges,90% of total billed charges,1138.32,93,,,percent of total billed charges,93% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,1040.4,85,,,percent of total billed charges,85% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,996.34,81.4,,,percent of total billed charges,81.4% of total billed charges,1101.6,90,,,percent of total billed charges,90% of total billed charges,1101.6,90,,,percent of total billed charges,90% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,918,75,,,percent of total billed charges,75% of total billed charges,1040.4,85,,,percent of total billed charges,85% of total billed charges,465.12,1138.32,
Clinic Racemic Epi Inh,3983,CDM,250,RC,46814,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Clinic Doxycycline 100mg/100ml,3984,CDM,250,RC,,,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
Medicaid Vaccine 1st,3985,CDM,771,RC,90471,HCPCS,outpatient,,,25.41,19.06,,22.87,90,,,percent of total billed charges,90% of total billed charges,23.63,93,,,percent of total billed charges,93% of total billed charges,9.66,38,,,percent of total billed charges,38% of total billed charges,9.66,38,,,percent of total billed charges,38% of total billed charges,21.6,85,,,percent of total billed charges,85% of total billed charges,9.66,38,,,percent of total billed charges,38% of total billed charges,20.68,81.4,,,percent of total billed charges,81.4% of total billed charges,22.87,90,,,percent of total billed charges,90% of total billed charges,22.87,90,,,percent of total billed charges,90% of total billed charges,9.66,38,,,percent of total billed charges,38% of total billed charges,9.66,38,,,percent of total billed charges,38% of total billed charges,9.66,38,,,percent of total billed charges,38% of total billed charges,19.06,75,,,percent of total billed charges,75% of total billed charges,21.6,85,,,percent of total billed charges,85% of total billed charges,9.66,23.63,
Clinic Men Quadfi vaccine,3986,CDM,636,RC,90619,HCPCS,both,,,176.87,132.65,,159.18,90,,,percent of total billed charges,90% of total billed charges,164.49,93,,,percent of total billed charges,93% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,143.97,81.4,,,percent of total billed charges,81.4% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,159.18,90,,,percent of total billed charges,90% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,67.21,38,,,percent of total billed charges,38% of total billed charges,132.65,75,,,percent of total billed charges,75% of total billed charges,150.34,85,,,percent of total billed charges,85% of total billed charges,67.21,164.49,
Clinic Hep A adult vaccine,3987,CDM,636,RC,90632,HCPCS,both,,,106.63,79.97,,95.97,90,,,percent of total billed charges,90% of total billed charges,99.17,93,,,percent of total billed charges,93% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,90.64,85,,,percent of total billed charges,85% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,86.8,81.4,,,percent of total billed charges,81.4% of total billed charges,95.97,90,,,percent of total billed charges,90% of total billed charges,95.97,90,,,percent of total billed charges,90% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,79.97,75,,,percent of total billed charges,75% of total billed charges,90.64,85,,,percent of total billed charges,85% of total billed charges,40.52,99.17,
Clinic Hep A Ped/Adolescent vaccine 2 dose,3988,CDM,636,RC,90633,HCPCS,both,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Clinic PedvaxHib,3989,CDM,636,RC,90647,HCPCS,both,,,73.83,55.37,,66.45,90,,,percent of total billed charges,90% of total billed charges,68.66,93,,,percent of total billed charges,93% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,62.76,85,,,percent of total billed charges,85% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,60.1,81.4,,,percent of total billed charges,81.4% of total billed charges,66.45,90,,,percent of total billed charges,90% of total billed charges,66.45,90,,,percent of total billed charges,90% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,55.37,75,,,percent of total billed charges,75% of total billed charges,62.76,85,,,percent of total billed charges,85% of total billed charges,28.06,68.66,
Clinic Haemophilus Influenza B (HIB),3990,CDM,636,RC,90648,HCPCS,both,,,52.72,39.54,,47.45,90,,,percent of total billed charges,90% of total billed charges,49.03,93,,,percent of total billed charges,93% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,42.91,81.4,,,percent of total billed charges,81.4% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,39.54,75,,,percent of total billed charges,75% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,49.03,
Clinic HPV (Human Palilloma Virus),3991,CDM,636,RC,90649,HCPCS,both,,,296.47,222.35,,266.82,90,,,percent of total billed charges,90% of total billed charges,275.72,93,,,percent of total billed charges,93% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,252,85,,,percent of total billed charges,85% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,241.33,81.4,,,percent of total billed charges,81.4% of total billed charges,266.82,90,,,percent of total billed charges,90% of total billed charges,266.82,90,,,percent of total billed charges,90% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,222.35,75,,,percent of total billed charges,75% of total billed charges,252,85,,,percent of total billed charges,85% of total billed charges,112.66,275.72,
"HPV 9 vaccine, Gardasil",3992,CDM,636,RC,90651,HCPCS,both,,,263.65,197.74,,237.29,90,,,percent of total billed charges,90% of total billed charges,245.19,93,,,percent of total billed charges,93% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,214.61,81.4,,,percent of total billed charges,81.4% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,197.74,75,,,percent of total billed charges,75% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,245.19,
"Clinic Flu vaccine, high dose 65 or greater",3993,CDM,636,RC,90662,HCPCS,both,,,78.54,58.91,,70.69,90,,,percent of total billed charges,90% of total billed charges,73.04,93,,,percent of total billed charges,93% of total billed charges,29.85,38,,,percent of total billed charges,38% of total billed charges,29.85,38,,,percent of total billed charges,38% of total billed charges,66.76,85,,,percent of total billed charges,85% of total billed charges,29.85,38,,,percent of total billed charges,38% of total billed charges,63.93,81.4,,,percent of total billed charges,81.4% of total billed charges,70.69,90,,,percent of total billed charges,90% of total billed charges,70.69,90,,,percent of total billed charges,90% of total billed charges,29.85,38,,,percent of total billed charges,38% of total billed charges,29.85,38,,,percent of total billed charges,38% of total billed charges,29.85,38,,,percent of total billed charges,38% of total billed charges,58.91,75,,,percent of total billed charges,75% of total billed charges,66.76,85,,,percent of total billed charges,85% of total billed charges,29.85,73.04,
Clinic Pneumococcal Conjugate (Prevnar PCV13),3994,CDM,636,RC,90670,HCPCS,both,,,491.21,368.41,,442.09,90,,,percent of total billed charges,90% of total billed charges,456.83,93,,,percent of total billed charges,93% of total billed charges,186.66,38,,,percent of total billed charges,38% of total billed charges,186.66,38,,,percent of total billed charges,38% of total billed charges,417.53,85,,,percent of total billed charges,85% of total billed charges,186.66,38,,,percent of total billed charges,38% of total billed charges,399.84,81.4,,,percent of total billed charges,81.4% of total billed charges,442.09,90,,,percent of total billed charges,90% of total billed charges,442.09,90,,,percent of total billed charges,90% of total billed charges,186.66,38,,,percent of total billed charges,38% of total billed charges,186.66,38,,,percent of total billed charges,38% of total billed charges,186.66,38,,,percent of total billed charges,38% of total billed charges,368.41,75,,,percent of total billed charges,75% of total billed charges,417.53,85,,,percent of total billed charges,85% of total billed charges,186.66,456.83,
Clnic Prevnar PCV20,3995,CDM,636,RC,90677,HCPCS,both,,,328.97,246.73,,296.07,90,,,percent of total billed charges,90% of total billed charges,305.94,93,,,percent of total billed charges,93% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,279.62,85,,,percent of total billed charges,85% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,267.78,81.4,,,percent of total billed charges,81.4% of total billed charges,296.07,90,,,percent of total billed charges,90% of total billed charges,296.07,90,,,percent of total billed charges,90% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,125.01,38,,,percent of total billed charges,38% of total billed charges,246.73,75,,,percent of total billed charges,75% of total billed charges,279.62,85,,,percent of total billed charges,85% of total billed charges,125.01,305.94,
Clinic Rotavirus vaccine 3 Dose,3996,CDM,636,RC,90680,HCPCS,both,,,124.22,93.17,,111.8,90,,,percent of total billed charges,90% of total billed charges,115.52,93,,,percent of total billed charges,93% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,105.59,85,,,percent of total billed charges,85% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,101.12,81.4,,,percent of total billed charges,81.4% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,93.17,75,,,percent of total billed charges,75% of total billed charges,105.59,85,,,percent of total billed charges,85% of total billed charges,47.2,115.52,
Clinic Flu (6 months to 35 months),3997,CDM,636,RC,90685,HCPCS,both,,,32.49,24.37,,29.24,90,,,percent of total billed charges,90% of total billed charges,30.22,93,,,percent of total billed charges,93% of total billed charges,12.35,38,,,percent of total billed charges,38% of total billed charges,12.35,38,,,percent of total billed charges,38% of total billed charges,27.62,85,,,percent of total billed charges,85% of total billed charges,12.35,38,,,percent of total billed charges,38% of total billed charges,26.45,81.4,,,percent of total billed charges,81.4% of total billed charges,29.24,90,,,percent of total billed charges,90% of total billed charges,29.24,90,,,percent of total billed charges,90% of total billed charges,12.35,38,,,percent of total billed charges,38% of total billed charges,12.35,38,,,percent of total billed charges,38% of total billed charges,12.35,38,,,percent of total billed charges,38% of total billed charges,24.37,75,,,percent of total billed charges,75% of total billed charges,27.62,85,,,percent of total billed charges,85% of total billed charges,12.35,30.22,
Clinic Flu vaccine 3 yrs and>,3998,CDM,636,RC,90688,HCPCS,both,,,25.5,19.13,,22.95,90,,,percent of total billed charges,90% of total billed charges,23.72,93,,,percent of total billed charges,93% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,20.76,81.4,,,percent of total billed charges,81.4% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,19.13,75,,,percent of total billed charges,75% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.69,23.72,
Clinic Flu vaccine 3 yrs and>,3999,CDM,636,RC,90688,HCPCS,both,,,25.5,19.13,,22.95,90,,,percent of total billed charges,90% of total billed charges,23.72,93,,,percent of total billed charges,93% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,20.76,81.4,,,percent of total billed charges,81.4% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,19.13,75,,,percent of total billed charges,75% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.69,23.72,
Flu vaccine 3 yrs and > 21/22,4000,CDM,636,RC,90688,HCPCS,both,,,26.01,19.51,,23.41,90,,,percent of total billed charges,90% of total billed charges,24.19,93,,,percent of total billed charges,93% of total billed charges,9.88,38,,,percent of total billed charges,38% of total billed charges,9.88,38,,,percent of total billed charges,38% of total billed charges,22.11,85,,,percent of total billed charges,85% of total billed charges,9.88,38,,,percent of total billed charges,38% of total billed charges,21.17,81.4,,,percent of total billed charges,81.4% of total billed charges,23.41,90,,,percent of total billed charges,90% of total billed charges,23.41,90,,,percent of total billed charges,90% of total billed charges,9.88,38,,,percent of total billed charges,38% of total billed charges,9.88,38,,,percent of total billed charges,38% of total billed charges,9.88,38,,,percent of total billed charges,38% of total billed charges,19.51,75,,,percent of total billed charges,75% of total billed charges,22.11,85,,,percent of total billed charges,85% of total billed charges,9.88,24.19,
Clinic Kinrix DTAP/IVP,4001,CDM,636,RC,90696,HCPCS,both,,,81.2,60.9,,73.08,90,,,percent of total billed charges,90% of total billed charges,75.52,93,,,percent of total billed charges,93% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,66.1,81.4,,,percent of total billed charges,81.4% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,60.9,75,,,percent of total billed charges,75% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,30.86,75.52,
"Clinic DTaP, HIB, IP",4002,CDM,636,RC,90698,HCPCS,both,,,110.17,82.63,,99.15,90,,,percent of total billed charges,90% of total billed charges,102.46,93,,,percent of total billed charges,93% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,93.64,85,,,percent of total billed charges,85% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,89.68,81.4,,,percent of total billed charges,81.4% of total billed charges,99.15,90,,,percent of total billed charges,90% of total billed charges,99.15,90,,,percent of total billed charges,90% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,41.86,38,,,percent of total billed charges,38% of total billed charges,82.63,75,,,percent of total billed charges,75% of total billed charges,93.64,85,,,percent of total billed charges,85% of total billed charges,41.86,102.46,
Clinic DTap <7 years,4003,CDM,636,RC,90700,HCPCS,both,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
Clinic MMR vaccine,4004,CDM,636,RC,90707,HCPCS,both,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
Clinic Vaccine  MMRV,4005,CDM,636,RC,90710,HCPCS,both,,,256.62,192.47,,230.96,90,,,percent of total billed charges,90% of total billed charges,238.66,93,,,percent of total billed charges,93% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,218.13,85,,,percent of total billed charges,85% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,208.89,81.4,,,percent of total billed charges,81.4% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,192.47,75,,,percent of total billed charges,75% of total billed charges,218.13,85,,,percent of total billed charges,85% of total billed charges,97.52,238.66,
Clinic IPV,4006,CDM,636,RC,90713,HCPCS,both,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
Clinic Td vaccine- Adult,4007,CDM,636,RC,90714,HCPCS,both,,,66.79,50.09,,60.11,90,,,percent of total billed charges,90% of total billed charges,62.11,93,,,percent of total billed charges,93% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,54.37,81.4,,,percent of total billed charges,81.4% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,50.09,75,,,percent of total billed charges,75% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,62.11,
Clinic - TDAP; 7 yrs or older,4008,CDM,636,RC,90715,HCPCS,both,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
Clinic Varicella vaccine- pediatric,4009,CDM,636,RC,90716,HCPCS,both,,,169.91,127.43,,152.92,90,,,percent of total billed charges,90% of total billed charges,158.02,93,,,percent of total billed charges,93% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,144.42,85,,,percent of total billed charges,85% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,138.31,81.4,,,percent of total billed charges,81.4% of total billed charges,152.92,90,,,percent of total billed charges,90% of total billed charges,152.92,90,,,percent of total billed charges,90% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,64.57,38,,,percent of total billed charges,38% of total billed charges,127.43,75,,,percent of total billed charges,75% of total billed charges,144.42,85,,,percent of total billed charges,85% of total billed charges,64.57,158.02,
"Clinic DTap, Hep B, IPV vaccine",4010,CDM,636,RC,90723,HCPCS,both,,,111.33,83.5,,100.2,90,,,percent of total billed charges,90% of total billed charges,103.54,93,,,percent of total billed charges,93% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,94.63,85,,,percent of total billed charges,85% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,90.62,81.4,,,percent of total billed charges,81.4% of total billed charges,100.2,90,,,percent of total billed charges,90% of total billed charges,100.2,90,,,percent of total billed charges,90% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,83.5,75,,,percent of total billed charges,75% of total billed charges,94.63,85,,,percent of total billed charges,85% of total billed charges,42.31,103.54,
Clinic Pneumovax,4011,CDM,636,RC,90732,HCPCS,both,,,234.7,176.03,,211.23,90,,,percent of total billed charges,90% of total billed charges,218.27,93,,,percent of total billed charges,93% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,199.5,85,,,percent of total billed charges,85% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,191.05,81.4,,,percent of total billed charges,81.4% of total billed charges,211.23,90,,,percent of total billed charges,90% of total billed charges,211.23,90,,,percent of total billed charges,90% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,176.03,75,,,percent of total billed charges,75% of total billed charges,199.5,85,,,percent of total billed charges,85% of total billed charges,89.19,218.27,
Clinic Meningococcal MCV4,4012,CDM,636,RC,90734,HCPCS,both,,,151.15,113.36,,136.04,90,,,percent of total billed charges,90% of total billed charges,140.57,93,,,percent of total billed charges,93% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,123.04,81.4,,,percent of total billed charges,81.4% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,113.36,75,,,percent of total billed charges,75% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,140.57,
Clinic Zoster (Shingles) vaccine,4013,CDM,636,RC,90736,HCPCS,both,,,296.47,222.35,,266.82,90,,,percent of total billed charges,90% of total billed charges,275.72,93,,,percent of total billed charges,93% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,252,85,,,percent of total billed charges,85% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,241.33,81.4,,,percent of total billed charges,81.4% of total billed charges,266.82,90,,,percent of total billed charges,90% of total billed charges,266.82,90,,,percent of total billed charges,90% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,112.66,38,,,percent of total billed charges,38% of total billed charges,222.35,75,,,percent of total billed charges,75% of total billed charges,252,85,,,percent of total billed charges,85% of total billed charges,112.66,275.72,
Clinic ZOSTER (patient's Med),4014,CDM,636,RC,90736,HCPCS,both,,,0.01,0.01,,0.01,90,,,percent of total billed charges,90% of total billed charges,0.01,93,,,percent of total billed charges,93% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,0.01,85,,,percent of total billed charges,85% of total billed charges,,,,,other,Not reimbursable per contract,0.01,81.4,,,percent of total billed charges,81.4% of total billed charges,0.01,90,,,percent of total billed charges,90% of total billed charges,0.01,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,0.01,75,,,percent of total billed charges,75% of total billed charges,0.01,85,,,percent of total billed charges,85% of total billed charges,0.01,0.01,
Hep B Ped/adolescent 3 dose,4015,CDM,636,RC,90744,HCPCS,both,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Clinic Hep B vaccine adult dose,4016,CDM,636,RC,90746,HCPCS,both,,,113.67,85.25,,102.3,90,,,percent of total billed charges,90% of total billed charges,105.71,93,,,percent of total billed charges,93% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,96.62,85,,,percent of total billed charges,85% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,92.53,81.4,,,percent of total billed charges,81.4% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,85.25,75,,,percent of total billed charges,75% of total billed charges,96.62,85,,,percent of total billed charges,85% of total billed charges,43.19,105.71,
INJ OPTISON - ECHO CONTRAST,4017,CDM,636,RC,A9700,HCPCS,both,,,337.48,253.11,,303.73,90,,,percent of total billed charges,90% of total billed charges,313.86,93,,,percent of total billed charges,93% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,274.71,81.4,,,percent of total billed charges,81.4% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,253.11,75,,,percent of total billed charges,75% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,313.86,
INJ OPTISON - ECHO CONTRAST,4018,CDM,636,RC,A9700,HCPCS,both,,,337.48,253.11,,303.73,90,,,percent of total billed charges,90% of total billed charges,313.86,93,,,percent of total billed charges,93% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,274.71,81.4,,,percent of total billed charges,81.4% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,253.11,75,,,percent of total billed charges,75% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,313.86,
INJ OPTISON - ECHO CONTRAST,4019,CDM,636,RC,A9700,HCPCS,both,,,337.48,253.11,,303.73,90,,,percent of total billed charges,90% of total billed charges,313.86,93,,,percent of total billed charges,93% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,274.71,81.4,,,percent of total billed charges,81.4% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,253.11,75,,,percent of total billed charges,75% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,313.86,
Clinic Adenosine 1mg,4020,CDM,250,RC,J0153,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
Clinic- Epinephrine 1:1000 1mg/ml per.1 mg,4021,CDM,250,RC,J0171,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
"Clinic Bicillin LA 100,000U",4022,CDM,636,RC,J0561,HCPCS,both,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
"Clinic Bicillin LA 100,000U",4023,CDM,636,RC,J0561,HCPCS,both,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
"Clinic Bicillin LA 100,000U",4024,CDM,636,RC,J0561,HCPCS,both,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
Clinic Rocephin 250mg per 250mg,4025,CDM,636,RC,J0696,HCPCS,both,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
Clinic Rocephin 500mg per 250,4026,CDM,636,RC,J0696,HCPCS,both,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
Clinic Rocephin 1gram per 250mg,4027,CDM,636,RC,J0696,HCPCS,both,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
Clinic Cipro 400mg  IV/200mg,4028,CDM,636,RC,J0744,HCPCS,both,,,132.65,99.49,,119.39,90,,,percent of total billed charges,90% of total billed charges,123.36,93,,,percent of total billed charges,93% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,112.75,85,,,percent of total billed charges,85% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,107.98,81.4,,,percent of total billed charges,81.4% of total billed charges,119.39,90,,,percent of total billed charges,90% of total billed charges,119.39,90,,,percent of total billed charges,90% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,50.41,38,,,percent of total billed charges,38% of total billed charges,99.49,75,,,percent of total billed charges,75% of total billed charges,112.75,85,,,percent of total billed charges,85% of total billed charges,50.41,123.36,
Clinic Depo-Esteradiol 5mg/mL,4029,CDM,636,RC,J1000,HCPCS,both,,,16.41,12.31,,14.77,90,,,percent of total billed charges,90% of total billed charges,15.26,93,,,percent of total billed charges,93% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.36,81.4,,,percent of total billed charges,81.4% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,12.31,75,,,percent of total billed charges,75% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,15.26,
Clinic Depo-Esteradiol 5mg/mL,4030,CDM,636,RC,J1000,HCPCS,both,,,16.41,12.31,,14.77,90,,,percent of total billed charges,90% of total billed charges,15.26,93,,,percent of total billed charges,93% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.36,81.4,,,percent of total billed charges,81.4% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,12.31,75,,,percent of total billed charges,75% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,15.26,
Clinic Depo-Esteradiol 5mg/mL,4031,CDM,636,RC,J1000,HCPCS,both,,,16.41,12.31,,14.77,90,,,percent of total billed charges,90% of total billed charges,15.26,93,,,percent of total billed charges,93% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.36,81.4,,,percent of total billed charges,81.4% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,12.31,75,,,percent of total billed charges,75% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,15.26,
Clinic Depo-Medrol 40mg/mL,4032,CDM,636,RC,J1030,HCPCS,both,,,51.55,38.66,,46.4,90,,,percent of total billed charges,90% of total billed charges,47.94,93,,,percent of total billed charges,93% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,41.96,81.4,,,percent of total billed charges,81.4% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,38.66,75,,,percent of total billed charges,75% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,47.94,
Clinic Depo-Medrol 40mg/mL,4033,CDM,636,RC,J1030,HCPCS,both,,,51.55,38.66,,46.4,90,,,percent of total billed charges,90% of total billed charges,47.94,93,,,percent of total billed charges,93% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,41.96,81.4,,,percent of total billed charges,81.4% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,38.66,75,,,percent of total billed charges,75% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,47.94,
Clinic Depo-Medrol 40mg/mL,4034,CDM,636,RC,J1030,HCPCS,both,,,51.55,38.66,,46.4,90,,,percent of total billed charges,90% of total billed charges,47.94,93,,,percent of total billed charges,93% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,41.96,81.4,,,percent of total billed charges,81.4% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,38.66,75,,,percent of total billed charges,75% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,47.94,
Clinic Depo-Medrol 80mg/mL,4035,CDM,636,RC,J1040,HCPCS,both,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,201.61,
Clinic Depo-Medrol 80mg/mL,4036,CDM,636,RC,J1040,HCPCS,both,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,201.61,
Clinic Depo-Medrol 80mg/mL,4037,CDM,636,RC,J1040,HCPCS,both,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,201.61,
"Clinic Depo-Provera, 1mg",4038,CDM,636,RC,J1050,HCPCS,both,,,0.37,0.28,,0.33,90,,,percent of total billed charges,90% of total billed charges,0.34,93,,,percent of total billed charges,93% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.31,85,,,percent of total billed charges,85% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.3,81.4,,,percent of total billed charges,81.4% of total billed charges,0.33,90,,,percent of total billed charges,90% of total billed charges,0.33,90,,,percent of total billed charges,90% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.28,75,,,percent of total billed charges,75% of total billed charges,0.31,85,,,percent of total billed charges,85% of total billed charges,0.14,0.34,
"Clinic Depo-Provera, 1mg",4039,CDM,636,RC,J1050,HCPCS,both,,,0.37,0.28,,0.33,90,,,percent of total billed charges,90% of total billed charges,0.34,93,,,percent of total billed charges,93% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.31,85,,,percent of total billed charges,85% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.3,81.4,,,percent of total billed charges,81.4% of total billed charges,0.33,90,,,percent of total billed charges,90% of total billed charges,0.33,90,,,percent of total billed charges,90% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.28,75,,,percent of total billed charges,75% of total billed charges,0.31,85,,,percent of total billed charges,85% of total billed charges,0.14,0.34,
"Clinic Depo-Provera, 1mg",4040,CDM,636,RC,J1050,HCPCS,both,,,0.37,0.28,,0.33,90,,,percent of total billed charges,90% of total billed charges,0.34,93,,,percent of total billed charges,93% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.31,85,,,percent of total billed charges,85% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.3,81.4,,,percent of total billed charges,81.4% of total billed charges,0.33,90,,,percent of total billed charges,90% of total billed charges,0.33,90,,,percent of total billed charges,90% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.14,38,,,percent of total billed charges,38% of total billed charges,0.28,75,,,percent of total billed charges,75% of total billed charges,0.31,85,,,percent of total billed charges,85% of total billed charges,0.14,0.34,
Clinic Depo-Testosterone-1 mg,4041,CDM,636,RC,J1071,HCPCS,both,,,0.11,0.08,,0.1,90,,,percent of total billed charges,90% of total billed charges,0.1,93,,,percent of total billed charges,93% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.09,85,,,percent of total billed charges,85% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.09,81.4,,,percent of total billed charges,81.4% of total billed charges,0.1,90,,,percent of total billed charges,90% of total billed charges,0.1,90,,,percent of total billed charges,90% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.08,75,,,percent of total billed charges,75% of total billed charges,0.09,85,,,percent of total billed charges,85% of total billed charges,0.04,0.1,
Clinic Depo-Testosterone-1 mg,4042,CDM,636,RC,J1071,HCPCS,both,,,0.11,0.08,,0.1,90,,,percent of total billed charges,90% of total billed charges,0.1,93,,,percent of total billed charges,93% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.09,85,,,percent of total billed charges,85% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.09,81.4,,,percent of total billed charges,81.4% of total billed charges,0.1,90,,,percent of total billed charges,90% of total billed charges,0.1,90,,,percent of total billed charges,90% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.08,75,,,percent of total billed charges,75% of total billed charges,0.09,85,,,percent of total billed charges,85% of total billed charges,0.04,0.1,
Clinic Depo-Testosterone-1 mg,4043,CDM,636,RC,J1071,HCPCS,both,,,0.11,0.08,,0.1,90,,,percent of total billed charges,90% of total billed charges,0.1,93,,,percent of total billed charges,93% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.09,85,,,percent of total billed charges,85% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.09,81.4,,,percent of total billed charges,81.4% of total billed charges,0.1,90,,,percent of total billed charges,90% of total billed charges,0.1,90,,,percent of total billed charges,90% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.08,75,,,percent of total billed charges,75% of total billed charges,0.09,85,,,percent of total billed charges,85% of total billed charges,0.04,0.1,
Clinic Decadron(dexamethasone),4044,CDM,636,RC,J1100,HCPCS,both,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
Clinic Decadron(dexamethasone),4045,CDM,636,RC,J1100,HCPCS,both,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
Clinic Decadron(dexamethasone),4046,CDM,636,RC,J1100,HCPCS,both,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
Clinic Dilaudid,4047,CDM,636,RC,J1170,HCPCS,both,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
Clinic Benadryl 50mg/ml,4048,CDM,636,RC,J1200,HCPCS,both,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
Clinic Benadryl 50mg/ml,4049,CDM,636,RC,J1200,HCPCS,both,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
Clinic Benadryl 50mg/ml,4050,CDM,636,RC,J1200,HCPCS,both,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
Clinic dobutamine,4051,CDM,250,RC,J1250,HCPCS,outpatient,,,29.8,22.35,,26.82,90,,,percent of total billed charges,90% of total billed charges,27.71,93,,,percent of total billed charges,93% of total billed charges,11.32,38,,,percent of total billed charges,38% of total billed charges,11.32,38,,,percent of total billed charges,38% of total billed charges,25.33,85,,,percent of total billed charges,85% of total billed charges,11.32,38,,,percent of total billed charges,38% of total billed charges,24.26,81.4,,,percent of total billed charges,81.4% of total billed charges,26.82,90,,,percent of total billed charges,90% of total billed charges,26.82,90,,,percent of total billed charges,90% of total billed charges,11.32,38,,,percent of total billed charges,38% of total billed charges,11.32,38,,,percent of total billed charges,38% of total billed charges,11.32,38,,,percent of total billed charges,38% of total billed charges,22.35,75,,,percent of total billed charges,75% of total billed charges,25.33,85,,,percent of total billed charges,85% of total billed charges,11.32,27.71,
Clinic Toradol 15mg,4052,CDM,636,RC,J1885,HCPCS,both,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Clinic Toradol 15mg,4053,CDM,636,RC,J1885,HCPCS,both,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Clinic Toradol 15mg,4054,CDM,636,RC,J1885,HCPCS,both,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Clinic Lasix 10mg/mL,4055,CDM,636,RC,J1940,HCPCS,both,,,16.41,12.31,,14.77,90,,,percent of total billed charges,90% of total billed charges,15.26,93,,,percent of total billed charges,93% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.36,81.4,,,percent of total billed charges,81.4% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,12.31,75,,,percent of total billed charges,75% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,15.26,
Clinic Lasix 10mg/mL,4056,CDM,636,RC,J1940,HCPCS,both,,,16.41,12.31,,14.77,90,,,percent of total billed charges,90% of total billed charges,15.26,93,,,percent of total billed charges,93% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.36,81.4,,,percent of total billed charges,81.4% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,12.31,75,,,percent of total billed charges,75% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,15.26,
Clinic Lasix 10mg/mL,4057,CDM,636,RC,J1940,HCPCS,both,,,16.41,12.31,,14.77,90,,,percent of total billed charges,90% of total billed charges,15.26,93,,,percent of total billed charges,93% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,13.36,81.4,,,percent of total billed charges,81.4% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,14.77,90,,,percent of total billed charges,90% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,6.24,38,,,percent of total billed charges,38% of total billed charges,12.31,75,,,percent of total billed charges,75% of total billed charges,13.95,85,,,percent of total billed charges,85% of total billed charges,6.24,15.26,
Clinic Lorazepam Inj.,4058,CDM,636,RC,J2060,HCPCS,both,,,72.66,54.5,,65.39,90,,,percent of total billed charges,90% of total billed charges,67.57,93,,,percent of total billed charges,93% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,59.15,81.4,,,percent of total billed charges,81.4% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,65.39,90,,,percent of total billed charges,90% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,27.61,38,,,percent of total billed charges,38% of total billed charges,54.5,75,,,percent of total billed charges,75% of total billed charges,61.76,85,,,percent of total billed charges,85% of total billed charges,27.61,67.57,
Clinic Demerol 50mg,4059,CDM,636,RC,J2175,HCPCS,both,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
Clinic Demerol 75mg,4060,CDM,636,RC,J2175,HCPCS,both,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
Clinic Demerol 100mg,4061,CDM,636,RC,J2175,HCPCS,both,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
Clinic Midazolam/ 1mg (5ml vial),4062,CDM,636,RC,J2250,HCPCS,both,,,3.37,2.53,,3.03,90,,,percent of total billed charges,90% of total billed charges,3.13,93,,,percent of total billed charges,93% of total billed charges,1.28,38,,,percent of total billed charges,38% of total billed charges,1.28,38,,,percent of total billed charges,38% of total billed charges,2.86,85,,,percent of total billed charges,85% of total billed charges,1.28,38,,,percent of total billed charges,38% of total billed charges,2.74,81.4,,,percent of total billed charges,81.4% of total billed charges,3.03,90,,,percent of total billed charges,90% of total billed charges,3.03,90,,,percent of total billed charges,90% of total billed charges,1.28,38,,,percent of total billed charges,38% of total billed charges,1.28,38,,,percent of total billed charges,38% of total billed charges,1.28,38,,,percent of total billed charges,38% of total billed charges,2.53,75,,,percent of total billed charges,75% of total billed charges,2.86,85,,,percent of total billed charges,85% of total billed charges,1.28,3.13,
Clinic Morphine Sulfate 10mg Inj.,4063,CDM,636,RC,J2270,HCPCS,both,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
Clinic Vivitrol per mg,4064,CDM,636,RC,J2315,HCPCS,both,,,4.75,3.56,,4.28,90,,,percent of total billed charges,90% of total billed charges,4.42,93,,,percent of total billed charges,93% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,4.04,85,,,percent of total billed charges,85% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,3.87,81.4,,,percent of total billed charges,81.4% of total billed charges,4.28,90,,,percent of total billed charges,90% of total billed charges,4.28,90,,,percent of total billed charges,90% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,3.56,75,,,percent of total billed charges,75% of total billed charges,4.04,85,,,percent of total billed charges,85% of total billed charges,1.81,4.42,
Clinic Zofran 2 mg,4065,CDM,636,RC,J2405,HCPCS,both,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Clinic Zofran 2 mg,4066,CDM,636,RC,J2405,HCPCS,both,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Clinic Zofran 2 mg,4067,CDM,636,RC,J2405,HCPCS,both,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Clinic Zofran 4mg,4068,CDM,636,RC,J2405,HCPCS,both,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Clinic Zofran 4mg,4069,CDM,636,RC,J2405,HCPCS,both,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Clinic Zofran 4mg,4070,CDM,636,RC,J2405,HCPCS,both,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Clinic Phenergan 25mg/mL,4071,CDM,636,RC,J2550,HCPCS,both,,,22.27,16.7,,20.04,90,,,percent of total billed charges,90% of total billed charges,20.71,93,,,percent of total billed charges,93% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.13,81.4,,,percent of total billed charges,81.4% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,16.7,75,,,percent of total billed charges,75% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,20.71,
Clinic Phenergan 25mg/mL,4072,CDM,636,RC,J2550,HCPCS,both,,,22.27,16.7,,20.04,90,,,percent of total billed charges,90% of total billed charges,20.71,93,,,percent of total billed charges,93% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.13,81.4,,,percent of total billed charges,81.4% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,16.7,75,,,percent of total billed charges,75% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,20.71,
Clinic Phenergan 25mg/mL,4073,CDM,636,RC,J2550,HCPCS,both,,,22.27,16.7,,20.04,90,,,percent of total billed charges,90% of total billed charges,20.71,93,,,percent of total billed charges,93% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.13,81.4,,,percent of total billed charges,81.4% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,16.7,75,,,percent of total billed charges,75% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,20.71,
Clinic Phenergan 50mg/mL,4074,CDM,636,RC,J2550,HCPCS,both,,,22.27,16.7,,20.04,90,,,percent of total billed charges,90% of total billed charges,20.71,93,,,percent of total billed charges,93% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.13,81.4,,,percent of total billed charges,81.4% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,16.7,75,,,percent of total billed charges,75% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,20.71,
Clinic Phenergan 50mg/mL,4075,CDM,636,RC,J2550,HCPCS,both,,,22.27,16.7,,20.04,90,,,percent of total billed charges,90% of total billed charges,20.71,93,,,percent of total billed charges,93% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.13,81.4,,,percent of total billed charges,81.4% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,16.7,75,,,percent of total billed charges,75% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,20.71,
Clinic Phenergan 50mg/mL,4076,CDM,636,RC,J2550,HCPCS,both,,,22.27,16.7,,20.04,90,,,percent of total billed charges,90% of total billed charges,20.71,93,,,percent of total billed charges,93% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,18.13,81.4,,,percent of total billed charges,81.4% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,20.04,90,,,percent of total billed charges,90% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,8.46,38,,,percent of total billed charges,38% of total billed charges,16.7,75,,,percent of total billed charges,75% of total billed charges,18.93,85,,,percent of total billed charges,85% of total billed charges,8.46,20.71,
Clinic Reglan Inj.,4077,CDM,636,RC,J2765,HCPCS,both,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
CLINIC Solu-Medrol 40 mg,4078,CDM,636,RC,J2920,HCPCS,both,,,31.83,23.87,,28.65,90,,,percent of total billed charges,90% of total billed charges,29.6,93,,,percent of total billed charges,93% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,27.06,85,,,percent of total billed charges,85% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,25.91,81.4,,,percent of total billed charges,81.4% of total billed charges,28.65,90,,,percent of total billed charges,90% of total billed charges,28.65,90,,,percent of total billed charges,90% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,23.87,75,,,percent of total billed charges,75% of total billed charges,27.06,85,,,percent of total billed charges,85% of total billed charges,12.1,29.6,
Clinic Solumedrol 125mg,4079,CDM,636,RC,J2930,HCPCS,both,,,45.7,34.28,,41.13,90,,,percent of total billed charges,90% of total billed charges,42.5,93,,,percent of total billed charges,93% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,37.2,81.4,,,percent of total billed charges,81.4% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,34.28,75,,,percent of total billed charges,75% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,42.5,
Clinic Solumedrol 125mg,4080,CDM,636,RC,J2930,HCPCS,both,,,45.7,34.28,,41.13,90,,,percent of total billed charges,90% of total billed charges,42.5,93,,,percent of total billed charges,93% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,37.2,81.4,,,percent of total billed charges,81.4% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,34.28,75,,,percent of total billed charges,75% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,42.5,
Clinic Solumedrol 125mg,4081,CDM,636,RC,J2930,HCPCS,both,,,45.7,34.28,,41.13,90,,,percent of total billed charges,90% of total billed charges,42.5,93,,,percent of total billed charges,93% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,37.2,81.4,,,percent of total billed charges,81.4% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,34.28,75,,,percent of total billed charges,75% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,42.5,
Clinic Imitrex 6mg,4082,CDM,636,RC,J3030,HCPCS,both,,,90.22,67.67,,81.2,90,,,percent of total billed charges,90% of total billed charges,83.9,93,,,percent of total billed charges,93% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,73.44,81.4,,,percent of total billed charges,81.4% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,67.67,75,,,percent of total billed charges,75% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,83.9,
Clinic Imitrex 6mg,4083,CDM,636,RC,J3030,HCPCS,both,,,90.22,67.67,,81.2,90,,,percent of total billed charges,90% of total billed charges,83.9,93,,,percent of total billed charges,93% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,73.44,81.4,,,percent of total billed charges,81.4% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,67.67,75,,,percent of total billed charges,75% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,83.9,
Clinic Imitrex 6mg,4084,CDM,636,RC,J3030,HCPCS,both,,,90.22,67.67,,81.2,90,,,percent of total billed charges,90% of total billed charges,83.9,93,,,percent of total billed charges,93% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,73.44,81.4,,,percent of total billed charges,81.4% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,67.67,75,,,percent of total billed charges,75% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,83.9,
Clinic Kenalog 10 mg,4085,CDM,636,RC,J3301,HCPCS,both,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
Clinic Kenalog 10 mg,4086,CDM,636,RC,J3301,HCPCS,both,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
Clinic Kenalog 10 mg,4087,CDM,636,RC,J3301,HCPCS,both,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
Clinic Zilretta 1mg (x32),4088,CDM,636,RC,J3304,HCPCS,both,,,20.4,15.3,,18.36,90,,,percent of total billed charges,90% of total billed charges,18.97,93,,,percent of total billed charges,93% of total billed charges,7.75,38,,,percent of total billed charges,38% of total billed charges,7.75,38,,,percent of total billed charges,38% of total billed charges,17.34,85,,,percent of total billed charges,85% of total billed charges,7.75,38,,,percent of total billed charges,38% of total billed charges,16.61,81.4,,,percent of total billed charges,81.4% of total billed charges,18.36,90,,,percent of total billed charges,90% of total billed charges,18.36,90,,,percent of total billed charges,90% of total billed charges,7.75,38,,,percent of total billed charges,38% of total billed charges,7.75,38,,,percent of total billed charges,38% of total billed charges,7.75,38,,,percent of total billed charges,38% of total billed charges,15.3,75,,,percent of total billed charges,75% of total billed charges,17.34,85,,,percent of total billed charges,85% of total billed charges,7.75,18.97,
Clinic Valium(Diazepam) Inj.,4089,CDM,636,RC,J3360,HCPCS,both,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
Clinic Valium(Diazepam) Inj.,4090,CDM,636,RC,J3360,HCPCS,both,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
Clinic Valium(Diazepam) Inj.,4091,CDM,636,RC,J3360,HCPCS,both,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
Clinic Vitamin B12 1000mcg,4092,CDM,636,RC,J3420,HCPCS,both,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Clinic Vitamin B12 1000mcg,4093,CDM,636,RC,J3420,HCPCS,both,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Clinic Vitamin B12 1000mcg,4094,CDM,636,RC,J3420,HCPCS,both,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Magnesium Sulfate 1gram/2 mL,4095,CDM,636,RC,J3475,HCPCS,both,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Clinic Metoprolo 5mg Inj.,4096,CDM,636,RC,J3490,HCPCS,both,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
IUD (MIRENA),4097,CDM,270,RC,J7298,HCPCS,outpatient,,,548.39,411.29,,493.55,90,,,percent of total billed charges,90% of total billed charges,510,93,,,percent of total billed charges,93% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,466.13,85,,,percent of total billed charges,85% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,446.39,81.4,,,percent of total billed charges,81.4% of total billed charges,493.55,90,,,percent of total billed charges,90% of total billed charges,493.55,90,,,percent of total billed charges,90% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,208.39,38,,,percent of total billed charges,38% of total billed charges,411.29,75,,,percent of total billed charges,75% of total billed charges,466.13,85,,,percent of total billed charges,85% of total billed charges,208.39,510,
IUD (Paragard),4098,CDM,270,RC,J7300,HCPCS,outpatient,,,1059.27,794.45,,953.34,90,,,percent of total billed charges,90% of total billed charges,985.12,93,,,percent of total billed charges,93% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,900.38,85,,,percent of total billed charges,85% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,862.25,81.4,,,percent of total billed charges,81.4% of total billed charges,953.34,90,,,percent of total billed charges,90% of total billed charges,953.34,90,,,percent of total billed charges,90% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,794.45,75,,,percent of total billed charges,75% of total billed charges,900.38,85,,,percent of total billed charges,85% of total billed charges,402.52,985.12,
IUD (Paragard),4099,CDM,270,RC,J7300,HCPCS,outpatient,,,1059.27,794.45,,953.34,90,,,percent of total billed charges,90% of total billed charges,985.12,93,,,percent of total billed charges,93% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,900.38,85,,,percent of total billed charges,85% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,862.25,81.4,,,percent of total billed charges,81.4% of total billed charges,953.34,90,,,percent of total billed charges,90% of total billed charges,953.34,90,,,percent of total billed charges,90% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,794.45,75,,,percent of total billed charges,75% of total billed charges,900.38,85,,,percent of total billed charges,85% of total billed charges,402.52,985.12,
Nexplanon,4100,CDM,636,RC,J7307,HCPCS,both,,,1054.6,790.95,,949.14,90,,,percent of total billed charges,90% of total billed charges,980.78,93,,,percent of total billed charges,93% of total billed charges,400.75,38,,,percent of total billed charges,38% of total billed charges,400.75,38,,,percent of total billed charges,38% of total billed charges,896.41,85,,,percent of total billed charges,85% of total billed charges,400.75,38,,,percent of total billed charges,38% of total billed charges,858.44,81.4,,,percent of total billed charges,81.4% of total billed charges,949.14,90,,,percent of total billed charges,90% of total billed charges,949.14,90,,,percent of total billed charges,90% of total billed charges,400.75,38,,,percent of total billed charges,38% of total billed charges,400.75,38,,,percent of total billed charges,38% of total billed charges,400.75,38,,,percent of total billed charges,38% of total billed charges,790.95,75,,,percent of total billed charges,75% of total billed charges,896.41,85,,,percent of total billed charges,85% of total billed charges,400.75,980.78,
Clinic Durolane x 60 units,4101,CDM,636,RC,J7318,HCPCS,both,,,19.42,14.57,,17.48,90,,,percent of total billed charges,90% of total billed charges,18.06,93,,,percent of total billed charges,93% of total billed charges,7.38,38,,,percent of total billed charges,38% of total billed charges,7.38,38,,,percent of total billed charges,38% of total billed charges,16.51,85,,,percent of total billed charges,85% of total billed charges,7.38,38,,,percent of total billed charges,38% of total billed charges,15.81,81.4,,,percent of total billed charges,81.4% of total billed charges,17.48,90,,,percent of total billed charges,90% of total billed charges,17.48,90,,,percent of total billed charges,90% of total billed charges,7.38,38,,,percent of total billed charges,38% of total billed charges,7.38,38,,,percent of total billed charges,38% of total billed charges,7.38,38,,,percent of total billed charges,38% of total billed charges,14.57,75,,,percent of total billed charges,75% of total billed charges,16.51,85,,,percent of total billed charges,85% of total billed charges,7.38,18.06,
Clinic Supartz/Hyalgan Inj.per dose,4102,CDM,636,RC,J7321,HCPCS,both,,,372.63,279.47,,335.37,90,,,percent of total billed charges,90% of total billed charges,346.55,93,,,percent of total billed charges,93% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,303.32,81.4,,,percent of total billed charges,81.4% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,279.47,75,,,percent of total billed charges,75% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,346.55,
Clinic Supartz/Hyalgan Inj.per dose,4103,CDM,636,RC,J7321,HCPCS,both,,,372.63,279.47,,335.37,90,,,percent of total billed charges,90% of total billed charges,346.55,93,,,percent of total billed charges,93% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,303.32,81.4,,,percent of total billed charges,81.4% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,279.47,75,,,percent of total billed charges,75% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,346.55,
Clinic Supartz/Hyalgan Inj.per dose,4104,CDM,636,RC,J7321,HCPCS,both,,,372.63,279.47,,335.37,90,,,percent of total billed charges,90% of total billed charges,346.55,93,,,percent of total billed charges,93% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,303.32,81.4,,,percent of total billed charges,81.4% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,279.47,75,,,percent of total billed charges,75% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,346.55,
Clinic Hymovis  1mg,4105,CDM,636,RC,J7322,HCPCS,both,,,28.15,21.11,,25.34,90,,,percent of total billed charges,90% of total billed charges,26.18,93,,,percent of total billed charges,93% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,23.93,85,,,percent of total billed charges,85% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,22.91,81.4,,,percent of total billed charges,81.4% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,25.34,90,,,percent of total billed charges,90% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,10.7,38,,,percent of total billed charges,38% of total billed charges,21.11,75,,,percent of total billed charges,75% of total billed charges,23.93,85,,,percent of total billed charges,85% of total billed charges,10.7,26.18,
Clinic Euflexxa,4106,CDM,636,RC,J7323,HCPCS,both,,,487.09,365.32,,438.38,90,,,percent of total billed charges,90% of total billed charges,452.99,93,,,percent of total billed charges,93% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,414.03,85,,,percent of total billed charges,85% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,396.49,81.4,,,percent of total billed charges,81.4% of total billed charges,438.38,90,,,percent of total billed charges,90% of total billed charges,438.38,90,,,percent of total billed charges,90% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,185.09,38,,,percent of total billed charges,38% of total billed charges,365.32,75,,,percent of total billed charges,75% of total billed charges,414.03,85,,,percent of total billed charges,85% of total billed charges,185.09,452.99,
Clinic ORTHOVISC /dose,4107,CDM,636,RC,J7324,HCPCS,both,,,636.72,477.54,,573.05,90,,,percent of total billed charges,90% of total billed charges,592.15,93,,,percent of total billed charges,93% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,541.21,85,,,percent of total billed charges,85% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,518.29,81.4,,,percent of total billed charges,81.4% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,573.05,90,,,percent of total billed charges,90% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,241.95,38,,,percent of total billed charges,38% of total billed charges,477.54,75,,,percent of total billed charges,75% of total billed charges,541.21,85,,,percent of total billed charges,85% of total billed charges,241.95,592.15,
Clinic Synvisc or Synvisc-one per mg,4108,CDM,636,RC,J7325,HCPCS,both,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Clinic GELSYN-3  /0.1mg,4109,CDM,636,RC,J7328,HCPCS,both,,,3.09,2.32,,2.78,90,,,percent of total billed charges,90% of total billed charges,2.87,93,,,percent of total billed charges,93% of total billed charges,1.17,38,,,percent of total billed charges,38% of total billed charges,1.17,38,,,percent of total billed charges,38% of total billed charges,2.63,85,,,percent of total billed charges,85% of total billed charges,1.17,38,,,percent of total billed charges,38% of total billed charges,2.52,81.4,,,percent of total billed charges,81.4% of total billed charges,2.78,90,,,percent of total billed charges,90% of total billed charges,2.78,90,,,percent of total billed charges,90% of total billed charges,1.17,38,,,percent of total billed charges,38% of total billed charges,1.17,38,,,percent of total billed charges,38% of total billed charges,1.17,38,,,percent of total billed charges,38% of total billed charges,2.32,75,,,percent of total billed charges,75% of total billed charges,2.63,85,,,percent of total billed charges,85% of total billed charges,1.17,2.87,
Clinic Albuterol Inhalent,4110,CDM,259,RC,J7609,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Clinic DuoNeb 0.5/3ml,4111,CDM,250,RC,J7620,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Clinic Dexamethasone (inhaled),4112,CDM,250,RC,J7638,HCPCS,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
Clinic Dexamethasone (inhaled),4113,CDM,250,RC,J7638,HCPCS,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
Clinic Dexamethasone (inhaled),4114,CDM,250,RC,J7638,HCPCS,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
Epifix per sq.cm,4115,CDM,636,RC,Q4186,HCPCS,both,,,521.13,390.85,,469.02,90,,,percent of total billed charges,90% of total billed charges,484.65,93,,,percent of total billed charges,93% of total billed charges,198.03,38,,,percent of total billed charges,38% of total billed charges,198.03,38,,,percent of total billed charges,38% of total billed charges,442.96,85,,,percent of total billed charges,85% of total billed charges,198.03,38,,,percent of total billed charges,38% of total billed charges,424.2,81.4,,,percent of total billed charges,81.4% of total billed charges,469.02,90,,,percent of total billed charges,90% of total billed charges,469.02,90,,,percent of total billed charges,90% of total billed charges,198.03,38,,,percent of total billed charges,38% of total billed charges,198.03,38,,,percent of total billed charges,38% of total billed charges,198.03,38,,,percent of total billed charges,38% of total billed charges,390.85,75,,,percent of total billed charges,75% of total billed charges,442.96,85,,,percent of total billed charges,85% of total billed charges,198.03,484.65,
Clinic SUBLOCADE (buprenorphine exrended-release) (patient's Med),4116,CDM,636,RC,Q9992,HCPCS,both,,,0.01,0.01,,0.01,90,,,percent of total billed charges,90% of total billed charges,0.01,93,,,percent of total billed charges,93% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,0.01,85,,,percent of total billed charges,85% of total billed charges,,,,,other,Not reimbursable per contract,0.01,81.4,,,percent of total billed charges,81.4% of total billed charges,0.01,90,,,percent of total billed charges,90% of total billed charges,0.01,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,0.01,75,,,percent of total billed charges,75% of total billed charges,0.01,85,,,percent of total billed charges,85% of total billed charges,0.01,0.01,
PT Dry Needle -1 or 2 muscles,4117,CDM,420,RC,20560,HCPCS,outpatient,,,37.88,28.41,,34.09,90,,,percent of total billed charges,90% of total billed charges,35.23,93,,,percent of total billed charges,93% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,30.83,81.4,,,percent of total billed charges,81.4% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,28.41,75,,,percent of total billed charges,75% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,35.23,
PT Dry Needle -1 or 2 muscles,4118,CDM,420,RC,20560,HCPCS,outpatient,,,37.88,28.41,,34.09,90,,,percent of total billed charges,90% of total billed charges,35.23,93,,,percent of total billed charges,93% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,30.83,81.4,,,percent of total billed charges,81.4% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,34.09,90,,,percent of total billed charges,90% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,14.39,38,,,percent of total billed charges,38% of total billed charges,28.41,75,,,percent of total billed charges,75% of total billed charges,32.2,85,,,percent of total billed charges,85% of total billed charges,14.39,35.23,
PT Dry Needle 3 or >muscles,4119,CDM,420,RC,20561,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
PT Dry Needle 3 or >muscles,4120,CDM,420,RC,20561,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,40.27,
"Wound Repair - Mouth, Tongue >2.6 cm-PRO",4121,CDM,981,RC,41252,HCPCS,outpatient,,,743.26,557.45,,289.46,130,,,fee schedule,130% of fee schedule,289.46,130,,,fee schedule,130% of fee schedule,214.64,100,,,fee schedule,Pays 100% Medicare OPPS,214.64,100,,,fee schedule,Pays 100% Medicare OPPS,259.71,119,,,fee schedule,119% of fee schedule,214.64,100,,,fee schedule,Pays 100% Medicare OPPS,214.64,100,,,fee schedule,100% of fee schedule,668.93,90,,,percent of total billed charges,90% of total billed charges,214.64,100,,,fee schedule,Pays 100% Medicare OPPS,214.64,100,,,fee schedule,Pays 100% Medicare OPPS,214.64,100,,,fee schedule,Pays 100% Medicare OPPS,214.64,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,214.64,100,,,fee schedule,100% of fee schedule,214.64,668.93,
PT Canalith repositioning,4123,CDM,420,RC,95992,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
PT Evaluation(orderset entry),4124,CDM,420,RC,97001,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PT Evaluation(orderset entry),4125,CDM,420,RC,97001,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
PT cold/hot packs,4126,CDM,420,RC,97010,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
PT cold/hot packs,4127,CDM,420,RC,97010,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
PT cold/hot packs,4128,CDM,420,RC,97010,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
Mechanical traction,4129,CDM,420,RC,97012,HCPCS,outpatient,,,48.72,36.54,,43.85,90,,,percent of total billed charges,90% of total billed charges,45.31,93,,,percent of total billed charges,93% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,39.66,81.4,,,percent of total billed charges,81.4% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,36.54,75,,,percent of total billed charges,75% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,45.31,
Mechanical traction,4130,CDM,420,RC,97012,HCPCS,outpatient,,,48.72,36.54,,43.85,90,,,percent of total billed charges,90% of total billed charges,45.31,93,,,percent of total billed charges,93% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,39.66,81.4,,,percent of total billed charges,81.4% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,36.54,75,,,percent of total billed charges,75% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,45.31,
Mechanical traction,4131,CDM,420,RC,97012,HCPCS,outpatient,,,48.72,36.54,,43.85,90,,,percent of total billed charges,90% of total billed charges,45.31,93,,,percent of total billed charges,93% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,39.66,81.4,,,percent of total billed charges,81.4% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,36.54,75,,,percent of total billed charges,75% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,45.31,
PT electrical stimulation,4132,CDM,420,RC,97014,HCPCS,outpatient,,,50.38,37.79,,45.34,90,,,percent of total billed charges,90% of total billed charges,46.85,93,,,percent of total billed charges,93% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,41.01,81.4,,,percent of total billed charges,81.4% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,37.79,75,,,percent of total billed charges,75% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,46.85,
PT electrical stimulation,4133,CDM,420,RC,97014,HCPCS,outpatient,,,50.38,37.79,,45.34,90,,,percent of total billed charges,90% of total billed charges,46.85,93,,,percent of total billed charges,93% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,41.01,81.4,,,percent of total billed charges,81.4% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,37.79,75,,,percent of total billed charges,75% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,46.85,
PT electrical stimulation,4134,CDM,420,RC,97014,HCPCS,outpatient,,,50.38,37.79,,45.34,90,,,percent of total billed charges,90% of total billed charges,46.85,93,,,percent of total billed charges,93% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,41.01,81.4,,,percent of total billed charges,81.4% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,37.79,75,,,percent of total billed charges,75% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,46.85,
PT electrical stimulation,4135,CDM,420,RC,97014,HCPCS,outpatient,,,50.38,37.79,,45.34,90,,,percent of total billed charges,90% of total billed charges,46.85,93,,,percent of total billed charges,93% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,41.01,81.4,,,percent of total billed charges,81.4% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,37.79,75,,,percent of total billed charges,75% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,46.85,
PT TENS evaluation/Training,4136,CDM,420,RC,97014,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
PT TENS evaluation/Training,4137,CDM,420,RC,97014,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
PT E-stim attended,4138,CDM,420,RC,97032,HCPCS,outpatient,,,64.94,48.71,,58.45,90,,,percent of total billed charges,90% of total billed charges,60.39,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.86,81.4,,,percent of total billed charges,81.4% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.71,75,,,percent of total billed charges,75% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,60.39,
PT E-stim attended,4139,CDM,420,RC,97032,HCPCS,outpatient,,,64.94,48.71,,58.45,90,,,percent of total billed charges,90% of total billed charges,60.39,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.86,81.4,,,percent of total billed charges,81.4% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.71,75,,,percent of total billed charges,75% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,60.39,
PT iontophoresis,4140,CDM,420,RC,97033,HCPCS,outpatient,,,48.72,36.54,,43.85,90,,,percent of total billed charges,90% of total billed charges,45.31,93,,,percent of total billed charges,93% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,39.66,81.4,,,percent of total billed charges,81.4% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,36.54,75,,,percent of total billed charges,75% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,45.31,
PT iontophoresis,4141,CDM,420,RC,97033,HCPCS,outpatient,,,48.72,36.54,,43.85,90,,,percent of total billed charges,90% of total billed charges,45.31,93,,,percent of total billed charges,93% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,39.66,81.4,,,percent of total billed charges,81.4% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,36.54,75,,,percent of total billed charges,75% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,45.31,
PT contrast bath,4142,CDM,420,RC,97034,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
PT contrast bath,4143,CDM,420,RC,97034,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
PT ultrasound,4144,CDM,420,RC,97035,HCPCS,outpatient,,,64.94,48.71,,58.45,90,,,percent of total billed charges,90% of total billed charges,60.39,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.86,81.4,,,percent of total billed charges,81.4% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.71,75,,,percent of total billed charges,75% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,60.39,
PT ultrasound,4145,CDM,420,RC,97035,HCPCS,outpatient,,,64.94,48.71,,58.45,90,,,percent of total billed charges,90% of total billed charges,60.39,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.86,81.4,,,percent of total billed charges,81.4% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.71,75,,,percent of total billed charges,75% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,60.39,
PT ultrasound,4146,CDM,420,RC,97035,HCPCS,outpatient,,,64.94,48.71,,58.45,90,,,percent of total billed charges,90% of total billed charges,60.39,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.86,81.4,,,percent of total billed charges,81.4% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.71,75,,,percent of total billed charges,75% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,60.39,
Laser therapy/attended15 min,4147,CDM,420,RC,97039,HCPCS,outpatient,,,90.09,67.57,,81.08,90,,,percent of total billed charges,90% of total billed charges,83.78,93,,,percent of total billed charges,93% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,76.58,85,,,percent of total billed charges,85% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,73.33,81.4,,,percent of total billed charges,81.4% of total billed charges,81.08,90,,,percent of total billed charges,90% of total billed charges,81.08,90,,,percent of total billed charges,90% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,67.57,75,,,percent of total billed charges,75% of total billed charges,76.58,85,,,percent of total billed charges,85% of total billed charges,34.23,83.78,
Laser therapy/attended15 min,4148,CDM,420,RC,97039,HCPCS,outpatient,,,90.09,67.57,,81.08,90,,,percent of total billed charges,90% of total billed charges,83.78,93,,,percent of total billed charges,93% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,76.58,85,,,percent of total billed charges,85% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,73.33,81.4,,,percent of total billed charges,81.4% of total billed charges,81.08,90,,,percent of total billed charges,90% of total billed charges,81.08,90,,,percent of total billed charges,90% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,67.57,75,,,percent of total billed charges,75% of total billed charges,76.58,85,,,percent of total billed charges,85% of total billed charges,34.23,83.78,
Laser therapy/attended15 min,4149,CDM,420,RC,97039,HCPCS,outpatient,,,90.09,67.57,,81.08,90,,,percent of total billed charges,90% of total billed charges,83.78,93,,,percent of total billed charges,93% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,76.58,85,,,percent of total billed charges,85% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,73.33,81.4,,,percent of total billed charges,81.4% of total billed charges,81.08,90,,,percent of total billed charges,90% of total billed charges,81.08,90,,,percent of total billed charges,90% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,34.23,38,,,percent of total billed charges,38% of total billed charges,67.57,75,,,percent of total billed charges,75% of total billed charges,76.58,85,,,percent of total billed charges,85% of total billed charges,34.23,83.78,
PT exercises,4150,CDM,420,RC,97110,HCPCS,outpatient,,,88.76,66.57,,79.88,90,,,percent of total billed charges,90% of total billed charges,82.55,93,,,percent of total billed charges,93% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,75.45,85,,,percent of total billed charges,85% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,72.25,81.4,,,percent of total billed charges,81.4% of total billed charges,79.88,90,,,percent of total billed charges,90% of total billed charges,79.88,90,,,percent of total billed charges,90% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,66.57,75,,,percent of total billed charges,75% of total billed charges,75.45,85,,,percent of total billed charges,85% of total billed charges,33.73,82.55,
PT exercises,4151,CDM,420,RC,97110,HCPCS,outpatient,,,88.76,66.57,,79.88,90,,,percent of total billed charges,90% of total billed charges,82.55,93,,,percent of total billed charges,93% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,75.45,85,,,percent of total billed charges,85% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,72.25,81.4,,,percent of total billed charges,81.4% of total billed charges,79.88,90,,,percent of total billed charges,90% of total billed charges,79.88,90,,,percent of total billed charges,90% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,66.57,75,,,percent of total billed charges,75% of total billed charges,75.45,85,,,percent of total billed charges,85% of total billed charges,33.73,82.55,
PT exercises,4152,CDM,420,RC,97110,HCPCS,outpatient,,,88.76,66.57,,79.88,90,,,percent of total billed charges,90% of total billed charges,82.55,93,,,percent of total billed charges,93% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,75.45,85,,,percent of total billed charges,85% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,72.25,81.4,,,percent of total billed charges,81.4% of total billed charges,79.88,90,,,percent of total billed charges,90% of total billed charges,79.88,90,,,percent of total billed charges,90% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,33.73,38,,,percent of total billed charges,38% of total billed charges,66.57,75,,,percent of total billed charges,75% of total billed charges,75.45,85,,,percent of total billed charges,85% of total billed charges,33.73,82.55,
PT Neuromuscular Re-ed,4153,CDM,420,RC,97112,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
PT Neuromuscular Re-ed,4154,CDM,420,RC,97112,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
PT Neuromuscular Re-ed,4155,CDM,420,RC,97112,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
PT Gait Training,4156,CDM,420,RC,97116,HCPCS,outpatient,,,64.94,48.71,,58.45,90,,,percent of total billed charges,90% of total billed charges,60.39,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.86,81.4,,,percent of total billed charges,81.4% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.71,75,,,percent of total billed charges,75% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,60.39,
PT Gait Training,4157,CDM,420,RC,97116,HCPCS,outpatient,,,64.94,48.71,,58.45,90,,,percent of total billed charges,90% of total billed charges,60.39,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.86,81.4,,,percent of total billed charges,81.4% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.71,75,,,percent of total billed charges,75% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,60.39,
PT Massage,4158,CDM,420,RC,97124,HCPCS,outpatient,,,64.94,48.71,,58.45,90,,,percent of total billed charges,90% of total billed charges,60.39,93,,,percent of total billed charges,93% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,52.86,81.4,,,percent of total billed charges,81.4% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,58.45,90,,,percent of total billed charges,90% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,24.68,38,,,percent of total billed charges,38% of total billed charges,48.71,75,,,percent of total billed charges,75% of total billed charges,55.2,85,,,percent of total billed charges,85% of total billed charges,24.68,60.39,
PT manual therapy,4159,CDM,420,RC,97140,HCPCS,outpatient,,,75.78,56.84,,68.2,90,,,percent of total billed charges,90% of total billed charges,70.48,93,,,percent of total billed charges,93% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,61.68,81.4,,,percent of total billed charges,81.4% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,56.84,75,,,percent of total billed charges,75% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,70.48,
PT manual therapy,4160,CDM,420,RC,97140,HCPCS,outpatient,,,75.78,56.84,,68.2,90,,,percent of total billed charges,90% of total billed charges,70.48,93,,,percent of total billed charges,93% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,61.68,81.4,,,percent of total billed charges,81.4% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,56.84,75,,,percent of total billed charges,75% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,70.48,
PT manual therapy,4161,CDM,420,RC,97140,HCPCS,outpatient,,,75.78,56.84,,68.2,90,,,percent of total billed charges,90% of total billed charges,70.48,93,,,percent of total billed charges,93% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,61.68,81.4,,,percent of total billed charges,81.4% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,56.84,75,,,percent of total billed charges,75% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,70.48,
PT group therapy,4162,CDM,420,RC,97150,HCPCS,outpatient,,,48.72,36.54,,43.85,90,,,percent of total billed charges,90% of total billed charges,45.31,93,,,percent of total billed charges,93% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,39.66,81.4,,,percent of total billed charges,81.4% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,36.54,75,,,percent of total billed charges,75% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,45.31,
PT group therapy,4163,CDM,420,RC,97150,HCPCS,outpatient,,,48.72,36.54,,43.85,90,,,percent of total billed charges,90% of total billed charges,45.31,93,,,percent of total billed charges,93% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,39.66,81.4,,,percent of total billed charges,81.4% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,43.85,90,,,percent of total billed charges,90% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,18.51,38,,,percent of total billed charges,38% of total billed charges,36.54,75,,,percent of total billed charges,75% of total billed charges,41.41,85,,,percent of total billed charges,85% of total billed charges,18.51,45.31,
PT Eval - low complex,4164,CDM,420,RC,97161,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT Eval - low complex,4165,CDM,420,RC,97161,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT Eval - low complex,4166,CDM,420,RC,97161,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT Eval - low complex,4167,CDM,420,RC,97161,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT eval- medium complex,4168,CDM,420,RC,97162,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT eval- medium complex,4169,CDM,420,RC,97162,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT eval- medium complex,4170,CDM,420,RC,97162,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT eval- medium complex,4171,CDM,420,RC,97162,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT Eval - high complex,4172,CDM,420,RC,97163,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT Eval - high complex,4173,CDM,420,RC,97163,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT Eval - high complex,4174,CDM,420,RC,97163,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT Eval - high complex,4175,CDM,420,RC,97163,HCPCS,outpatient,,,199.87,149.9,,179.88,90,,,percent of total billed charges,90% of total billed charges,185.88,93,,,percent of total billed charges,93% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,162.69,81.4,,,percent of total billed charges,81.4% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,179.88,90,,,percent of total billed charges,90% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,75.95,38,,,percent of total billed charges,38% of total billed charges,149.9,75,,,percent of total billed charges,75% of total billed charges,169.89,85,,,percent of total billed charges,85% of total billed charges,75.95,185.88,
PT  re-evaluation,4176,CDM,420,RC,97164,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,100.66,
PT  re-evaluation,4177,CDM,420,RC,97164,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,100.66,
PT Therapeutic Activities,4178,CDM,420,RC,97530,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
PT Therapeutic Activities,4179,CDM,420,RC,97530,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
PT Therapeutic Activities,4180,CDM,420,RC,97530,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
PT Self Care/Home,4181,CDM,420,RC,97535,HCPCS,outpatient,,,54.12,40.59,,48.71,90,,,percent of total billed charges,90% of total billed charges,50.33,93,,,percent of total billed charges,93% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,44.05,81.4,,,percent of total billed charges,81.4% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,40.59,75,,,percent of total billed charges,75% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,50.33,
PT Wheel Chair Mgmt/Fitting,4182,CDM,420,RC,97542,HCPCS,outpatient,,,86.59,64.94,,77.93,90,,,percent of total billed charges,90% of total billed charges,80.53,93,,,percent of total billed charges,93% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,73.6,85,,,percent of total billed charges,85% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,70.48,81.4,,,percent of total billed charges,81.4% of total billed charges,77.93,90,,,percent of total billed charges,90% of total billed charges,77.93,90,,,percent of total billed charges,90% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,64.94,75,,,percent of total billed charges,75% of total billed charges,73.6,85,,,percent of total billed charges,85% of total billed charges,32.9,80.53,
PT PROSTHETIC TRAINING INIT,4183,CDM,420,RC,97761,HCPCS,outpatient,,,94.17,70.63,,84.75,90,,,percent of total billed charges,90% of total billed charges,87.58,93,,,percent of total billed charges,93% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,80.04,85,,,percent of total billed charges,85% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,76.65,81.4,,,percent of total billed charges,81.4% of total billed charges,84.75,90,,,percent of total billed charges,90% of total billed charges,84.75,90,,,percent of total billed charges,90% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,70.63,75,,,percent of total billed charges,75% of total billed charges,80.04,85,,,percent of total billed charges,85% of total billed charges,35.78,87.58,
PT PROSTHETIC TRAINING INIT,4184,CDM,420,RC,97761,HCPCS,outpatient,,,94.17,70.63,,84.75,90,,,percent of total billed charges,90% of total billed charges,87.58,93,,,percent of total billed charges,93% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,80.04,85,,,percent of total billed charges,85% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,76.65,81.4,,,percent of total billed charges,81.4% of total billed charges,84.75,90,,,percent of total billed charges,90% of total billed charges,84.75,90,,,percent of total billed charges,90% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,35.78,38,,,percent of total billed charges,38% of total billed charges,70.63,75,,,percent of total billed charges,75% of total billed charges,80.04,85,,,percent of total billed charges,85% of total billed charges,35.78,87.58,
Work Comp Dry Needle trigger 3-,4185,CDM,420,RC,Z0501,HCPCS,outpatient,,,41,30.75,,36.9,90,,,percent of total billed charges,90% of total billed charges,38.13,93,,,percent of total billed charges,93% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,34.85,85,,,percent of total billed charges,85% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,33.37,81.4,,,percent of total billed charges,81.4% of total billed charges,36.9,90,,,percent of total billed charges,90% of total billed charges,36.9,90,,,percent of total billed charges,90% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,30.75,75,,,percent of total billed charges,75% of total billed charges,34.85,85,,,percent of total billed charges,85% of total billed charges,15.58,38.13,
Work Comp Dry Needle trigger 3-,4186,CDM,420,RC,Z0501,HCPCS,outpatient,,,41,30.75,,36.9,90,,,percent of total billed charges,90% of total billed charges,38.13,93,,,percent of total billed charges,93% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,34.85,85,,,percent of total billed charges,85% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,33.37,81.4,,,percent of total billed charges,81.4% of total billed charges,36.9,90,,,percent of total billed charges,90% of total billed charges,36.9,90,,,percent of total billed charges,90% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,30.75,75,,,percent of total billed charges,75% of total billed charges,34.85,85,,,percent of total billed charges,85% of total billed charges,15.58,38.13,
Work Comp Dry Needle Trigger +3 mus,4187,CDM,420,RC,Z0502,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
Work Comp Dry Needle Trigger +3 mus,4188,CDM,420,RC,Z0502,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
Anesthesia Total Knee-AA,4189,CDM,963,RC,1402,HCPCS,outpatient,,,119.06,89.3,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,107.15,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,107.15,107.15,
Anesthesia Total Knee-AA,4190,CDM,963,RC,1402,HCPCS,outpatient,,,119.06,89.3,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,107.15,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,107.15,107.15,
Acne surgery,4191,CDM,521,RC,10040,HCPCS,outpatient,,,232.01,174.01,,208.81,90,,,percent of total billed charges,90% of total billed charges,215.77,93,,,percent of total billed charges,93% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,188.86,81.4,,,percent of total billed charges,81.4% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,174.01,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,88.16,215.77,
DERM ACNE SURGERY - PRO,4192,CDM,982,RC,10040,HCPCS,outpatient,,,244.08,183.06,,119.04,130,,,fee schedule,130% of fee schedule,119.04,130,,,fee schedule,130% of fee schedule,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.08,119,,,fee schedule,119% of fee schedule,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,100% of fee schedule,219.67,90,,,percent of total billed charges,90% of total billed charges,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,52.55,100,,,fee schedule,100% of fee schedule,35.93,219.67,
DERM Acne Surgery - G,4193,CDM,982,RC,10040,HCPCS,outpatient,,,360.81,270.61,,119.04,130,,,fee schedule,130% of fee schedule,119.04,130,,,fee schedule,130% of fee schedule,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.08,119,,,fee schedule,119% of fee schedule,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,100% of fee schedule,324.73,90,,,percent of total billed charges,90% of total billed charges,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,52.55,100,,,fee schedule,100% of fee schedule,35.93,324.73,
Acne surgery-PRO,4194,CDM,981,RC,10040,HCPCS,outpatient,,,140.62,105.47,,119.04,130,,,fee schedule,130% of fee schedule,119.04,130,,,fee schedule,130% of fee schedule,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.08,119,,,fee schedule,119% of fee schedule,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,100% of fee schedule,126.56,90,,,percent of total billed charges,90% of total billed charges,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,52.55,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,52.55,100,,,fee schedule,100% of fee schedule,35.93,126.56,
I&D Abcess Simple or Single[Package],4195,CDM,521,RC,10060,HCPCS,outpatient,,,225,168.75,,202.5,90,,,percent of total billed charges,90% of total billed charges,209.25,93,,,percent of total billed charges,93% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,183.15,81.4,,,percent of total billed charges,81.4% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,168.75,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,85.5,209.25,
I&D Abcess Simple or Single[Package],4196,CDM,521,RC,10060,HCPCS,outpatient,,,225,168.75,,202.5,90,,,percent of total billed charges,90% of total billed charges,209.25,93,,,percent of total billed charges,93% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,183.15,81.4,,,percent of total billed charges,81.4% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,168.75,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,85.5,209.25,
DERM I&D ABCESS SIMPLE OR SINGLE - PRO,4197,CDM,982,RC,10060,HCPCS,outpatient,,,256.82,192.62,,125.29,130,,,fee schedule,130% of fee schedule,125.29,130,,,fee schedule,130% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,124.88,119,,,fee schedule,119% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,100% of fee schedule,231.14,90,,,percent of total billed charges,90% of total billed charges,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,108.83,100,,,fee schedule,100% of fee schedule,57.49,231.14,
WND I&D Abcess Simple-G,4198,CDM,982,RC,10060,HCPCS,outpatient,,,519.1,389.33,,125.29,130,,,fee schedule,130% of fee schedule,125.29,130,,,fee schedule,130% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,124.88,119,,,fee schedule,119% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,100% of fee schedule,467.19,90,,,percent of total billed charges,90% of total billed charges,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,108.83,100,,,fee schedule,100% of fee schedule,57.49,467.19,
WND I&D Abcess Simple PRO,4199,CDM,982,RC,10060,HCPCS,outpatient,,,255.45,191.59,,125.29,130,,,fee schedule,130% of fee schedule,125.29,130,,,fee schedule,130% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,124.88,119,,,fee schedule,119% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,100% of fee schedule,229.91,90,,,percent of total billed charges,90% of total billed charges,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,108.83,100,,,fee schedule,100% of fee schedule,57.49,229.91,
DERM I&D ABCESS SIMPLE OR SINGLE - G,4200,CDM,982,RC,10060,HCPCS,outpatient,,,559.26,419.45,,125.29,130,,,fee schedule,130% of fee schedule,125.29,130,,,fee schedule,130% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,124.88,119,,,fee schedule,119% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,100% of fee schedule,503.33,90,,,percent of total billed charges,90% of total billed charges,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,108.83,100,,,fee schedule,100% of fee schedule,57.49,503.33,
I&D Abcess Simple or Single (SQ)-PRO,4201,CDM,981,RC,10060,HCPCS,outpatient,,,255.45,191.59,,125.29,130,,,fee schedule,130% of fee schedule,125.29,130,,,fee schedule,130% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,124.88,119,,,fee schedule,119% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,100% of fee schedule,229.91,90,,,percent of total billed charges,90% of total billed charges,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,108.83,100,,,fee schedule,100% of fee schedule,57.49,229.91,
I&D Abcess Simple or Single (SQ)-PRO,4202,CDM,981,RC,10060,HCPCS,outpatient,,,255.45,191.59,,125.29,130,,,fee schedule,130% of fee schedule,125.29,130,,,fee schedule,130% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,124.88,119,,,fee schedule,119% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,100% of fee schedule,229.91,90,,,percent of total billed charges,90% of total billed charges,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,108.83,100,,,fee schedule,100% of fee schedule,57.49,229.91,
I&D Abcess Simple or Single (SQ)-PRO,4203,CDM,981,RC,10060,HCPCS,outpatient,,,255.45,191.59,,125.29,130,,,fee schedule,130% of fee schedule,125.29,130,,,fee schedule,130% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,124.88,119,,,fee schedule,119% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,100% of fee schedule,229.91,90,,,percent of total billed charges,90% of total billed charges,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,108.83,100,,,fee schedule,100% of fee schedule,57.49,229.91,
I&D Complicated or Multiple[Package],4204,CDM,521,RC,10061,HCPCS,outpatient,,,397.24,297.93,,357.52,90,,,percent of total billed charges,90% of total billed charges,369.43,93,,,percent of total billed charges,93% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,337.65,85,,,percent of total billed charges,85% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,323.35,81.4,,,percent of total billed charges,81.4% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,297.93,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,150.95,369.43,
I&D Complicated or Multiple[Package],4205,CDM,521,RC,10061,HCPCS,outpatient,,,397.24,297.93,,357.52,90,,,percent of total billed charges,90% of total billed charges,369.43,93,,,percent of total billed charges,93% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,337.65,85,,,percent of total billed charges,85% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,323.35,81.4,,,percent of total billed charges,81.4% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,297.93,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,150.95,369.43,
I&D Complicated or Multiple[Package],4206,CDM,521,RC,10061,HCPCS,outpatient,,,397.24,297.93,,357.52,90,,,percent of total billed charges,90% of total billed charges,369.43,93,,,percent of total billed charges,93% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,337.65,85,,,percent of total billed charges,85% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,323.35,81.4,,,percent of total billed charges,81.4% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,297.93,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,150.95,369.43,
WND I&D multi/complex-PRO,4207,CDM,982,RC,10061,HCPCS,outpatient,,,263.65,197.74,,212.82,130,,,fee schedule,130% of fee schedule,212.82,130,,,fee schedule,130% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,225.9,119,,,fee schedule,119% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,100% of fee schedule,237.29,90,,,percent of total billed charges,90% of total billed charges,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,188.32,100,,,fee schedule,100% of fee schedule,114.98,237.29,
WND I&D multi/complex-G,4208,CDM,982,RC,10061,HCPCS,outpatient,,,701.89,526.42,,212.82,130,,,fee schedule,130% of fee schedule,212.82,130,,,fee schedule,130% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,225.9,119,,,fee schedule,119% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,100% of fee schedule,631.7,90,,,percent of total billed charges,90% of total billed charges,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,188.32,100,,,fee schedule,100% of fee schedule,114.98,631.7,
I&D multi/complex-PRO,4209,CDM,981,RC,10061,HCPCS,outpatient,,,263.65,197.74,,212.82,130,,,fee schedule,130% of fee schedule,212.82,130,,,fee schedule,130% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,225.9,119,,,fee schedule,119% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,100% of fee schedule,237.29,90,,,percent of total billed charges,90% of total billed charges,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,188.32,100,,,fee schedule,100% of fee schedule,114.98,237.29,
I&D multi/complex-PRO,4210,CDM,981,RC,10061,HCPCS,outpatient,,,263.65,197.74,,212.82,130,,,fee schedule,130% of fee schedule,212.82,130,,,fee schedule,130% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,225.9,119,,,fee schedule,119% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,100% of fee schedule,237.29,90,,,percent of total billed charges,90% of total billed charges,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,188.32,100,,,fee schedule,100% of fee schedule,114.98,237.29,
WND drain pilonidal cyst-simple PRO,4211,CDM,982,RC,10080,HCPCS,outpatient,,,301.82,226.37,,133.97,130,,,fee schedule,130% of fee schedule,133.97,130,,,fee schedule,130% of fee schedule,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,128.09,119,,,fee schedule,119% of fee schedule,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,100% of fee schedule,271.64,90,,,percent of total billed charges,90% of total billed charges,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,107.52,100,,,fee schedule,100% of fee schedule,57.49,271.64,
drain pilonidal cyst-simple pro,4212,CDM,981,RC,10080,HCPCS,outpatient,,,417.67,313.25,,133.97,130,,,fee schedule,130% of fee schedule,133.97,130,,,fee schedule,130% of fee schedule,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,128.09,119,,,fee schedule,119% of fee schedule,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,100% of fee schedule,375.9,90,,,percent of total billed charges,90% of total billed charges,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,107.52,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,107.52,100,,,fee schedule,100% of fee schedule,57.49,375.9,
FB Removal/Incision[Package],4213,CDM,521,RC,10120,HCPCS,outpatient,,,223.81,167.86,,201.43,90,,,percent of total billed charges,90% of total billed charges,208.14,93,,,percent of total billed charges,93% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,190.24,85,,,percent of total billed charges,85% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,182.18,81.4,,,percent of total billed charges,81.4% of total billed charges,201.43,90,,,percent of total billed charges,90% of total billed charges,201.43,90,,,percent of total billed charges,90% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,167.86,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,85.05,208.14,
FB Removal/Incision[Package],4214,CDM,521,RC,10120,HCPCS,outpatient,,,223.81,167.86,,201.43,90,,,percent of total billed charges,90% of total billed charges,208.14,93,,,percent of total billed charges,93% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,190.24,85,,,percent of total billed charges,85% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,182.18,81.4,,,percent of total billed charges,81.4% of total billed charges,201.43,90,,,percent of total billed charges,90% of total billed charges,201.43,90,,,percent of total billed charges,90% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,167.86,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,85.05,208.14,
FB Removal/Incision -PRO,4215,CDM,981,RC,10120,HCPCS,outpatient,,,107.79,80.84,,122.29,130,,,fee schedule,130% of fee schedule,122.29,130,,,fee schedule,130% of fee schedule,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,127.98,119,,,fee schedule,119% of fee schedule,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,97.01,90,,,percent of total billed charges,90% of total billed charges,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,107.79,100,,,fee schedule,100% of fee schedule,71.86,127.98,
FB Removal/Incision -PRO,4216,CDM,981,RC,10120,HCPCS,outpatient,,,107.79,80.84,,122.29,130,,,fee schedule,130% of fee schedule,122.29,130,,,fee schedule,130% of fee schedule,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,127.98,119,,,fee schedule,119% of fee schedule,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,97.01,90,,,percent of total billed charges,90% of total billed charges,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,107.79,100,,,fee schedule,100% of fee schedule,71.86,127.98,
FBR-Complicated [Package],4217,CDM,521,RC,10121,HCPCS,outpatient,,,453.48,340.11,,408.13,90,,,percent of total billed charges,90% of total billed charges,421.74,93,,,percent of total billed charges,93% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,385.46,85,,,percent of total billed charges,85% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,369.13,81.4,,,percent of total billed charges,81.4% of total billed charges,408.13,90,,,percent of total billed charges,90% of total billed charges,408.13,90,,,percent of total billed charges,90% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,340.11,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,172.32,421.74,
FBR-Complicated -PRO,4218,CDM,981,RC,10121,HCPCS,outpatient,,,270.67,203,,245.09,130,,,fee schedule,130% of fee schedule,245.09,130,,,fee schedule,130% of fee schedule,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,230.31,119,,,fee schedule,119% of fee schedule,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,100% of fee schedule,243.6,90,,,percent of total billed charges,90% of total billed charges,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,187.19,100,,,fee schedule,100% of fee schedule,143.72,245.09,
FBR-Complicated -PRO,4219,CDM,981,RC,10121,HCPCS,outpatient,,,270.67,203,,245.09,130,,,fee schedule,130% of fee schedule,245.09,130,,,fee schedule,130% of fee schedule,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,230.31,119,,,fee schedule,119% of fee schedule,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,100% of fee schedule,243.6,90,,,percent of total billed charges,90% of total billed charges,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,187.19,100,,,fee schedule,100% of fee schedule,143.72,245.09,
I&D hematoma/fluid [Package],4220,CDM,521,RC,10140,HCPCS,outpatient,,,2404.49,1803.37,,2164.04,90,,,percent of total billed charges,90% of total billed charges,2236.18,93,,,percent of total billed charges,93% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,2043.82,85,,,percent of total billed charges,85% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,1957.25,81.4,,,percent of total billed charges,81.4% of total billed charges,2164.04,90,,,percent of total billed charges,90% of total billed charges,2164.04,90,,,percent of total billed charges,90% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,1803.37,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,913.71,2236.18,
I&D hematoma/fluid [Package],4221,CDM,521,RC,10140,HCPCS,outpatient,,,2404.49,1803.37,,2164.04,90,,,percent of total billed charges,90% of total billed charges,2236.18,93,,,percent of total billed charges,93% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,2043.82,85,,,percent of total billed charges,85% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,1957.25,81.4,,,percent of total billed charges,81.4% of total billed charges,2164.04,90,,,percent of total billed charges,90% of total billed charges,2164.04,90,,,percent of total billed charges,90% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,913.71,38,,,percent of total billed charges,38% of total billed charges,1803.37,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,913.71,2236.18,
WND I&D hematoma/fluid-PRO,4222,CDM,982,RC,10140,HCPCS,outpatient,,,346.85,260.14,,154.88,130,,,fee schedule,130% of fee schedule,154.88,130,,,fee schedule,130% of fee schedule,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,147.82,119,,,fee schedule,119% of fee schedule,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,100% of fee schedule,312.17,90,,,percent of total billed charges,90% of total billed charges,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,120.76,100,,,fee schedule,100% of fee schedule,28.74,312.17,
WND I&D hematoma/fluid-G,4223,CDM,982,RC,10140,HCPCS,outpatient,,,2404.49,1803.37,,154.88,130,,,fee schedule,130% of fee schedule,154.88,130,,,fee schedule,130% of fee schedule,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,147.82,119,,,fee schedule,119% of fee schedule,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,100% of fee schedule,2164.04,90,,,percent of total billed charges,90% of total billed charges,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,120.76,100,,,fee schedule,100% of fee schedule,28.74,2164.04,
I&D hematoma/fluid-PRO,4224,CDM,981,RC,10140,HCPCS,outpatient,,,346.85,260.14,,154.88,130,,,fee schedule,130% of fee schedule,154.88,130,,,fee schedule,130% of fee schedule,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,147.82,119,,,fee schedule,119% of fee schedule,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,100% of fee schedule,312.17,90,,,percent of total billed charges,90% of total billed charges,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,120.76,100,,,fee schedule,100% of fee schedule,28.74,312.17,
"Punct. asp. abscess,hematoma,bulla or cyst",4225,CDM,521,RC,10160,HCPCS,outpatient,,,234.37,175.78,,210.93,90,,,percent of total billed charges,90% of total billed charges,217.96,93,,,percent of total billed charges,93% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,199.21,85,,,percent of total billed charges,85% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,190.78,81.4,,,percent of total billed charges,81.4% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,175.78,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,89.06,217.96,
WND Punct. drainage-PRO,4226,CDM,982,RC,10160,HCPCS,outpatient,,,279.29,209.47,,125.48,130,,,fee schedule,130% of fee schedule,125.48,130,,,fee schedule,130% of fee schedule,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,117.62,119,,,fee schedule,119% of fee schedule,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,100% of fee schedule,251.36,90,,,percent of total billed charges,90% of total billed charges,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,99.11,100,,,fee schedule,100% of fee schedule,21.56,251.36,
"Punct. asp. abscess,hematoma,bulla or cyst-PRO",4227,CDM,981,RC,10160,HCPCS,outpatient,,,139.45,104.59,,125.48,130,,,fee schedule,130% of fee schedule,125.48,130,,,fee schedule,130% of fee schedule,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,117.62,119,,,fee schedule,119% of fee schedule,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,100% of fee schedule,125.51,90,,,percent of total billed charges,90% of total billed charges,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,99.11,100,,,fee schedule,100% of fee schedule,21.56,125.51,
"Punct. asp. abscess,hematoma,bulla or cyst-PRO",4228,CDM,981,RC,10160,HCPCS,outpatient,,,139.45,104.59,,125.48,130,,,fee schedule,130% of fee schedule,125.48,130,,,fee schedule,130% of fee schedule,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,117.62,119,,,fee schedule,119% of fee schedule,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,100% of fee schedule,125.51,90,,,percent of total billed charges,90% of total billed charges,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,99.11,100,,,fee schedule,100% of fee schedule,21.56,125.51,
DERM I&D COMPLEX POST OP - PRO,4229,CDM,982,RC,10180,HCPCS,outpatient,,,386.28,289.71,,234.38,130,,,fee schedule,130% of fee schedule,234.38,130,,,fee schedule,130% of fee schedule,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,220.75,119,,,fee schedule,119% of fee schedule,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,100% of fee schedule,347.65,90,,,percent of total billed charges,90% of total billed charges,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,182.12,100,,,fee schedule,100% of fee schedule,182.12,347.65,
WND I & D complex post op-PRO,4230,CDM,988,RC,10180,HCPCS,outpatient,,,584.52,438.39,,234.38,130,,,fee schedule,130% of fee schedule,234.38,130,,,fee schedule,130% of fee schedule,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,220.75,119,,,fee schedule,119% of fee schedule,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,100% of fee schedule,526.07,90,,,percent of total billed charges,90% of total billed charges,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,182.12,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,182.12,100,,,fee schedule,100% of fee schedule,182.12,526.07,
WND I & D complex post op-fac,4231,CDM,761,RC,10180,HCPCS,outpatient,,,1931.05,1448.29,,1737.95,90,,,percent of total billed charges,90% of total billed charges,1795.88,93,,,percent of total billed charges,93% of total billed charges,733.8,38,,,percent of total billed charges,38% of total billed charges,733.8,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,733.8,38,,,percent of total billed charges,38% of total billed charges,1571.87,81.4,,,percent of total billed charges,81.4% of total billed charges,1737.95,90,,,percent of total billed charges,90% of total billed charges,1737.95,90,,,percent of total billed charges,90% of total billed charges,733.8,38,,,percent of total billed charges,38% of total billed charges,733.8,38,,,percent of total billed charges,38% of total billed charges,733.8,38,,,percent of total billed charges,38% of total billed charges,1448.29,75,,,percent of total billed charges,75% of total billed charges,1641.39,85,,,percent of total billed charges,85% of total billed charges,733.8,1795.88,
Repair INT Layer 20[Package],4232,CDM,521,RC,10256,HCPCS,outpatient,,,819.08,614.31,,737.17,90,,,percent of total billed charges,90% of total billed charges,761.74,93,,,percent of total billed charges,93% of total billed charges,311.25,38,,,percent of total billed charges,38% of total billed charges,311.25,38,,,percent of total billed charges,38% of total billed charges,696.22,85,,,percent of total billed charges,85% of total billed charges,311.25,38,,,percent of total billed charges,38% of total billed charges,666.73,81.4,,,percent of total billed charges,81.4% of total billed charges,737.17,90,,,percent of total billed charges,90% of total billed charges,737.17,90,,,percent of total billed charges,90% of total billed charges,311.25,38,,,percent of total billed charges,38% of total billed charges,311.25,38,,,percent of total billed charges,38% of total billed charges,311.25,38,,,percent of total billed charges,38% of total billed charges,614.31,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,311.25,761.74,
WND Debridement infected skin PRO,4233,CDM,982,RC,11000,HCPCS,outpatient,,,202.71,152.03,,38.08,130,,,fee schedule,130% of fee schedule,38.08,130,,,fee schedule,130% of fee schedule,27.2,100,,,fee schedule,Pays 100% Medicare OPPS,27.2,100,,,fee schedule,Pays 100% Medicare OPPS,35.19,119,,,fee schedule,119% of fee schedule,27.2,100,,,fee schedule,Pays 100% Medicare OPPS,27.2,100,,,fee schedule,100% of fee schedule,182.44,90,,,percent of total billed charges,90% of total billed charges,27.2,100,,,fee schedule,Pays 100% Medicare OPPS,27.2,100,,,fee schedule,Pays 100% Medicare OPPS,27.2,100,,,fee schedule,Pays 100% Medicare OPPS,27.2,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,27.2,100,,,fee schedule,100% of fee schedule,27.2,182.44,
"Debride, Rem Fo-skin to Muscle",4234,CDM,521,RC,11011,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,29.39,71.94,
Rmv. Inf./Devit.Tissue;Partial Thick,4235,CDM,521,RC,11040,HCPCS,outpatient,,,124.22,93.17,,111.8,90,,,percent of total billed charges,90% of total billed charges,115.52,93,,,percent of total billed charges,93% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,105.59,85,,,percent of total billed charges,85% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,101.12,81.4,,,percent of total billed charges,81.4% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,93.17,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,47.2,115.52,
Rmv. Inf./Devit.Tissue;Partial Thick-PRO,4236,CDM,981,RC,11040,HCPCS,outpatient,,,76.17,57.13,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,68.55,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,35.93,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,35.93,68.55,
Debridement - Skin 20 Sq cm or<[Package],4237,CDM,521,RC,11042,HCPCS,outpatient,,,518.68,389.01,,466.81,90,,,percent of total billed charges,90% of total billed charges,482.37,93,,,percent of total billed charges,93% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,440.88,85,,,percent of total billed charges,85% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,422.21,81.4,,,percent of total billed charges,81.4% of total billed charges,466.81,90,,,percent of total billed charges,90% of total billed charges,466.81,90,,,percent of total billed charges,90% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,389.01,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,197.1,482.37,
Debridement - Skin 20 Sq cm or<[Package],4238,CDM,521,RC,11042,HCPCS,outpatient,,,518.68,389.01,,466.81,90,,,percent of total billed charges,90% of total billed charges,482.37,93,,,percent of total billed charges,93% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,440.88,85,,,percent of total billed charges,85% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,422.21,81.4,,,percent of total billed charges,81.4% of total billed charges,466.81,90,,,percent of total billed charges,90% of total billed charges,466.81,90,,,percent of total billed charges,90% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,197.1,38,,,percent of total billed charges,38% of total billed charges,389.01,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,197.1,482.37,
WND Deb sq tissue 20 cm2/< -G,4239,CDM,982,RC,11042,HCPCS,outpatient,,,743.26,557.45,,67.16,130,,,fee schedule,130% of fee schedule,67.16,130,,,fee schedule,130% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,75.54,119,,,fee schedule,119% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,100% of fee schedule,668.93,90,,,percent of total billed charges,90% of total billed charges,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,60.41,100,,,fee schedule,100% of fee schedule,60.41,668.93,
WND Deb sq tissue 20 cm2/< PRO,4240,CDM,982,RC,11042,HCPCS,outpatient,,,337.84,253.38,,67.16,130,,,fee schedule,130% of fee schedule,67.16,130,,,fee schedule,130% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,75.54,119,,,fee schedule,119% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,100% of fee schedule,304.06,90,,,percent of total billed charges,90% of total billed charges,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,60.41,100,,,fee schedule,100% of fee schedule,60.41,304.06,
"WND Deb Mus/fascia <20cm2,-G",4241,CDM,982,RC,11043,HCPCS,outpatient,,,962.87,722.15,,159.47,130,,,fee schedule,130% of fee schedule,159.47,130,,,fee schedule,130% of fee schedule,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,192.16,119,,,fee schedule,119% of fee schedule,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,100% of fee schedule,866.58,90,,,percent of total billed charges,90% of total billed charges,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,154.34,100,,,fee schedule,100% of fee schedule,154.34,866.58,
"WND Deb Mus/fascia <20cm2,-PRO",4242,CDM,982,RC,11043,HCPCS,outpatient,,,456.1,342.08,,159.47,130,,,fee schedule,130% of fee schedule,159.47,130,,,fee schedule,130% of fee schedule,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,192.16,119,,,fee schedule,119% of fee schedule,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,100% of fee schedule,410.49,90,,,percent of total billed charges,90% of total billed charges,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,154.34,100,,,fee schedule,100% of fee schedule,154.34,410.49,
Debridement - Muscle or fascia <20cm or less-PRO,4243,CDM,981,RC,11043,HCPCS,outpatient,,,506.77,380.08,,159.47,130,,,fee schedule,130% of fee schedule,159.47,130,,,fee schedule,130% of fee schedule,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,192.16,119,,,fee schedule,119% of fee schedule,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,100% of fee schedule,456.09,90,,,percent of total billed charges,90% of total billed charges,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,154.34,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,154.34,100,,,fee schedule,100% of fee schedule,154.34,456.09,
WND Deb Bone <20cm/<-G,4244,CDM,982,RC,11044,HCPCS,outpatient,,,1689.24,1266.93,,276.35,130,,,fee schedule,130% of fee schedule,276.35,130,,,fee schedule,130% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,281.7,119,,,fee schedule,119% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,100% of fee schedule,1520.32,90,,,percent of total billed charges,90% of total billed charges,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,225.5,100,,,fee schedule,100% of fee schedule,225.5,1520.32,
WND Deb Bone <20cm/<-PRO,4245,CDM,982,RC,11044,HCPCS,outpatient,,,675.69,506.77,,276.35,130,,,fee schedule,130% of fee schedule,276.35,130,,,fee schedule,130% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,281.7,119,,,fee schedule,119% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,100% of fee schedule,608.12,90,,,percent of total billed charges,90% of total billed charges,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,225.5,100,,,fee schedule,100% of fee schedule,225.5,608.12,
Debridement - Bone <20cm-PRO,4246,CDM,981,RC,11044,HCPCS,outpatient,,,675.69,506.77,,276.35,130,,,fee schedule,130% of fee schedule,276.35,130,,,fee schedule,130% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,281.7,119,,,fee schedule,119% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,100% of fee schedule,608.12,90,,,percent of total billed charges,90% of total billed charges,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,225.5,100,,,fee schedule,100% of fee schedule,225.5,608.12,
Debridement - Bone <20cm-PRO,4247,CDM,981,RC,11044,HCPCS,outpatient,,,675.69,506.77,,276.35,130,,,fee schedule,130% of fee schedule,276.35,130,,,fee schedule,130% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,281.7,119,,,fee schedule,119% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,100% of fee schedule,608.12,90,,,percent of total billed charges,90% of total billed charges,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,225.5,100,,,fee schedule,100% of fee schedule,225.5,608.12,
WND Deb subq add on 20 sq cm -G,4248,CDM,982,RC,11045,HCPCS,outpatient,,,157.38,118.04,,23.3,130,,,fee schedule,130% of fee schedule,23.3,130,,,fee schedule,130% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,32.95,119,,,fee schedule,119% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,100% of fee schedule,141.64,90,,,percent of total billed charges,90% of total billed charges,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.23,100,,,fee schedule,100% of fee schedule,23.3,141.64,
WND Deb subq add on 20 sq cm PRO,4249,CDM,982,RC,11045,HCPCS,outpatient,,,99.93,74.95,,23.3,130,,,fee schedule,130% of fee schedule,23.3,130,,,fee schedule,130% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,32.95,119,,,fee schedule,119% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,100% of fee schedule,89.94,90,,,percent of total billed charges,90% of total billed charges,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.23,100,,,fee schedule,100% of fee schedule,23.3,89.94,
Debridement skin addtn 20 sq cm-PRO,4250,CDM,982,RC,11045,HCPCS,outpatient,,,99.93,74.95,,23.3,130,,,fee schedule,130% of fee schedule,23.3,130,,,fee schedule,130% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,32.95,119,,,fee schedule,119% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,100% of fee schedule,89.94,90,,,percent of total billed charges,90% of total billed charges,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.23,100,,,fee schedule,100% of fee schedule,23.3,89.94,
Debridement skin addtn 20 sq cm-PRO,4251,CDM,982,RC,11045,HCPCS,outpatient,,,99.93,74.95,,23.3,130,,,fee schedule,130% of fee schedule,23.3,130,,,fee schedule,130% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,32.95,119,,,fee schedule,119% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,100% of fee schedule,89.94,90,,,percent of total billed charges,90% of total billed charges,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.23,100,,,fee schedule,100% of fee schedule,23.3,89.94,
Debridement skin addtn 20 sq cm-PRO,4252,CDM,982,RC,11045,HCPCS,outpatient,,,99.93,74.95,,23.3,130,,,fee schedule,130% of fee schedule,23.3,130,,,fee schedule,130% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,32.95,119,,,fee schedule,119% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,100% of fee schedule,89.94,90,,,percent of total billed charges,90% of total billed charges,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.23,100,,,fee schedule,100% of fee schedule,23.3,89.94,
WND Deb mus/fascia add-on PRO,4253,CDM,982,RC,11046,HCPCS,outpatient,,,171.18,128.39,,49.4,130,,,fee schedule,130% of fee schedule,49.4,130,,,fee schedule,130% of fee schedule,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,69.37,119,,,fee schedule,119% of fee schedule,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,100% of fee schedule,154.06,90,,,percent of total billed charges,90% of total billed charges,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,54.44,100,,,fee schedule,100% of fee schedule,49.4,154.06,
WND Deb mus/fascia add-on -G,4254,CDM,982,RC,11046,HCPCS,outpatient,,,723.01,542.26,,49.4,130,,,fee schedule,130% of fee schedule,49.4,130,,,fee schedule,130% of fee schedule,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,69.37,119,,,fee schedule,119% of fee schedule,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,100% of fee schedule,650.71,90,,,percent of total billed charges,90% of total billed charges,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,54.44,100,,,fee schedule,100% of fee schedule,49.4,650.71,
Debridement - additional 20 cm - muscle-PRO,4255,CDM,981,RC,11046,HCPCS,outpatient,,,171.18,128.39,,49.4,130,,,fee schedule,130% of fee schedule,49.4,130,,,fee schedule,130% of fee schedule,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,69.37,119,,,fee schedule,119% of fee schedule,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,100% of fee schedule,154.06,90,,,percent of total billed charges,90% of total billed charges,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,54.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,54.44,100,,,fee schedule,100% of fee schedule,49.4,154.06,
Deb bone add-on [Package],4256,CDM,521,RC,11047,HCPCS,outpatient,,,1809.94,1357.46,,1628.95,90,,,percent of total billed charges,90% of total billed charges,1683.24,93,,,percent of total billed charges,93% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,1538.45,85,,,percent of total billed charges,85% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,1473.29,81.4,,,percent of total billed charges,81.4% of total billed charges,1628.95,90,,,percent of total billed charges,90% of total billed charges,1628.95,90,,,percent of total billed charges,90% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,1357.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,687.78,1683.24,
Deb bone add-on [Package],4257,CDM,521,RC,11047,HCPCS,outpatient,,,1809.94,1357.46,,1628.95,90,,,percent of total billed charges,90% of total billed charges,1683.24,93,,,percent of total billed charges,93% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,1538.45,85,,,percent of total billed charges,85% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,1473.29,81.4,,,percent of total billed charges,81.4% of total billed charges,1628.95,90,,,percent of total billed charges,90% of total billed charges,1628.95,90,,,percent of total billed charges,90% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,687.78,38,,,percent of total billed charges,38% of total billed charges,1357.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,687.78,1683.24,
WND Deb bone add-on PRO,4258,CDM,982,RC,11047,HCPCS,outpatient,,,289.63,217.22,,85.97,130,,,fee schedule,130% of fee schedule,85.97,130,,,fee schedule,130% of fee schedule,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,122.4,119,,,fee schedule,119% of fee schedule,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,100% of fee schedule,260.67,90,,,percent of total billed charges,90% of total billed charges,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,96.37,100,,,fee schedule,100% of fee schedule,85.97,260.67,
Debridement - additional 20cm - bone-PRO,4259,CDM,981,RC,11047,HCPCS,outpatient,,,289.63,217.22,,85.97,130,,,fee schedule,130% of fee schedule,85.97,130,,,fee schedule,130% of fee schedule,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,122.4,119,,,fee schedule,119% of fee schedule,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,100% of fee schedule,260.67,90,,,percent of total billed charges,90% of total billed charges,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,96.37,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,96.37,100,,,fee schedule,100% of fee schedule,85.97,260.67,
ORTHO EXC-trimming single lession,4260,CDM,982,RC,11055,HCPCS,outpatient,,,94.91,71.18,,26.12,130,,,fee schedule,130% of fee schedule,26.12,130,,,fee schedule,130% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,19.74,119,,,fee schedule,119% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,100% of fee schedule,85.42,90,,,percent of total billed charges,90% of total billed charges,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,15.84,100,,,fee schedule,100% of fee schedule,15.84,85.42,
WND Trim skin lesion-G,4261,CDM,982,RC,11055,HCPCS,outpatient,,,94.9,71.18,,26.12,130,,,fee schedule,130% of fee schedule,26.12,130,,,fee schedule,130% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,19.74,119,,,fee schedule,119% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,100% of fee schedule,85.41,90,,,percent of total billed charges,90% of total billed charges,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,15.84,100,,,fee schedule,100% of fee schedule,15.84,85.41,
WND Trim skin lesion PRO,4262,CDM,982,RC,11055,HCPCS,outpatient,,,59.76,44.82,,26.12,130,,,fee schedule,130% of fee schedule,26.12,130,,,fee schedule,130% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,19.74,119,,,fee schedule,119% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,100% of fee schedule,53.78,90,,,percent of total billed charges,90% of total billed charges,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,15.84,100,,,fee schedule,100% of fee schedule,15.84,53.78,
EXC - paring or cutting benign lesion -singlePRO,4263,CDM,982,RC,11055,HCPCS,outpatient,,,59.76,44.82,,26.12,130,,,fee schedule,130% of fee schedule,26.12,130,,,fee schedule,130% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,19.74,119,,,fee schedule,119% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,100% of fee schedule,53.78,90,,,percent of total billed charges,90% of total billed charges,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,15.84,100,,,fee schedule,100% of fee schedule,15.84,53.78,
Exc. Benign Hyper. Lesion; 2-4,4264,CDM,521,RC,11056,HCPCS,outpatient,,,123.04,92.28,,110.74,90,,,percent of total billed charges,90% of total billed charges,114.43,93,,,percent of total billed charges,93% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,100.15,81.4,,,percent of total billed charges,81.4% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,92.28,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,46.76,114.43,
WND Trim skin.Lesion; 2-4-PRO,4265,CDM,982,RC,11056,HCPCS,outpatient,,,75,56.25,,36.75,130,,,fee schedule,130% of fee schedule,36.75,130,,,fee schedule,130% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,119,,,fee schedule,119% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,100% of fee schedule,67.5,90,,,percent of total billed charges,90% of total billed charges,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,22.02,100,,,fee schedule,100% of fee schedule,22.02,67.5,
Exc. Benign Hyper. Lesion; 2-4-PRO,4266,CDM,981,RC,11056,HCPCS,outpatient,,,75,56.25,,36.75,130,,,fee schedule,130% of fee schedule,36.75,130,,,fee schedule,130% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,119,,,fee schedule,119% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,100% of fee schedule,67.5,90,,,percent of total billed charges,90% of total billed charges,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,22.02,100,,,fee schedule,100% of fee schedule,22.02,67.5,
Exc. Benign Hyper. Lesion; 2-4-PRO,4267,CDM,981,RC,11056,HCPCS,outpatient,,,75,56.25,,36.75,130,,,fee schedule,130% of fee schedule,36.75,130,,,fee schedule,130% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,119,,,fee schedule,119% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,100% of fee schedule,67.5,90,,,percent of total billed charges,90% of total billed charges,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,22.02,100,,,fee schedule,100% of fee schedule,22.02,67.5,
DERM BIOPSY-tangential (scrape)-G,4268,CDM,982,RC,11102,HCPCS,outpatient,,,231.35,173.51,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,48.3,119,,,fee schedule,119% of fee schedule,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,100% of fee schedule,208.22,90,,,percent of total billed charges,90% of total billed charges,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,100% of fee schedule,38.24,208.22,
WND BIOPSY-tangential (scrape) -G,4269,CDM,982,RC,11102,HCPCS,outpatient,,,333.43,250.07,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,48.3,119,,,fee schedule,119% of fee schedule,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,100% of fee schedule,300.09,90,,,percent of total billed charges,90% of total billed charges,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,100% of fee schedule,38.24,300.09,
WND BIOPSY-tangential (scrape-PRO,4270,CDM,982,RC,11102,HCPCS,outpatient,,,112.61,84.46,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,48.3,119,,,fee schedule,119% of fee schedule,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,100% of fee schedule,101.35,90,,,percent of total billed charges,90% of total billed charges,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,100% of fee schedule,38.24,101.35,
DERM BIOPSY-TANGENTIAL (SCRAPE) - PRO,4271,CDM,982,RC,11102,HCPCS,outpatient,,,178.29,133.72,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,48.3,119,,,fee schedule,119% of fee schedule,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,100% of fee schedule,160.46,90,,,percent of total billed charges,90% of total billed charges,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,100% of fee schedule,38.24,160.46,
BIOPSY-tangential (scrape-PRO,4272,CDM,983,RC,11102,HCPCS,outpatient,,,112.61,84.46,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,48.3,119,,,fee schedule,119% of fee schedule,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,100% of fee schedule,101.35,90,,,percent of total billed charges,90% of total billed charges,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,100% of fee schedule,38.24,101.35,
BIOPSY-tangential (scrape-PRO,4273,CDM,983,RC,11102,HCPCS,outpatient,,,112.61,84.46,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,48.3,119,,,fee schedule,119% of fee schedule,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,100% of fee schedule,101.35,90,,,percent of total billed charges,90% of total billed charges,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,100% of fee schedule,38.24,101.35,
"DERM Biopsy tangential, ea add-G",4274,CDM,982,RC,11103,HCPCS,outpatient,,,117.79,88.34,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,28.01,119,,,fee schedule,119% of fee schedule,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,100% of fee schedule,106.01,90,,,percent of total billed charges,90% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,21.84,100,,,fee schedule,100% of fee schedule,21.84,106.01,
WND Biopsy tangential ea add PRO,4275,CDM,982,RC,11103,HCPCS,outpatient,,,60.72,45.54,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,28.01,119,,,fee schedule,119% of fee schedule,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,100% of fee schedule,54.65,90,,,percent of total billed charges,90% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,21.84,100,,,fee schedule,100% of fee schedule,21.84,54.65,
DERM BIOPSY TANGENTIAL EA ADD - PRO,4276,CDM,982,RC,11103,HCPCS,outpatient,,,62.61,46.96,,50.09,80,,,percent of total billed charges,90% of total billed charges,50.09,80,,,percent of total billed charges,93% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,28.01,119,,,fee schedule,119% of fee schedule,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,100% of fee schedule,56.35,90,,,percent of total billed charges,90% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,21.84,100,,,fee schedule,100% of fee schedule,21.84,56.35,
Biopsy tangential ea add PRO,4277,CDM,983,RC,11103,HCPCS,outpatient,,,60.72,45.54,,48.58,80,,,percent of total billed charges,90% of total billed charges,48.58,80,,,percent of total billed charges,93% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,28.01,119,,,fee schedule,119% of fee schedule,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,100% of fee schedule,54.65,90,,,percent of total billed charges,90% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,21.84,100,,,fee schedule,100% of fee schedule,21.84,54.65,
Biopsy tangential ea add PRO,4278,CDM,983,RC,11103,HCPCS,outpatient,,,60.72,45.54,,48.58,80,,,percent of total billed charges,90% of total billed charges,48.58,80,,,percent of total billed charges,93% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,28.01,119,,,fee schedule,119% of fee schedule,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,100% of fee schedule,54.65,90,,,percent of total billed charges,90% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,21.84,100,,,fee schedule,100% of fee schedule,21.84,54.65,
BIopsy Punch  Single[Package],4279,CDM,521,RC,11104,HCPCS,outpatient,,,384.22,288.17,,345.8,90,,,percent of total billed charges,90% of total billed charges,357.32,93,,,percent of total billed charges,93% of total billed charges,146,38,,,percent of total billed charges,38% of total billed charges,146,38,,,percent of total billed charges,38% of total billed charges,326.59,85,,,percent of total billed charges,85% of total billed charges,146,38,,,percent of total billed charges,38% of total billed charges,312.76,81.4,,,percent of total billed charges,81.4% of total billed charges,345.8,90,,,percent of total billed charges,90% of total billed charges,345.8,90,,,percent of total billed charges,90% of total billed charges,146,38,,,percent of total billed charges,38% of total billed charges,146,38,,,percent of total billed charges,38% of total billed charges,146,38,,,percent of total billed charges,38% of total billed charges,288.17,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,146,357.32,
DERM BIOPSY PUNCH SINGLE- PRO,4280,CDM,982,RC,11104,HCPCS,outpatient,,,212.24,159.18,,169.79,80,,,percent of total billed charges,90% of total billed charges,169.79,80,,,percent of total billed charges,93% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,119,,,fee schedule,119% of fee schedule,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,100% of fee schedule,191.02,90,,,percent of total billed charges,90% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,47.33,100,,,fee schedule,100% of fee schedule,47.33,191.02,
DERM Biopsy Punch Single-G,4281,CDM,982,RC,11104,HCPCS,outpatient,,,318.36,238.77,,254.69,80,,,percent of total billed charges,90% of total billed charges,254.69,80,,,percent of total billed charges,93% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,119,,,fee schedule,119% of fee schedule,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,100% of fee schedule,286.52,90,,,percent of total billed charges,90% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,47.33,100,,,fee schedule,100% of fee schedule,47.33,286.52,
WND Biopsy Punch-PRO,4282,CDM,982,RC,11104,HCPCS,outpatient,,,141.32,105.99,,113.06,80,,,percent of total billed charges,90% of total billed charges,113.06,80,,,percent of total billed charges,93% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,119,,,fee schedule,119% of fee schedule,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,100% of fee schedule,127.19,90,,,percent of total billed charges,90% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,47.33,100,,,fee schedule,100% of fee schedule,47.33,127.19,
WND Biopsy Punch-G,4283,CDM,982,RC,11104,HCPCS,outpatient,,,384.22,288.17,,307.38,80,,,percent of total billed charges,90% of total billed charges,307.38,80,,,percent of total billed charges,93% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,119,,,fee schedule,119% of fee schedule,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,100% of fee schedule,345.8,90,,,percent of total billed charges,90% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,47.33,100,,,fee schedule,100% of fee schedule,47.33,345.8,
Biopsy Punch-PRO,4284,CDM,983,RC,11104,HCPCS,outpatient,,,141.32,105.99,,113.06,80,,,percent of total billed charges,90% of total billed charges,113.06,80,,,percent of total billed charges,93% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,119,,,fee schedule,119% of fee schedule,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,100% of fee schedule,127.19,90,,,percent of total billed charges,90% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,47.33,100,,,fee schedule,100% of fee schedule,47.33,127.19,
Biopsy Punch-PRO,4285,CDM,983,RC,11104,HCPCS,outpatient,,,141.32,105.99,,113.06,80,,,percent of total billed charges,90% of total billed charges,113.06,80,,,percent of total billed charges,93% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,119,,,fee schedule,119% of fee schedule,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,100% of fee schedule,127.19,90,,,percent of total billed charges,90% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,47.33,100,,,fee schedule,100% of fee schedule,47.33,127.19,
DERM BIOPSY PUNCH EA ADD - PRO,4286,CDM,982,RC,11105,HCPCS,outpatient,,,63.67,47.75,,50.94,80,,,percent of total billed charges,90% of total billed charges,50.94,80,,,percent of total billed charges,93% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,32.8,119,,,fee schedule,119% of fee schedule,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,100% of fee schedule,57.3,90,,,percent of total billed charges,90% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.84,100,,,fee schedule,100% of fee schedule,25.84,57.3,
DERM Biopsy -punch ea add-G,4287,CDM,982,RC,11105,HCPCS,outpatient,,,127.35,95.51,,101.88,80,,,percent of total billed charges,90% of total billed charges,101.88,80,,,percent of total billed charges,93% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,32.8,119,,,fee schedule,119% of fee schedule,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,100% of fee schedule,114.62,90,,,percent of total billed charges,90% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.84,100,,,fee schedule,100% of fee schedule,25.84,114.62,
WND Biopsy Punch each add Pro,4288,CDM,982,RC,11105,HCPCS,outpatient,,,69.56,52.17,,55.65,80,,,percent of total billed charges,90% of total billed charges,55.65,80,,,percent of total billed charges,93% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,32.8,119,,,fee schedule,119% of fee schedule,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,100% of fee schedule,62.6,90,,,percent of total billed charges,90% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.84,100,,,fee schedule,100% of fee schedule,25.84,62.6,
WND Biopsy Incisional-G,4289,CDM,982,RC,11106,HCPCS,outpatient,,,552.03,414.02,,441.62,80,,,percent of total billed charges,90% of total billed charges,441.62,80,,,percent of total billed charges,93% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,73.04,119,,,fee schedule,119% of fee schedule,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,100% of fee schedule,496.83,90,,,percent of total billed charges,90% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,56.85,100,,,fee schedule,100% of fee schedule,56.85,496.83,
WND Biopsy Incisional-PRO,4290,CDM,982,RC,11106,HCPCS,outpatient,,,220.81,165.61,,176.65,80,,,percent of total billed charges,90% of total billed charges,176.65,80,,,percent of total billed charges,93% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,73.04,119,,,fee schedule,119% of fee schedule,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,100% of fee schedule,198.73,90,,,percent of total billed charges,90% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,56.85,100,,,fee schedule,100% of fee schedule,56.85,198.73,
Biopsy Incisional-PRO,4291,CDM,983,RC,11106,HCPCS,outpatient,,,220.81,165.61,,176.65,80,,,percent of total billed charges,90% of total billed charges,176.65,80,,,percent of total billed charges,93% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,73.04,119,,,fee schedule,119% of fee schedule,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,100% of fee schedule,198.73,90,,,percent of total billed charges,90% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,56.85,100,,,fee schedule,100% of fee schedule,56.85,198.73,
Biopsy Incisional-PRO,4292,CDM,983,RC,11106,HCPCS,outpatient,,,220.81,165.61,,176.65,80,,,percent of total billed charges,90% of total billed charges,176.65,80,,,percent of total billed charges,93% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,73.04,119,,,fee schedule,119% of fee schedule,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,100% of fee schedule,198.73,90,,,percent of total billed charges,90% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,56.85,100,,,fee schedule,100% of fee schedule,56.85,198.73,
Biopsy incisional ea add[Package],4293,CDM,521,RC,11107,HCPCS,outpatient,,,247.31,185.48,,222.58,90,,,percent of total billed charges,90% of total billed charges,230,93,,,percent of total billed charges,93% of total billed charges,93.98,38,,,percent of total billed charges,38% of total billed charges,93.98,38,,,percent of total billed charges,38% of total billed charges,210.21,85,,,percent of total billed charges,85% of total billed charges,93.98,38,,,percent of total billed charges,38% of total billed charges,201.31,81.4,,,percent of total billed charges,81.4% of total billed charges,222.58,90,,,percent of total billed charges,90% of total billed charges,222.58,90,,,percent of total billed charges,90% of total billed charges,93.98,38,,,percent of total billed charges,38% of total billed charges,93.98,38,,,percent of total billed charges,38% of total billed charges,93.98,38,,,percent of total billed charges,38% of total billed charges,185.48,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,93.98,230,
WND Biopsy Incisional ea add PRO,4294,CDM,982,RC,11107,HCPCS,outpatient,,,81.7,61.28,,65.36,80,,,percent of total billed charges,90% of total billed charges,65.36,80,,,percent of total billed charges,93% of total billed charges,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,39.33,119,,,fee schedule,119% of fee schedule,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,100% of fee schedule,73.53,90,,,percent of total billed charges,90% of total billed charges,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,30.95,100,,,fee schedule,100% of fee schedule,30.95,73.53,
Biopsy Incisional ea add PRO,4295,CDM,983,RC,11107,HCPCS,outpatient,,,81.7,61.28,,65.36,80,,,percent of total billed charges,90% of total billed charges,65.36,80,,,percent of total billed charges,93% of total billed charges,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,39.33,119,,,fee schedule,119% of fee schedule,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,100% of fee schedule,73.53,90,,,percent of total billed charges,90% of total billed charges,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,30.95,100,,,fee schedule,100% of fee schedule,30.95,73.53,
Biopsy Incisional ea add PRO,4296,CDM,983,RC,11107,HCPCS,outpatient,,,81.7,61.28,,65.36,80,,,percent of total billed charges,90% of total billed charges,65.36,80,,,percent of total billed charges,93% of total billed charges,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,39.33,119,,,fee schedule,119% of fee schedule,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,100% of fee schedule,73.53,90,,,percent of total billed charges,90% of total billed charges,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,30.95,100,,,fee schedule,100% of fee schedule,30.95,73.53,
"Shave-Benign, Skin Tags1-15",4297,CDM,521,RC,11200,HCPCS,outpatient,,,195.71,146.78,,176.14,90,,,percent of total billed charges,90% of total billed charges,182.01,93,,,percent of total billed charges,93% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,166.35,85,,,percent of total billed charges,85% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,159.31,81.4,,,percent of total billed charges,81.4% of total billed charges,176.14,90,,,percent of total billed charges,90% of total billed charges,176.14,90,,,percent of total billed charges,90% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,74.37,38,,,percent of total billed charges,38% of total billed charges,146.78,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,74.37,182.01,
"DERM Shave-Benign, Skin Tags1-15-G",4298,CDM,982,RC,11200,HCPCS,outpatient,,,227.1,170.33,,95.82,130,,,fee schedule,130% of fee schedule,95.82,130,,,fee schedule,130% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,91.5,119,,,fee schedule,119% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,100% of fee schedule,204.39,90,,,percent of total billed charges,90% of total billed charges,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,79.01,100,,,fee schedule,100% of fee schedule,28.74,204.39,
"WND Shave-B9, Skin Tags1-15-PRO",4299,CDM,982,RC,11200,HCPCS,outpatient,,,225.23,168.92,,95.82,130,,,fee schedule,130% of fee schedule,95.82,130,,,fee schedule,130% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,91.5,119,,,fee schedule,119% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,100% of fee schedule,202.71,90,,,percent of total billed charges,90% of total billed charges,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,79.01,100,,,fee schedule,100% of fee schedule,28.74,202.71,
"DERM SHAVE-BENIGN, SKIN TAGS 1-15 - PRO",4300,CDM,982,RC,11200,HCPCS,outpatient,,,191.02,143.27,,95.82,130,,,fee schedule,130% of fee schedule,95.82,130,,,fee schedule,130% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,91.5,119,,,fee schedule,119% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,100% of fee schedule,171.92,90,,,percent of total billed charges,90% of total billed charges,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,79.01,100,,,fee schedule,100% of fee schedule,28.74,171.92,
"Shave-Benign, Skin Tags1-15-PRO",4301,CDM,981,RC,11200,HCPCS,outpatient,,,117.18,87.89,,95.82,130,,,fee schedule,130% of fee schedule,95.82,130,,,fee schedule,130% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,91.5,119,,,fee schedule,119% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,100% of fee schedule,105.46,90,,,percent of total billed charges,90% of total billed charges,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,79.01,100,,,fee schedule,100% of fee schedule,28.74,105.46,
"Shave-Benign, Skin Tags1-15-PRO",4302,CDM,981,RC,11200,HCPCS,outpatient,,,117.18,87.89,,95.82,130,,,fee schedule,130% of fee schedule,95.82,130,,,fee schedule,130% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,91.5,119,,,fee schedule,119% of fee schedule,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,100% of fee schedule,105.46,90,,,percent of total billed charges,90% of total billed charges,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,79.01,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,79.01,100,,,fee schedule,100% of fee schedule,28.74,105.46,
"Shave, Benign;Each Additional 10",4303,CDM,521,RC,11201,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.41,101.34,
"DERM SHAVE, BENIGN; EACH ADDITIONAL 10 - PRO",4304,CDM,982,RC,11201,HCPCS,outpatient,,,26.53,19.9,,22.62,130,,,fee schedule,130% of fee schedule,22.62,130,,,fee schedule,130% of fee schedule,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,20.27,119,,,fee schedule,119% of fee schedule,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,100% of fee schedule,23.88,90,,,percent of total billed charges,90% of total billed charges,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,14.37,100,,,fee schedule,100% of fee schedule,16.64,100,,,fee schedule,100% of fee schedule,14.37,23.88,
"DERM SHAVE, BENIGN; EACH ADDITIONAL 10 - G",4305,CDM,982,RC,11201,HCPCS,outpatient,,,47.76,35.82,,22.62,130,,,fee schedule,130% of fee schedule,22.62,130,,,fee schedule,130% of fee schedule,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,20.27,119,,,fee schedule,119% of fee schedule,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,100% of fee schedule,42.98,90,,,percent of total billed charges,90% of total billed charges,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,14.37,100,,,fee schedule,100% of fee schedule,16.64,100,,,fee schedule,100% of fee schedule,14.37,42.98,
"WND Shave, B9;Each Additional 10 PRO",4306,CDM,982,RC,11201,HCPCS,outpatient,,,49.55,37.16,,22.62,130,,,fee schedule,130% of fee schedule,22.62,130,,,fee schedule,130% of fee schedule,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,20.27,119,,,fee schedule,119% of fee schedule,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,100% of fee schedule,44.6,90,,,percent of total billed charges,90% of total billed charges,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,16.64,100,,,fee schedule,Pays 100% Medicare OPPS,14.37,100,,,fee schedule,100% of fee schedule,16.64,100,,,fee schedule,100% of fee schedule,14.37,44.6,
"Shaving,Benign(tr, a, l)=<0.5cm",4307,CDM,521,RC,11300,HCPCS,outpatient,,,127.72,95.79,,114.95,90,,,percent of total billed charges,90% of total billed charges,118.78,93,,,percent of total billed charges,93% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,108.56,85,,,percent of total billed charges,85% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,103.96,81.4,,,percent of total billed charges,81.4% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,95.79,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.53,118.78,
"Shaving,Benign(tr, a, l)=<0.5cm",4308,CDM,521,RC,11300,HCPCS,outpatient,,,127.72,95.79,,114.95,90,,,percent of total billed charges,90% of total billed charges,118.78,93,,,percent of total billed charges,93% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,108.56,85,,,percent of total billed charges,85% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,103.96,81.4,,,percent of total billed charges,81.4% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,95.79,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.53,118.78,
"Derm Shave/benigh(tr,a,l)05.cm &less-G",4309,CDM,982,RC,11300,HCPCS,outpatient,,,176.87,132.65,,40.38,130,,,fee schedule,130% of fee schedule,40.38,130,,,fee schedule,130% of fee schedule,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,42.73,119,,,fee schedule,119% of fee schedule,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,100% of fee schedule,159.18,90,,,percent of total billed charges,90% of total billed charges,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,34.42,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,34.42,100,,,fee schedule,100% of fee schedule,34.42,159.18,
"Shave Benign(tr,a,l); Diameter 0.6-1.0cm",4310,CDM,521,RC,11301,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
"Shave Benign(tr,a,l); Diameter 0.6-1.0cm-PRO",4311,CDM,981,RC,11301,HCPCS,outpatient,,,105.47,79.1,,68.85,130,,,fee schedule,130% of fee schedule,68.85,130,,,fee schedule,130% of fee schedule,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,64.77,119,,,fee schedule,119% of fee schedule,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,100% of fee schedule,94.92,90,,,percent of total billed charges,90% of total billed charges,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,51.85,100,,,fee schedule,100% of fee schedule,51.85,107.79,
Skin Rmv.: Shave;1.1-2.0cm[Package],4312,CDM,521,RC,11302,HCPCS,outpatient,,,207.41,155.56,,186.67,90,,,percent of total billed charges,90% of total billed charges,192.89,93,,,percent of total billed charges,93% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,176.3,85,,,percent of total billed charges,85% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,168.83,81.4,,,percent of total billed charges,81.4% of total billed charges,186.67,90,,,percent of total billed charges,90% of total billed charges,186.67,90,,,percent of total billed charges,90% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,155.56,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,78.82,192.89,
DERM Skin Rmv.: Shave;1.1-2.0cm-G,4313,CDM,982,RC,11302,HCPCS,outpatient,,,207.41,155.56,,85.74,130,,,fee schedule,130% of fee schedule,85.74,130,,,fee schedule,130% of fee schedule,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.98,119,,,fee schedule,119% of fee schedule,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,100% of fee schedule,186.67,90,,,percent of total billed charges,90% of total billed charges,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,60.43,100,,,fee schedule,100% of fee schedule,60.43,186.67,
Skin Rmv.: Shave;1.1-2.0cm-PRO,4314,CDM,981,RC,11302,HCPCS,outpatient,,,99.59,74.69,,85.74,130,,,fee schedule,130% of fee schedule,85.74,130,,,fee schedule,130% of fee schedule,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.98,119,,,fee schedule,119% of fee schedule,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,100% of fee schedule,89.63,90,,,percent of total billed charges,90% of total billed charges,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,60.43,100,,,fee schedule,100% of fee schedule,60.43,129.35,
Skin Rmv.: Shave;1.1-2.0cm-PRO,4315,CDM,981,RC,11302,HCPCS,outpatient,,,99.59,74.69,,85.74,130,,,fee schedule,130% of fee schedule,85.74,130,,,fee schedule,130% of fee schedule,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.98,119,,,fee schedule,119% of fee schedule,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,100% of fee schedule,89.63,90,,,percent of total billed charges,90% of total billed charges,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,60.43,100,,,fee schedule,100% of fee schedule,60.43,129.35,
Skin Rmv.: Shave;over 2.0cm[Package],4316,CDM,521,RC,11303,HCPCS,outpatient,,,261.29,195.97,,235.16,90,,,percent of total billed charges,90% of total billed charges,243,93,,,percent of total billed charges,93% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,222.1,85,,,percent of total billed charges,85% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,212.69,81.4,,,percent of total billed charges,81.4% of total billed charges,235.16,90,,,percent of total billed charges,90% of total billed charges,235.16,90,,,percent of total billed charges,90% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,195.97,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,99.29,243,
DERM SKIN RMV: SHAVE OVER 2.0CM - PRO,4317,CDM,982,RC,11303,HCPCS,outpatient,,,238.77,179.08,,101.19,130,,,fee schedule,130% of fee schedule,101.19,130,,,fee schedule,130% of fee schedule,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,89.39,119,,,fee schedule,119% of fee schedule,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,100% of fee schedule,214.89,90,,,percent of total billed charges,90% of total billed charges,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,71.61,100,,,fee schedule,100% of fee schedule,71.61,214.89,
Skin Rmv.: Shave; over 2.0cm-PRO,4318,CDM,981,RC,11303,HCPCS,outpatient,,,123.04,92.28,,101.19,130,,,fee schedule,130% of fee schedule,101.19,130,,,fee schedule,130% of fee schedule,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,89.39,119,,,fee schedule,119% of fee schedule,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,100% of fee schedule,110.74,90,,,percent of total billed charges,90% of total billed charges,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,71.61,100,,,fee schedule,100% of fee schedule,71.61,110.74,
Skin Rmv.: Shave; over 2.0cm-PRO,4319,CDM,981,RC,11303,HCPCS,outpatient,,,123.04,92.28,,101.19,130,,,fee schedule,130% of fee schedule,101.19,130,,,fee schedule,130% of fee schedule,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,89.39,119,,,fee schedule,119% of fee schedule,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,100% of fee schedule,110.74,90,,,percent of total billed charges,90% of total billed charges,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,71.61,100,,,fee schedule,100% of fee schedule,71.61,110.74,
"Shave Benign(sc,n,ha,fe,g);Lesion .5cm or less",4320,CDM,521,RC,11305,HCPCS,outpatient,,,154.67,116,,139.2,90,,,percent of total billed charges,90% of total billed charges,143.84,93,,,percent of total billed charges,93% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,125.9,81.4,,,percent of total billed charges,81.4% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,116,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,58.77,143.84,
DERM SHAVE SKIN LESION 004CM/< - PRO,4321,CDM,982,RC,11305,HCPCS,outpatient,,,84.89,63.67,,43.45,130,,,fee schedule,130% of fee schedule,43.45,130,,,fee schedule,130% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,48.55,119,,,fee schedule,119% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,100% of fee schedule,76.4,90,,,percent of total billed charges,90% of total billed charges,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,37.67,100,,,fee schedule,100% of fee schedule,37.67,86.23,
DERM SHAVE SKIN LESION 004CM/< -G,4322,CDM,982,RC,11305,HCPCS,outpatient,,,297.14,222.86,,43.45,130,,,fee schedule,130% of fee schedule,43.45,130,,,fee schedule,130% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,48.55,119,,,fee schedule,119% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,100% of fee schedule,267.43,90,,,percent of total billed charges,90% of total billed charges,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,37.67,100,,,fee schedule,100% of fee schedule,37.67,267.43,
"Shave Benign(sc,n,ha,fe,g);Lesion .5cm or less-PRO",4323,CDM,981,RC,11305,HCPCS,outpatient,,,93.74,70.31,,43.45,130,,,fee schedule,130% of fee schedule,43.45,130,,,fee schedule,130% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,48.55,119,,,fee schedule,119% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,100% of fee schedule,84.37,90,,,percent of total billed charges,90% of total billed charges,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,37.67,100,,,fee schedule,100% of fee schedule,37.67,86.23,
"Shave Benign(sc,n,ha,fe,g);Lesion .5cm or less-PRO",4324,CDM,981,RC,11305,HCPCS,outpatient,,,93.74,70.31,,43.45,130,,,fee schedule,130% of fee schedule,43.45,130,,,fee schedule,130% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,48.55,119,,,fee schedule,119% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,100% of fee schedule,84.37,90,,,percent of total billed charges,90% of total billed charges,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,37.67,100,,,fee schedule,100% of fee schedule,37.67,86.23,
"Shave Benign(sc,n,ha,fe,g);Lesion 0.6-1.0cm",4325,CDM,521,RC,11306,HCPCS,outpatient,,,228.5,171.38,,205.65,90,,,percent of total billed charges,90% of total billed charges,212.51,93,,,percent of total billed charges,93% of total billed charges,86.83,38,,,percent of total billed charges,38% of total billed charges,86.83,38,,,percent of total billed charges,38% of total billed charges,194.23,85,,,percent of total billed charges,85% of total billed charges,86.83,38,,,percent of total billed charges,38% of total billed charges,186,81.4,,,percent of total billed charges,81.4% of total billed charges,205.65,90,,,percent of total billed charges,90% of total billed charges,205.65,90,,,percent of total billed charges,90% of total billed charges,86.83,38,,,percent of total billed charges,38% of total billed charges,86.83,38,,,percent of total billed charges,38% of total billed charges,86.83,38,,,percent of total billed charges,38% of total billed charges,171.38,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,86.83,212.51,
"Shave Benign(sc,n,ha,fe,g);Lesion 0.6-1.0cm-PRO",4326,CDM,981,RC,11306,HCPCS,outpatient,,,107.79,80.84,,71.84,130,,,fee schedule,130% of fee schedule,71.84,130,,,fee schedule,130% of fee schedule,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,62.46,119,,,fee schedule,119% of fee schedule,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,100% of fee schedule,97.01,90,,,percent of total billed charges,90% of total billed charges,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,49.62,100,,,fee schedule,100% of fee schedule,49.62,122.16,
"Shave Benign(sc,n,ha,fe,g);Lesion 0.6-1.0cm-PRO",4327,CDM,981,RC,11306,HCPCS,outpatient,,,107.79,80.84,,71.84,130,,,fee schedule,130% of fee schedule,71.84,130,,,fee schedule,130% of fee schedule,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,62.46,119,,,fee schedule,119% of fee schedule,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,100% of fee schedule,97.01,90,,,percent of total billed charges,90% of total billed charges,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,49.62,100,,,fee schedule,100% of fee schedule,49.62,122.16,
"Shave: Epid/Derm., Nonface; Lesion over 2.0cm",4328,CDM,521,RC,11308,HCPCS,outpatient,,,310.53,232.9,,279.48,90,,,percent of total billed charges,90% of total billed charges,288.79,93,,,percent of total billed charges,93% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,252.77,81.4,,,percent of total billed charges,81.4% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,232.9,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,118,288.79,
"Shave: Epid/Derm., Nonface; Lesion over 2.0cm-PRO",4329,CDM,981,RC,11308,HCPCS,outpatient,,,187.48,140.61,,99.8,130,,,fee schedule,130% of fee schedule,99.8,130,,,fee schedule,130% of fee schedule,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,90.87,119,,,fee schedule,119% of fee schedule,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,100% of fee schedule,168.73,90,,,percent of total billed charges,90% of total billed charges,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,70.39,100,,,fee schedule,100% of fee schedule,70.39,168.73,
"Shave: Epid/Derm., Nonface; Lesion over 2.0cm-PRO",4330,CDM,981,RC,11308,HCPCS,outpatient,,,187.48,140.61,,99.8,130,,,fee schedule,130% of fee schedule,99.8,130,,,fee schedule,130% of fee schedule,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,90.87,119,,,fee schedule,119% of fee schedule,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,100% of fee schedule,168.73,90,,,percent of total billed charges,90% of total billed charges,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,70.39,100,,,fee schedule,100% of fee schedule,70.39,168.73,
"Shave: Epid/Derm.,Face; 0.6 to 1.0cm",4331,CDM,521,RC,11311,HCPCS,outpatient,,,194.51,145.88,,175.06,90,,,percent of total billed charges,90% of total billed charges,180.89,93,,,percent of total billed charges,93% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,165.33,85,,,percent of total billed charges,85% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,158.33,81.4,,,percent of total billed charges,81.4% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,145.88,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,73.91,180.89,
"DERM SHAVE LESION EPID, DERM - PRO",4332,CDM,982,RC,11311,HCPCS,outpatient,,,132.65,99.49,,85.74,130,,,fee schedule,130% of fee schedule,85.74,130,,,fee schedule,130% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,79.02,119,,,fee schedule,119% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,100% of fee schedule,119.39,90,,,percent of total billed charges,90% of total billed charges,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,63.47,100,,,fee schedule,100% of fee schedule,63.47,129.35,
"DERM Shave: Epid/Derm.,Face; 0.6 to 1.0cm-G",4333,CDM,982,RC,11311,HCPCS,outpatient,,,451.01,338.26,,85.74,130,,,fee schedule,130% of fee schedule,85.74,130,,,fee schedule,130% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,79.02,119,,,fee schedule,119% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,100% of fee schedule,405.91,90,,,percent of total billed charges,90% of total billed charges,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,63.47,100,,,fee schedule,100% of fee schedule,63.47,405.91,
"Shave: Epid/Derm.,Face; 0.6 to 1.0cm-PRO",4334,CDM,981,RC,11311,HCPCS,outpatient,,,116,87,,85.74,130,,,fee schedule,130% of fee schedule,85.74,130,,,fee schedule,130% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,79.02,119,,,fee schedule,119% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,100% of fee schedule,104.4,90,,,percent of total billed charges,90% of total billed charges,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,63.47,100,,,fee schedule,100% of fee schedule,63.47,129.35,
"Shave: Epid/Derm.,Face; 0.6 to 1.0cm-PRO",4335,CDM,981,RC,11311,HCPCS,outpatient,,,116,87,,85.74,130,,,fee schedule,130% of fee schedule,85.74,130,,,fee schedule,130% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,79.02,119,,,fee schedule,119% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,100% of fee schedule,104.4,90,,,percent of total billed charges,90% of total billed charges,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,63.47,100,,,fee schedule,100% of fee schedule,63.47,129.35,
"Excision Benign(tr,a,l); Lesion 0.5cm/less",4336,CDM,521,RC,11400,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.46,309.49,
"WND Excise B9 (tr,a,l) Lesion .5cm-> PRO",4337,CDM,982,RC,11400,HCPCS,outpatient,,,236.5,177.38,,104.31,130,,,fee schedule,130% of fee schedule,104.31,130,,,fee schedule,130% of fee schedule,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,101.48,119,,,fee schedule,119% of fee schedule,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,100% of fee schedule,212.85,90,,,percent of total billed charges,90% of total billed charges,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,86.9,100,,,fee schedule,100% of fee schedule,57.49,212.85,
"Excision Benign(tr,a,l); Lesion 0.5cm/less-PRO",4338,CDM,981,RC,11400,HCPCS,outpatient,,,200.38,150.29,,104.31,130,,,fee schedule,130% of fee schedule,104.31,130,,,fee schedule,130% of fee schedule,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,101.48,119,,,fee schedule,119% of fee schedule,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,86.9,100,,,fee schedule,100% of fee schedule,57.49,180.34,
"Excision Benign(tr,a,l); Lesion 0.5cm/less-PRO",4339,CDM,981,RC,11400,HCPCS,outpatient,,,200.38,150.29,,104.31,130,,,fee schedule,130% of fee schedule,104.31,130,,,fee schedule,130% of fee schedule,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,101.48,119,,,fee schedule,119% of fee schedule,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,86.9,100,,,fee schedule,100% of fee schedule,57.49,180.34,
"Excision Benign(tr,a,l); Lesion .6 to 1.0cm",4340,CDM,521,RC,11401,HCPCS,outpatient,,,301.16,225.87,,271.04,90,,,percent of total billed charges,90% of total billed charges,280.08,93,,,percent of total billed charges,93% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,255.99,85,,,percent of total billed charges,85% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,245.14,81.4,,,percent of total billed charges,81.4% of total billed charges,271.04,90,,,percent of total billed charges,90% of total billed charges,271.04,90,,,percent of total billed charges,90% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,225.87,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,114.44,280.08,
"DERM Excision Benign(tr,a,l); Lesion .6 to 1.0cm-G",4341,CDM,982,RC,11401,HCPCS,outpatient,,,574.35,430.76,,137.53,130,,,fee schedule,130% of fee schedule,137.53,130,,,fee schedule,130% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,128.67,119,,,fee schedule,119% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,100% of fee schedule,516.92,90,,,percent of total billed charges,90% of total billed charges,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,109.29,100,,,fee schedule,100% of fee schedule,71.86,516.92,
"WND Excise B9(tr,a,l) Lesion .6 to 1cm-PRO",4342,CDM,982,RC,11401,HCPCS,outpatient,,,304.07,228.05,,137.53,130,,,fee schedule,130% of fee schedule,137.53,130,,,fee schedule,130% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,128.67,119,,,fee schedule,119% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,100% of fee schedule,273.66,90,,,percent of total billed charges,90% of total billed charges,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,109.29,100,,,fee schedule,100% of fee schedule,71.86,273.66,
"WND Excise B9(tr,a,l) Lesion .6 to 1cm-G",4343,CDM,982,RC,11401,HCPCS,outpatient,,,574.35,430.76,,137.53,130,,,fee schedule,130% of fee schedule,137.53,130,,,fee schedule,130% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,128.67,119,,,fee schedule,119% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,100% of fee schedule,516.92,90,,,percent of total billed charges,90% of total billed charges,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,109.29,100,,,fee schedule,100% of fee schedule,71.86,516.92,
"Excision Benign(tr,a,l); Lesion .6 to 1.0cm-PRO",4344,CDM,981,RC,11401,HCPCS,outpatient,,,180.45,135.34,,137.53,130,,,fee schedule,130% of fee schedule,137.53,130,,,fee schedule,130% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,128.67,119,,,fee schedule,119% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,100% of fee schedule,162.41,90,,,percent of total billed charges,90% of total billed charges,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,109.29,100,,,fee schedule,100% of fee schedule,71.86,162.41,
"Excision Benign(tr,a,l); Lesion .6 to 1.0cm-PRO",4345,CDM,981,RC,11401,HCPCS,outpatient,,,180.45,135.34,,137.53,130,,,fee schedule,130% of fee schedule,137.53,130,,,fee schedule,130% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,128.67,119,,,fee schedule,119% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,100% of fee schedule,162.41,90,,,percent of total billed charges,90% of total billed charges,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,109.29,100,,,fee schedule,100% of fee schedule,71.86,162.41,
"Excision Benign(tr,a,l);1.1 to 2.0cm",4346,CDM,521,RC,11402,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.46,309.49,
"DERM EXCISION BENIGN (TR,A,L); 1.1-2C - PRO",4347,CDM,982,RC,11402,HCPCS,outpatient,,,254.69,191.02,,151.2,130,,,fee schedule,130% of fee schedule,151.2,130,,,fee schedule,130% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,141.97,119,,,fee schedule,119% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,100% of fee schedule,229.22,90,,,percent of total billed charges,90% of total billed charges,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,118.91,100,,,fee schedule,100% of fee schedule,86.23,229.22,
"DERM Excision Benign(tr,a,l);1.1 to 2.0cm-G",4348,CDM,982,RC,11402,HCPCS,outpatient,,,891.42,668.57,,151.2,130,,,fee schedule,130% of fee schedule,151.2,130,,,fee schedule,130% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,141.97,119,,,fee schedule,119% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,100% of fee schedule,802.28,90,,,percent of total billed charges,90% of total billed charges,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,118.91,100,,,fee schedule,100% of fee schedule,86.23,802.28,
"WND Excise B9(tr,a,l) 1 to 2cm-PRO",4349,CDM,982,RC,11402,HCPCS,outpatient,,,337.84,253.38,,151.2,130,,,fee schedule,130% of fee schedule,151.2,130,,,fee schedule,130% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,141.97,119,,,fee schedule,119% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,100% of fee schedule,304.06,90,,,percent of total billed charges,90% of total billed charges,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,118.91,100,,,fee schedule,100% of fee schedule,86.23,304.06,
"Excision Benign(tr,a,l);1.1 to 2.0cm-PRO",4350,CDM,981,RC,11402,HCPCS,outpatient,,,200.38,150.29,,151.2,130,,,fee schedule,130% of fee schedule,151.2,130,,,fee schedule,130% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,141.97,119,,,fee schedule,119% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,118.91,100,,,fee schedule,100% of fee schedule,86.23,180.34,
"Excision Benign(tr,a,l);1.1 to 2.0cm-PRO",4351,CDM,981,RC,11402,HCPCS,outpatient,,,200.38,150.29,,151.2,130,,,fee schedule,130% of fee schedule,151.2,130,,,fee schedule,130% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,141.97,119,,,fee schedule,119% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,118.91,100,,,fee schedule,100% of fee schedule,86.23,180.34,
"Excision Benign(tr,a,l);2.1-3.0cm",4352,CDM,521,RC,11403,HCPCS,outpatient,,,438.24,328.68,,394.42,90,,,percent of total billed charges,90% of total billed charges,407.56,93,,,percent of total billed charges,93% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,372.5,85,,,percent of total billed charges,85% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,356.73,81.4,,,percent of total billed charges,81.4% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,328.68,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,166.53,407.56,
"DERM EXCISION BENIGN (TR, A, L): 2.1-3.0CM - PRO",4353,CDM,982,RC,11403,HCPCS,outpatient,,,318.36,238.77,,194.04,130,,,fee schedule,130% of fee schedule,194.04,130,,,fee schedule,130% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,183.51,119,,,fee schedule,119% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,100% of fee schedule,286.52,90,,,percent of total billed charges,90% of total billed charges,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,153.21,100,,,fee schedule,100% of fee schedule,107.79,286.52,
"DERM Excision Benign(tr,a,l);2.1-3.0cm-G",4354,CDM,982,RC,11403,HCPCS,outpatient,,,1167.33,875.5,,194.04,130,,,fee schedule,130% of fee schedule,194.04,130,,,fee schedule,130% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,183.51,119,,,fee schedule,119% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,100% of fee schedule,1050.6,90,,,percent of total billed charges,90% of total billed charges,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,153.21,100,,,fee schedule,100% of fee schedule,107.79,1050.6,
"WND Excise B9(tr,a,l)2.1-3cm-PRO",4355,CDM,982,RC,11403,HCPCS,outpatient,,,394.16,295.62,,194.04,130,,,fee schedule,130% of fee schedule,194.04,130,,,fee schedule,130% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,183.51,119,,,fee schedule,119% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,100% of fee schedule,354.74,90,,,percent of total billed charges,90% of total billed charges,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,153.21,100,,,fee schedule,100% of fee schedule,107.79,354.74,
"Excision Benign(tr,a,l);2.1-3.0cm-PRO",4356,CDM,981,RC,11403,HCPCS,outpatient,,,262.48,196.86,,194.04,130,,,fee schedule,130% of fee schedule,194.04,130,,,fee schedule,130% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,183.51,119,,,fee schedule,119% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,100% of fee schedule,236.23,90,,,percent of total billed charges,90% of total billed charges,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,153.21,100,,,fee schedule,100% of fee schedule,107.79,236.23,
"Excision Benign(tr,a,l);2.1-3.0cm-PRO",4357,CDM,981,RC,11403,HCPCS,outpatient,,,262.48,196.86,,194.04,130,,,fee schedule,130% of fee schedule,194.04,130,,,fee schedule,130% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,183.51,119,,,fee schedule,119% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,100% of fee schedule,236.23,90,,,percent of total billed charges,90% of total billed charges,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,153.21,100,,,fee schedule,100% of fee schedule,107.79,236.23,
"Excision Benign(tr,a,l);3.1-4.0cm",4358,CDM,521,RC,11404,HCPCS,outpatient,,,496.82,372.62,,447.14,90,,,percent of total billed charges,90% of total billed charges,462.04,93,,,percent of total billed charges,93% of total billed charges,188.79,38,,,percent of total billed charges,38% of total billed charges,188.79,38,,,percent of total billed charges,38% of total billed charges,422.3,85,,,percent of total billed charges,85% of total billed charges,188.79,38,,,percent of total billed charges,38% of total billed charges,404.41,81.4,,,percent of total billed charges,81.4% of total billed charges,447.14,90,,,percent of total billed charges,90% of total billed charges,447.14,90,,,percent of total billed charges,90% of total billed charges,188.79,38,,,percent of total billed charges,38% of total billed charges,188.79,38,,,percent of total billed charges,38% of total billed charges,188.79,38,,,percent of total billed charges,38% of total billed charges,372.62,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,188.79,462.04,
"WND Excision B9(tr,a,l);3.1-4.0cm-PRO",4359,CDM,982,RC,11404,HCPCS,outpatient,,,506.77,380.08,,213.84,130,,,fee schedule,130% of fee schedule,213.84,130,,,fee schedule,130% of fee schedule,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,201.81,119,,,fee schedule,119% of fee schedule,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,100% of fee schedule,456.09,90,,,percent of total billed charges,90% of total billed charges,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,168.48,100,,,fee schedule,100% of fee schedule,129.35,456.09,
"Excision Benign(tr,a,l);3.1-4.0cm-PRO",4360,CDM,981,RC,11404,HCPCS,outpatient,,,297.64,223.23,,213.84,130,,,fee schedule,130% of fee schedule,213.84,130,,,fee schedule,130% of fee schedule,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,201.81,119,,,fee schedule,119% of fee schedule,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,100% of fee schedule,267.88,90,,,percent of total billed charges,90% of total billed charges,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,168.48,100,,,fee schedule,100% of fee schedule,129.35,267.88,
"Excision Benign(tr,a,l);Over 4.0cm",4361,CDM,521,RC,11406,HCPCS,outpatient,,,687.84,515.88,,619.06,90,,,percent of total billed charges,90% of total billed charges,639.69,93,,,percent of total billed charges,93% of total billed charges,261.38,38,,,percent of total billed charges,38% of total billed charges,261.38,38,,,percent of total billed charges,38% of total billed charges,584.66,85,,,percent of total billed charges,85% of total billed charges,261.38,38,,,percent of total billed charges,38% of total billed charges,559.9,81.4,,,percent of total billed charges,81.4% of total billed charges,619.06,90,,,percent of total billed charges,90% of total billed charges,619.06,90,,,percent of total billed charges,90% of total billed charges,261.38,38,,,percent of total billed charges,38% of total billed charges,261.38,38,,,percent of total billed charges,38% of total billed charges,261.38,38,,,percent of total billed charges,38% of total billed charges,515.88,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,261.38,639.69,
"DERM Excision Benign(tr,a,l);Over 4.0cm-G",4362,CDM,982,RC,11406,HCPCS,outpatient,,,1800.87,1350.65,,323.25,130,,,fee schedule,130% of fee schedule,323.25,130,,,fee schedule,130% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,306.03,119,,,fee schedule,119% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,100% of fee schedule,1620.78,90,,,percent of total billed charges,90% of total billed charges,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,150.91,100,,,fee schedule,100% of fee schedule,252,100,,,fee schedule,100% of fee schedule,150.91,1620.78,
"WND Excision B9(tr,a,l);Over 4.0cm-PRO",4363,CDM,982,RC,11406,HCPCS,outpatient,,,675.69,506.77,,323.25,130,,,fee schedule,130% of fee schedule,323.25,130,,,fee schedule,130% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,306.03,119,,,fee schedule,119% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,100% of fee schedule,608.12,90,,,percent of total billed charges,90% of total billed charges,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,150.91,100,,,fee schedule,100% of fee schedule,252,100,,,fee schedule,100% of fee schedule,150.91,608.12,
"Excision Benign(tr,a,l);Over 4.0cm-PRO",4364,CDM,981,RC,11406,HCPCS,outpatient,,,411.29,308.47,,323.25,130,,,fee schedule,130% of fee schedule,323.25,130,,,fee schedule,130% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,306.03,119,,,fee schedule,119% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,100% of fee schedule,370.16,90,,,percent of total billed charges,90% of total billed charges,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,150.91,100,,,fee schedule,100% of fee schedule,252,100,,,fee schedule,100% of fee schedule,150.91,370.16,
"Excision Benign(tr,a,l);Over 4.0cm-PRO",4365,CDM,981,RC,11406,HCPCS,outpatient,,,411.29,308.47,,323.25,130,,,fee schedule,130% of fee schedule,323.25,130,,,fee schedule,130% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,306.03,119,,,fee schedule,119% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,100% of fee schedule,370.16,90,,,percent of total billed charges,90% of total billed charges,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,150.91,100,,,fee schedule,100% of fee schedule,252,100,,,fee schedule,100% of fee schedule,150.91,370.16,
"Excis Benign(sc,n,ha,fe,g);0.5 cm or <",4366,CDM,521,RC,11420,HCPCS,outpatient,,,196.87,147.65,,177.18,90,,,percent of total billed charges,90% of total billed charges,183.09,93,,,percent of total billed charges,93% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,167.34,85,,,percent of total billed charges,85% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,160.25,81.4,,,percent of total billed charges,81.4% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,147.65,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,74.81,183.09,
"WND Excise B9(sc,n,ha,fe,g);.5cm or<-PRO",4367,CDM,982,RC,11420,HCPCS,outpatient,,,236.5,177.38,,107.77,130,,,fee schedule,130% of fee schedule,107.77,130,,,fee schedule,130% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,101.75,119,,,fee schedule,119% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,100% of fee schedule,212.85,90,,,percent of total billed charges,90% of total billed charges,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,84.66,100,,,fee schedule,100% of fee schedule,57.49,212.85,
"DERM Excise B9(sc,n,ha,fe,g);.5cm or<-PRO",4368,CDM,982,RC,11420,HCPCS,outpatient,,,236.5,177.38,,107.77,130,,,fee schedule,130% of fee schedule,107.77,130,,,fee schedule,130% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,101.75,119,,,fee schedule,119% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,100% of fee schedule,212.85,90,,,percent of total billed charges,90% of total billed charges,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,84.66,100,,,fee schedule,100% of fee schedule,57.49,212.85,
"Excis Benign(sc,n,ha,fe,g);0.5cm or <-PRO",4369,CDM,981,RC,11420,HCPCS,outpatient,,,117.18,87.89,,107.77,130,,,fee schedule,130% of fee schedule,107.77,130,,,fee schedule,130% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,101.75,119,,,fee schedule,119% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,100% of fee schedule,105.46,90,,,percent of total billed charges,90% of total billed charges,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,84.66,100,,,fee schedule,100% of fee schedule,57.49,107.77,
"Excis Benign(sc,n,ha,fe,g);0.5cm or <-PRO",4370,CDM,981,RC,11420,HCPCS,outpatient,,,117.18,87.89,,107.77,130,,,fee schedule,130% of fee schedule,107.77,130,,,fee schedule,130% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,101.75,119,,,fee schedule,119% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,100% of fee schedule,105.46,90,,,percent of total billed charges,90% of total billed charges,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,84.66,100,,,fee schedule,100% of fee schedule,57.49,107.77,
"Excis Benign(sc,n,ha,fe,g); 0.6 to 1.0cm",4371,CDM,521,RC,11421,HCPCS,outpatient,,,304.66,228.5,,274.19,90,,,percent of total billed charges,90% of total billed charges,283.33,93,,,percent of total billed charges,93% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,247.99,81.4,,,percent of total billed charges,81.4% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,228.5,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,115.77,283.33,
"DERM EXCIS BENIGN (SC,N,HA,FE,G); 0.6 TO 1.0CM - PRO",4372,CDM,982,RC,11421,HCPCS,outpatient,,,212.24,159.18,,147.17,130,,,fee schedule,130% of fee schedule,147.17,130,,,fee schedule,130% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,135.78,119,,,fee schedule,119% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,100% of fee schedule,191.02,90,,,percent of total billed charges,90% of total billed charges,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,112.56,100,,,fee schedule,100% of fee schedule,71.86,191.02,
"DERM EXCIS BENIGN (SC,N,HA,FE,G); 0.6 TO 1.0CM - G",4373,CDM,982,RC,11421,HCPCS,outpatient,,,530.6,397.95,,147.17,130,,,fee schedule,130% of fee schedule,147.17,130,,,fee schedule,130% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,135.78,119,,,fee schedule,119% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,100% of fee schedule,477.54,90,,,percent of total billed charges,90% of total billed charges,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,112.56,100,,,fee schedule,100% of fee schedule,71.86,477.54,
"WND Excise B9(sc,n,ha,fe,g) .6 to 1.cm-PRO",4374,CDM,982,RC,11421,HCPCS,outpatient,,,309.69,232.27,,147.17,130,,,fee schedule,130% of fee schedule,147.17,130,,,fee schedule,130% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,135.78,119,,,fee schedule,119% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,100% of fee schedule,278.72,90,,,percent of total billed charges,90% of total billed charges,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,112.56,100,,,fee schedule,100% of fee schedule,71.86,278.72,
"Excis Benign(sc,n,ha,fe,g); 0.6 to 1.0cm-PRO",4375,CDM,981,RC,11421,HCPCS,outpatient,,,155.85,116.89,,147.17,130,,,fee schedule,130% of fee schedule,147.17,130,,,fee schedule,130% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,135.78,119,,,fee schedule,119% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,100% of fee schedule,140.27,90,,,percent of total billed charges,90% of total billed charges,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,112.56,100,,,fee schedule,100% of fee schedule,71.86,147.17,
"Excis Benign(sc,n,ha,fe,g); 0.6 to 1.0cm-PRO",4376,CDM,981,RC,11421,HCPCS,outpatient,,,155.85,116.89,,147.17,130,,,fee schedule,130% of fee schedule,147.17,130,,,fee schedule,130% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,135.78,119,,,fee schedule,119% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,100% of fee schedule,140.27,90,,,percent of total billed charges,90% of total billed charges,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,112.56,100,,,fee schedule,100% of fee schedule,71.86,147.17,
"DERM EXC BENIGN (HEAD, NECK, EXT, GEN) 1.1-2CM - PRO",4377,CDM,982,RC,11422,HCPCS,outpatient,,,477.54,358.16,,179.49,130,,,fee schedule,130% of fee schedule,179.49,130,,,fee schedule,130% of fee schedule,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,119,,,fee schedule,119% of fee schedule,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,100% of fee schedule,429.79,90,,,percent of total billed charges,90% of total billed charges,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,139.65,100,,,fee schedule,100% of fee schedule,100.6,429.79,
"DERM Exc Benigh(head,neck,ext, gen) 1.1-2cm-G",4378,CDM,982,RC,11422,HCPCS,outpatient,,,1061.21,795.91,,179.49,130,,,fee schedule,130% of fee schedule,179.49,130,,,fee schedule,130% of fee schedule,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,119,,,fee schedule,119% of fee schedule,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,100% of fee schedule,955.09,90,,,percent of total billed charges,90% of total billed charges,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,139.65,100,,,fee schedule,100% of fee schedule,100.6,955.09,
"WND Exc B9(head,neck,ext, gen) 1.1-2cm PRO",4379,CDM,982,RC,11422,HCPCS,outpatient,,,394.16,295.62,,179.49,130,,,fee schedule,130% of fee schedule,179.49,130,,,fee schedule,130% of fee schedule,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,119,,,fee schedule,119% of fee schedule,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,100% of fee schedule,354.74,90,,,percent of total billed charges,90% of total billed charges,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,139.65,100,,,fee schedule,100% of fee schedule,100.6,354.74,
"Exc Benigh(head,neck,ext, gen) 1.1-2cm PRO",4380,CDM,982,RC,11422,HCPCS,outpatient,,,187.48,140.61,,179.49,130,,,fee schedule,130% of fee schedule,179.49,130,,,fee schedule,130% of fee schedule,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,168.48,119,,,fee schedule,119% of fee schedule,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,100% of fee schedule,168.73,90,,,percent of total billed charges,90% of total billed charges,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,139.65,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,139.65,100,,,fee schedule,100% of fee schedule,100.6,179.49,
"Excis Benign(sc,n,ha,fe,g);2.1 to 3.0cm",4381,CDM,521,RC,11423,HCPCS,outpatient,,,478.07,358.55,,430.26,90,,,percent of total billed charges,90% of total billed charges,444.61,93,,,percent of total billed charges,93% of total billed charges,181.67,38,,,percent of total billed charges,38% of total billed charges,181.67,38,,,percent of total billed charges,38% of total billed charges,406.36,85,,,percent of total billed charges,85% of total billed charges,181.67,38,,,percent of total billed charges,38% of total billed charges,389.15,81.4,,,percent of total billed charges,81.4% of total billed charges,430.26,90,,,percent of total billed charges,90% of total billed charges,430.26,90,,,percent of total billed charges,90% of total billed charges,181.67,38,,,percent of total billed charges,38% of total billed charges,181.67,38,,,percent of total billed charges,38% of total billed charges,181.67,38,,,percent of total billed charges,38% of total billed charges,358.55,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,181.67,444.61,
"DERM EXCIS BENIGN (SC, N, HA, FE, G); 2.1 TO 3.0CM - PRO",4382,CDM,982,RC,11423,HCPCS,outpatient,,,337.47,253.1,,208.66,130,,,fee schedule,130% of fee schedule,208.66,130,,,fee schedule,130% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,192.96,119,,,fee schedule,119% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,100% of fee schedule,303.72,90,,,percent of total billed charges,90% of total billed charges,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,160.35,100,,,fee schedule,100% of fee schedule,129.35,303.72,
"DERM Excis Benign(sc,n,ha,fe,g);2.1 to 3.0cm-G",4383,CDM,982,RC,11423,HCPCS,outpatient,,,2778.25,2083.69,,208.66,130,,,fee schedule,130% of fee schedule,208.66,130,,,fee schedule,130% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,192.96,119,,,fee schedule,119% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,100% of fee schedule,2500.43,90,,,percent of total billed charges,90% of total billed charges,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,160.35,100,,,fee schedule,100% of fee schedule,129.35,2500.43,
"WND Exc B9(sc,n,ha,fe,g) 2.1 to 3cm-PRO",4384,CDM,982,RC,11423,HCPCS,outpatient,,,450.46,337.85,,208.66,130,,,fee schedule,130% of fee schedule,208.66,130,,,fee schedule,130% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,192.96,119,,,fee schedule,119% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,100% of fee schedule,405.41,90,,,percent of total billed charges,90% of total billed charges,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,160.35,100,,,fee schedule,100% of fee schedule,129.35,405.41,
"Excis Benign(sc,n,ha,fe,g);2.1 to 3.0cm-PRO",4385,CDM,981,RC,11423,HCPCS,outpatient,,,285.92,214.44,,208.66,130,,,fee schedule,130% of fee schedule,208.66,130,,,fee schedule,130% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,192.96,119,,,fee schedule,119% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,100% of fee schedule,257.33,90,,,percent of total billed charges,90% of total billed charges,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,160.35,100,,,fee schedule,100% of fee schedule,129.35,257.33,
"Excis Benign(sc,n,ha,fe,g);2.1 to 3.0cm-PRO",4386,CDM,981,RC,11423,HCPCS,outpatient,,,285.92,214.44,,208.66,130,,,fee schedule,130% of fee schedule,208.66,130,,,fee schedule,130% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,192.96,119,,,fee schedule,119% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,100% of fee schedule,257.33,90,,,percent of total billed charges,90% of total billed charges,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,160.35,100,,,fee schedule,100% of fee schedule,129.35,257.33,
"WND Exc B9(sc,n,ha,fe,g)3.1-4cm PRO",4387,CDM,982,RC,11424,HCPCS,outpatient,,,518.03,388.52,,237.71,130,,,fee schedule,130% of fee schedule,237.71,130,,,fee schedule,130% of fee schedule,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,221.15,119,,,fee schedule,119% of fee schedule,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,100% of fee schedule,466.23,90,,,percent of total billed charges,90% of total billed charges,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,182.51,100,,,fee schedule,100% of fee schedule,158.09,466.23,
DERM Skin Lesion Rmv.:Benign;3.1-4.0cm-G,4388,CDM,982,RC,11424,HCPCS,outpatient,,,1869.84,1402.38,,237.71,130,,,fee schedule,130% of fee schedule,237.71,130,,,fee schedule,130% of fee schedule,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,221.15,119,,,fee schedule,119% of fee schedule,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,100% of fee schedule,1682.86,90,,,percent of total billed charges,90% of total billed charges,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,182.51,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,182.51,100,,,fee schedule,100% of fee schedule,158.09,1682.86,
Excis Benign Face;0.5cm or <,4389,CDM,521,RC,11440,HCPCS,outpatient,,,236.69,177.52,,213.02,90,,,percent of total billed charges,90% of total billed charges,220.12,93,,,percent of total billed charges,93% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,201.19,85,,,percent of total billed charges,85% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,192.67,81.4,,,percent of total billed charges,81.4% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,177.52,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,89.94,220.12,
WND Excis B9 Face;0.5cm or <-PRO,4390,CDM,982,RC,11440,HCPCS,outpatient,,,281.54,211.16,,135.36,130,,,fee schedule,130% of fee schedule,135.36,130,,,fee schedule,130% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,128.33,119,,,fee schedule,119% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,100% of fee schedule,253.39,90,,,percent of total billed charges,90% of total billed charges,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,110.24,100,,,fee schedule,100% of fee schedule,71.86,253.39,
DERM Excis B9 Face .5cm/<-G,4391,CDM,982,RC,11440,HCPCS,outpatient,,,450.46,337.85,,135.36,130,,,fee schedule,130% of fee schedule,135.36,130,,,fee schedule,130% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,128.33,119,,,fee schedule,119% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,100% of fee schedule,405.41,90,,,percent of total billed charges,90% of total billed charges,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,110.24,100,,,fee schedule,100% of fee schedule,71.86,405.41,
DERM Excis B9 Face .5cm/<-PRO,4392,CDM,982,RC,11440,HCPCS,outpatient,,,281.54,211.16,,135.36,130,,,fee schedule,130% of fee schedule,135.36,130,,,fee schedule,130% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,128.33,119,,,fee schedule,119% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,100% of fee schedule,253.39,90,,,percent of total billed charges,90% of total billed charges,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,110.24,100,,,fee schedule,100% of fee schedule,71.86,253.39,
Excis Benign Face;0.5cm or <-PRO,4393,CDM,981,RC,11440,HCPCS,outpatient,,,140.62,105.47,,135.36,130,,,fee schedule,130% of fee schedule,135.36,130,,,fee schedule,130% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,128.33,119,,,fee schedule,119% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,100% of fee schedule,126.56,90,,,percent of total billed charges,90% of total billed charges,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,110.24,100,,,fee schedule,100% of fee schedule,71.86,135.36,
Excis Benign Face;0.5cm or <-PRO,4394,CDM,981,RC,11440,HCPCS,outpatient,,,140.62,105.47,,135.36,130,,,fee schedule,130% of fee schedule,135.36,130,,,fee schedule,130% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,128.33,119,,,fee schedule,119% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,100% of fee schedule,126.56,90,,,percent of total billed charges,90% of total billed charges,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,110.24,100,,,fee schedule,100% of fee schedule,71.86,135.36,
Excis Benign(Face);0.6-1.0cm,4395,CDM,521,RC,11441,HCPCS,outpatient,,,308.17,231.13,,277.35,90,,,percent of total billed charges,90% of total billed charges,286.6,93,,,percent of total billed charges,93% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,261.94,85,,,percent of total billed charges,85% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,250.85,81.4,,,percent of total billed charges,81.4% of total billed charges,277.35,90,,,percent of total billed charges,90% of total billed charges,277.35,90,,,percent of total billed charges,90% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,231.13,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,117.1,286.6,
DERM EXCIS BENIGN (FACE);0.6-1.0CM - PRO,4396,CDM,982,RC,11441,HCPCS,outpatient,,,382.03,286.52,,174.36,130,,,fee schedule,130% of fee schedule,174.36,130,,,fee schedule,130% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,162.26,119,,,fee schedule,119% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,100% of fee schedule,343.83,90,,,percent of total billed charges,90% of total billed charges,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,137.29,100,,,fee schedule,100% of fee schedule,100.6,343.83,
DERM EXCIS BENIGN (FACE);0.6-1.0CM - G,4397,CDM,982,RC,11441,HCPCS,outpatient,,,700.39,525.29,,174.36,130,,,fee schedule,130% of fee schedule,174.36,130,,,fee schedule,130% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,162.26,119,,,fee schedule,119% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,100% of fee schedule,630.35,90,,,percent of total billed charges,90% of total billed charges,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,137.29,100,,,fee schedule,100% of fee schedule,100.6,630.35,
WND Excis B9 (Face);0.6-1.0cm-PRO,4398,CDM,982,RC,11441,HCPCS,outpatient,,,366.01,274.51,,174.36,130,,,fee schedule,130% of fee schedule,174.36,130,,,fee schedule,130% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,162.26,119,,,fee schedule,119% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,100% of fee schedule,329.41,90,,,percent of total billed charges,90% of total billed charges,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,137.29,100,,,fee schedule,100% of fee schedule,100.6,329.41,
Excis Benign(Face);0.6-1.0cm-PRO,4399,CDM,982,RC,11441,HCPCS,outpatient,,,185.14,138.86,,174.36,130,,,fee schedule,130% of fee schedule,174.36,130,,,fee schedule,130% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,162.26,119,,,fee schedule,119% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,100% of fee schedule,166.63,90,,,percent of total billed charges,90% of total billed charges,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,137.29,100,,,fee schedule,100% of fee schedule,100.6,174.36,
Excis Benign(Face);0.6-1.0cm-PRO,4400,CDM,982,RC,11441,HCPCS,outpatient,,,185.14,138.86,,174.36,130,,,fee schedule,130% of fee schedule,174.36,130,,,fee schedule,130% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,162.26,119,,,fee schedule,119% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,100% of fee schedule,166.63,90,,,percent of total billed charges,90% of total billed charges,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,137.29,100,,,fee schedule,100% of fee schedule,100.6,174.36,
Excis Benign(Face);1.1-2.0cm,4401,CDM,521,RC,11442,HCPCS,outpatient,,,338.64,253.98,,304.78,90,,,percent of total billed charges,90% of total billed charges,314.94,93,,,percent of total billed charges,93% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,287.84,85,,,percent of total billed charges,85% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,275.65,81.4,,,percent of total billed charges,81.4% of total billed charges,304.78,90,,,percent of total billed charges,90% of total billed charges,304.78,90,,,percent of total billed charges,90% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,253.98,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,128.68,314.94,
DERM EXCIS BENIGN (FACE); 1.1-2.0CM - PRO,4402,CDM,982,RC,11442,HCPCS,outpatient,,,318.36,238.77,,193.79,130,,,fee schedule,130% of fee schedule,193.79,130,,,fee schedule,130% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,179.83,119,,,fee schedule,119% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,100% of fee schedule,286.52,90,,,percent of total billed charges,90% of total billed charges,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,151.17,100,,,fee schedule,100% of fee schedule,129.35,286.52,
DERM EXCIS BENIGN (FACE); 1.1-2.0CM - G,4403,CDM,982,RC,11442,HCPCS,outpatient,,,636.72,477.54,,193.79,130,,,fee schedule,130% of fee schedule,193.79,130,,,fee schedule,130% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,179.83,119,,,fee schedule,119% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,100% of fee schedule,573.05,90,,,percent of total billed charges,90% of total billed charges,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,151.17,100,,,fee schedule,100% of fee schedule,129.35,573.05,
WND Excis B9(Face);1.1-2cm-PRO,4404,CDM,982,RC,11442,HCPCS,outpatient,,,394.16,295.62,,193.79,130,,,fee schedule,130% of fee schedule,193.79,130,,,fee schedule,130% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,179.83,119,,,fee schedule,119% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,100% of fee schedule,354.74,90,,,percent of total billed charges,90% of total billed charges,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,151.17,100,,,fee schedule,100% of fee schedule,129.35,354.74,
Excis Benign(Face);1.1-2.0cm-PRO,4405,CDM,981,RC,11442,HCPCS,outpatient,,,203.89,152.92,,193.79,130,,,fee schedule,130% of fee schedule,193.79,130,,,fee schedule,130% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,179.83,119,,,fee schedule,119% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,100% of fee schedule,183.5,90,,,percent of total billed charges,90% of total billed charges,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,151.17,100,,,fee schedule,100% of fee schedule,129.35,193.79,
Excis Benign(Face);1.1-2.0cm-PRO,4406,CDM,981,RC,11442,HCPCS,outpatient,,,203.89,152.92,,193.79,130,,,fee schedule,130% of fee schedule,193.79,130,,,fee schedule,130% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,179.83,119,,,fee schedule,119% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,100% of fee schedule,183.5,90,,,percent of total billed charges,90% of total billed charges,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,151.17,100,,,fee schedule,100% of fee schedule,129.35,193.79,
Derm Excis B9 (Face); 2.1-3cm - PRO,4407,CDM,982,RC,11443,HCPCS,outpatient,,,424.48,318.36,,237.63,130,,,fee schedule,130% of fee schedule,237.63,130,,,fee schedule,130% of fee schedule,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,220.29,119,,,fee schedule,119% of fee schedule,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,100% of fee schedule,382.03,90,,,percent of total billed charges,90% of total billed charges,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,183.42,100,,,fee schedule,100% of fee schedule,158.09,382.03,
Derm Excis B9 (Face); 2.1-3cm -G,4408,CDM,982,RC,11443,HCPCS,outpatient,,,1273.45,955.09,,237.63,130,,,fee schedule,130% of fee schedule,237.63,130,,,fee schedule,130% of fee schedule,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,220.29,119,,,fee schedule,119% of fee schedule,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,100% of fee schedule,1146.11,90,,,percent of total billed charges,90% of total billed charges,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,183.42,100,,,fee schedule,100% of fee schedule,158.09,1146.11,
WND Excis B9(Face);2.1-3cm-PRO,4409,CDM,982,RC,11443,HCPCS,outpatient,,,450.46,337.85,,237.63,130,,,fee schedule,130% of fee schedule,237.63,130,,,fee schedule,130% of fee schedule,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,220.29,119,,,fee schedule,119% of fee schedule,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,100% of fee schedule,405.41,90,,,percent of total billed charges,90% of total billed charges,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,183.42,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,183.42,100,,,fee schedule,100% of fee schedule,158.09,405.41,
"Exc,Skin,Mal-(tr,a,l);0.5 or <",4410,CDM,521,RC,11600,HCPCS,outpatient,,,261.29,195.97,,235.16,90,,,percent of total billed charges,90% of total billed charges,243,93,,,percent of total billed charges,93% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,222.1,85,,,percent of total billed charges,85% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,212.69,81.4,,,percent of total billed charges,81.4% of total billed charges,235.16,90,,,percent of total billed charges,90% of total billed charges,235.16,90,,,percent of total billed charges,90% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,195.97,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,99.29,243,
"Exc,Skin,Mal-(tr,a,l);0.5 or <-PRO",4411,CDM,981,RC,11600,HCPCS,outpatient,,,155.85,116.89,,159.04,130,,,fee schedule,130% of fee schedule,159.04,130,,,fee schedule,130% of fee schedule,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,150.02,119,,,fee schedule,119% of fee schedule,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,100% of fee schedule,140.27,90,,,percent of total billed charges,90% of total billed charges,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,125.14,100,,,fee schedule,100% of fee schedule,86.23,159.04,
"Exc,Skin,Mal-(tr,a,l);0.5 or <-PRO",4412,CDM,981,RC,11600,HCPCS,outpatient,,,155.85,116.89,,159.04,130,,,fee schedule,130% of fee schedule,159.04,130,,,fee schedule,130% of fee schedule,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,150.02,119,,,fee schedule,119% of fee schedule,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,100% of fee schedule,140.27,90,,,percent of total billed charges,90% of total billed charges,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,125.14,100,,,fee schedule,100% of fee schedule,86.23,159.04,
"Exc,Skin,Mal-(tr,a,l);0.5 or <-FAC",4413,CDM,450,RC,11600,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
"Exc,Skin,Mal-(tr,a,l);0.5 or <-FAC",4414,CDM,450,RC,11600,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
"Exc,Skin,Mal-(tr,a,l);0.6-1.0cm",4415,CDM,521,RC,11601,HCPCS,outpatient,,,336.29,252.22,,302.66,90,,,percent of total billed charges,90% of total billed charges,312.75,93,,,percent of total billed charges,93% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,285.85,85,,,percent of total billed charges,85% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,273.74,81.4,,,percent of total billed charges,81.4% of total billed charges,302.66,90,,,percent of total billed charges,90% of total billed charges,302.66,90,,,percent of total billed charges,90% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,127.79,38,,,percent of total billed charges,38% of total billed charges,252.22,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,127.79,312.75,
"DERM EXC, SKIN, MAL - (TR, A, L); 0.6-1.0CM - PRO",4416,CDM,982,RC,11601,HCPCS,outpatient,,,320.48,240.36,,200.08,130,,,fee schedule,130% of fee schedule,200.08,130,,,fee schedule,130% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,183.78,119,,,fee schedule,119% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,100% of fee schedule,288.43,90,,,percent of total billed charges,90% of total billed charges,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,151.61,100,,,fee schedule,100% of fee schedule,114.98,288.43,
"DERM Exc,Skin,Mal-(tr,a,l);0.6-1.0cm-G",4417,CDM,982,RC,11601,HCPCS,outpatient,,,1169.45,877.09,,200.08,130,,,fee schedule,130% of fee schedule,200.08,130,,,fee schedule,130% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,183.78,119,,,fee schedule,119% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,100% of fee schedule,1052.51,90,,,percent of total billed charges,90% of total billed charges,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,151.61,100,,,fee schedule,100% of fee schedule,114.98,1052.51,
"Exc,Skin,Mal-(tr,a,l);0.6-1.0cm-PRO",4418,CDM,981,RC,11601,HCPCS,outpatient,,,202.73,152.05,,200.08,130,,,fee schedule,130% of fee schedule,200.08,130,,,fee schedule,130% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,183.78,119,,,fee schedule,119% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,100% of fee schedule,182.46,90,,,percent of total billed charges,90% of total billed charges,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,151.61,100,,,fee schedule,100% of fee schedule,114.98,200.08,
"Exc,Skin,Mal-(tr,a,l);0.6-1.0cm-PRO",4419,CDM,981,RC,11601,HCPCS,outpatient,,,202.73,152.05,,200.08,130,,,fee schedule,130% of fee schedule,200.08,130,,,fee schedule,130% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,183.78,119,,,fee schedule,119% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,100% of fee schedule,182.46,90,,,percent of total billed charges,90% of total billed charges,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,151.61,100,,,fee schedule,100% of fee schedule,114.98,200.08,
"Exc,Skin,Mal-(tr,a,l);1.1-2.0cm",4420,CDM,521,RC,11602,HCPCS,outpatient,,,393.71,295.28,,354.34,90,,,percent of total billed charges,90% of total billed charges,366.15,93,,,percent of total billed charges,93% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,334.65,85,,,percent of total billed charges,85% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,320.48,81.4,,,percent of total billed charges,81.4% of total billed charges,354.34,90,,,percent of total billed charges,90% of total billed charges,354.34,90,,,percent of total billed charges,90% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,149.61,38,,,percent of total billed charges,38% of total billed charges,295.28,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,149.61,366.15,
"DERM EXC, SKIN, MAL - (TR, A, L); 1.1-2.0CM - PRO",4421,CDM,982,RC,11602,HCPCS,outpatient,,,339.59,254.69,,220.61,130,,,fee schedule,130% of fee schedule,220.61,130,,,fee schedule,130% of fee schedule,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,200.81,119,,,fee schedule,119% of fee schedule,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,100% of fee schedule,305.63,90,,,percent of total billed charges,90% of total billed charges,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,164.83,100,,,fee schedule,100% of fee schedule,143.72,305.63,
"DERM Exc,Skin,Mal-(tr,a,l);1.1-2.0cm-G",4422,CDM,982,RC,11602,HCPCS,outpatient,,,551.83,413.87,,220.61,130,,,fee schedule,130% of fee schedule,220.61,130,,,fee schedule,130% of fee schedule,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,200.81,119,,,fee schedule,119% of fee schedule,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,100% of fee schedule,496.65,90,,,percent of total billed charges,90% of total billed charges,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,164.83,100,,,fee schedule,100% of fee schedule,143.72,496.65,
"Exc,Skin,Mal-(tr,a,l);1.1-2.0cm-PRO",4423,CDM,981,RC,11602,HCPCS,outpatient,,,236.69,177.52,,220.61,130,,,fee schedule,130% of fee schedule,220.61,130,,,fee schedule,130% of fee schedule,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,200.81,119,,,fee schedule,119% of fee schedule,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,100% of fee schedule,213.02,90,,,percent of total billed charges,90% of total billed charges,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,164.83,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,164.83,100,,,fee schedule,100% of fee schedule,143.72,220.61,
"Excision,Mal(tr,a,l);2.1-3.0cm",4424,CDM,521,RC,11603,HCPCS,outpatient,,,1206.92,905.19,,1086.23,90,,,percent of total billed charges,90% of total billed charges,1122.44,93,,,percent of total billed charges,93% of total billed charges,458.63,38,,,percent of total billed charges,38% of total billed charges,458.63,38,,,percent of total billed charges,38% of total billed charges,1025.88,85,,,percent of total billed charges,85% of total billed charges,458.63,38,,,percent of total billed charges,38% of total billed charges,982.43,81.4,,,percent of total billed charges,81.4% of total billed charges,1086.23,90,,,percent of total billed charges,90% of total billed charges,1086.23,90,,,percent of total billed charges,90% of total billed charges,458.63,38,,,percent of total billed charges,38% of total billed charges,458.63,38,,,percent of total billed charges,38% of total billed charges,458.63,38,,,percent of total billed charges,38% of total billed charges,905.19,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,458.63,1122.44,
"DERM EXCISION, MAL (TR,A,L);2.1-3.0 - PRO",4425,CDM,982,RC,11603,HCPCS,outpatient,,,371.42,278.57,,263.16,130,,,fee schedule,130% of fee schedule,263.16,130,,,fee schedule,130% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,240.01,119,,,fee schedule,119% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,100% of fee schedule,334.28,90,,,percent of total billed charges,90% of total billed charges,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,196.93,100,,,fee schedule,100% of fee schedule,172.46,334.28,
"DERM EXCISION, MAL (TR,A,L);2.1-3.0 - G",4426,CDM,982,RC,11603,HCPCS,outpatient,,,1008.15,756.11,,263.16,130,,,fee schedule,130% of fee schedule,263.16,130,,,fee schedule,130% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,240.01,119,,,fee schedule,119% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,100% of fee schedule,907.34,90,,,percent of total billed charges,90% of total billed charges,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,196.93,100,,,fee schedule,100% of fee schedule,172.46,907.34,
"WND Excision,Mal(tr,a,l);2.1-3.0cm-PRO",4427,CDM,982,RC,11603,HCPCS,outpatient,,,337.71,253.28,,263.16,130,,,fee schedule,130% of fee schedule,263.16,130,,,fee schedule,130% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,240.01,119,,,fee schedule,119% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,100% of fee schedule,303.94,90,,,percent of total billed charges,90% of total billed charges,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,196.93,100,,,fee schedule,100% of fee schedule,172.46,303.94,
"Excision,Mal(tr,a,l);2.1-3.0cm-PRO",4428,CDM,981,RC,11603,HCPCS,outpatient,,,338.64,253.98,,263.16,130,,,fee schedule,130% of fee schedule,263.16,130,,,fee schedule,130% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,240.01,119,,,fee schedule,119% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,100% of fee schedule,304.78,90,,,percent of total billed charges,90% of total billed charges,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,196.93,100,,,fee schedule,100% of fee schedule,172.46,304.78,
"Excision,Mal(tr,a,l);2.1-3.0cm-PRO",4429,CDM,981,RC,11603,HCPCS,outpatient,,,338.64,253.98,,263.16,130,,,fee schedule,130% of fee schedule,263.16,130,,,fee schedule,130% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,240.01,119,,,fee schedule,119% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,100% of fee schedule,304.78,90,,,percent of total billed charges,90% of total billed charges,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,196.93,100,,,fee schedule,100% of fee schedule,172.46,304.78,
"Lesion Rmv.:Malig.(ma,tr,ar,le); exc. 3.1-4.0cm",4430,CDM,521,RC,11604,HCPCS,outpatient,,,756.96,567.72,,681.26,90,,,percent of total billed charges,90% of total billed charges,703.97,93,,,percent of total billed charges,93% of total billed charges,287.64,38,,,percent of total billed charges,38% of total billed charges,287.64,38,,,percent of total billed charges,38% of total billed charges,643.42,85,,,percent of total billed charges,85% of total billed charges,287.64,38,,,percent of total billed charges,38% of total billed charges,616.17,81.4,,,percent of total billed charges,81.4% of total billed charges,681.26,90,,,percent of total billed charges,90% of total billed charges,681.26,90,,,percent of total billed charges,90% of total billed charges,287.64,38,,,percent of total billed charges,38% of total billed charges,287.64,38,,,percent of total billed charges,38% of total billed charges,287.64,38,,,percent of total billed charges,38% of total billed charges,567.72,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,287.64,703.97,
DERM EXC MAL INC MARG (TR/EXT) - PRO,4431,CDM,982,RC,11604,HCPCS,outpatient,,,451.01,338.26,,289,130,,,fee schedule,130% of fee schedule,289,130,,,fee schedule,130% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,264.75,119,,,fee schedule,119% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,100% of fee schedule,405.91,90,,,percent of total billed charges,90% of total billed charges,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,216.44,100,,,fee schedule,100% of fee schedule,201.21,405.91,
DERM EXC MAL INC MARG (TR/EXT) - G,4432,CDM,982,RC,11604,HCPCS,outpatient,,,1353.04,1014.78,,289,130,,,fee schedule,130% of fee schedule,289,130,,,fee schedule,130% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,264.75,119,,,fee schedule,119% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,100% of fee schedule,1217.74,90,,,percent of total billed charges,90% of total billed charges,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,216.44,100,,,fee schedule,100% of fee schedule,201.21,1217.74,
"Lesion Rmv.:Malig.(ma,tr,ar,le); exc. 3.1-4.0cm-PRO",4433,CDM,981,RC,11604,HCPCS,outpatient,,,454.65,340.99,,289,130,,,fee schedule,130% of fee schedule,289,130,,,fee schedule,130% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,264.75,119,,,fee schedule,119% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,100% of fee schedule,409.19,90,,,percent of total billed charges,90% of total billed charges,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,216.44,100,,,fee schedule,100% of fee schedule,201.21,409.19,
"Lesion Rmv.:Malig.(ma,tr,ar,le); exc. 3.1-4.0cm-PRO",4434,CDM,981,RC,11604,HCPCS,outpatient,,,454.65,340.99,,289,130,,,fee schedule,130% of fee schedule,289,130,,,fee schedule,130% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,264.75,119,,,fee schedule,119% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,100% of fee schedule,409.19,90,,,percent of total billed charges,90% of total billed charges,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,216.44,100,,,fee schedule,100% of fee schedule,201.21,409.19,
"Lesion Rmv.:Malig.(ma,tr,ar,le); exc. 3.1-4.0cm-FAC",4435,CDM,450,RC,11604,HCPCS,outpatient,,,304.66,228.5,,274.19,90,,,percent of total billed charges,90% of total billed charges,283.33,93,,,percent of total billed charges,93% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,247.99,81.4,,,percent of total billed charges,81.4% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,228.5,75,,,percent of total billed charges,75% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,283.33,
"Lesion Rmv.:Malig.(ma,tr,ar,le); exc. 3.1-4.0cm-FAC",4436,CDM,450,RC,11604,HCPCS,outpatient,,,304.66,228.5,,274.19,90,,,percent of total billed charges,90% of total billed charges,283.33,93,,,percent of total billed charges,93% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,247.99,81.4,,,percent of total billed charges,81.4% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,228.5,75,,,percent of total billed charges,75% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,283.33,
Derm Exc mal lesion tr/A/L>4cm-G,4437,CDM,982,RC,11606,HCPCS,outpatient,,,2749.92,2062.44,,428.45,130,,,fee schedule,130% of fee schedule,428.45,130,,,fee schedule,130% of fee schedule,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,394.46,119,,,fee schedule,119% of fee schedule,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,100% of fee schedule,2474.93,90,,,percent of total billed charges,90% of total billed charges,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,319.33,100,,,fee schedule,100% of fee schedule,229.95,2474.93,
Derm Exc mal lesion tr/A/L>4cm-PRO,4438,CDM,982,RC,11606,HCPCS,outpatient,,,653.82,490.37,,428.45,130,,,fee schedule,130% of fee schedule,428.45,130,,,fee schedule,130% of fee schedule,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,394.46,119,,,fee schedule,119% of fee schedule,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,100% of fee schedule,588.44,90,,,percent of total billed charges,90% of total billed charges,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,319.33,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,319.33,100,,,fee schedule,100% of fee schedule,229.95,588.44,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen)0.5cm/less",4439,CDM,521,RC,11620,HCPCS,outpatient,,,455.83,341.87,,410.25,90,,,percent of total billed charges,90% of total billed charges,423.92,93,,,percent of total billed charges,93% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,387.46,85,,,percent of total billed charges,85% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,371.05,81.4,,,percent of total billed charges,81.4% of total billed charges,410.25,90,,,percent of total billed charges,90% of total billed charges,410.25,90,,,percent of total billed charges,90% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,341.87,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,173.22,423.92,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen)0.5cm/less-PRO",4440,CDM,981,RC,11620,HCPCS,outpatient,,,271.84,203.88,,161.76,130,,,fee schedule,130% of fee schedule,161.76,130,,,fee schedule,130% of fee schedule,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,151.74,119,,,fee schedule,119% of fee schedule,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,100% of fee schedule,244.66,90,,,percent of total billed charges,90% of total billed charges,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,125.84,100,,,fee schedule,100% of fee schedule,125.84,244.66,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen)0.5cm/less-PRO",4441,CDM,981,RC,11620,HCPCS,outpatient,,,271.84,203.88,,161.76,130,,,fee schedule,130% of fee schedule,161.76,130,,,fee schedule,130% of fee schedule,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,151.74,119,,,fee schedule,119% of fee schedule,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,100% of fee schedule,244.66,90,,,percent of total billed charges,90% of total billed charges,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,125.84,100,,,fee schedule,100% of fee schedule,125.84,244.66,
"Exc., Mal(sc,n,ha,fe,g);0.6-1.0cm",4442,CDM,521,RC,11621,HCPCS,outpatient,,,338.64,253.98,,304.78,90,,,percent of total billed charges,90% of total billed charges,314.94,93,,,percent of total billed charges,93% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,287.84,85,,,percent of total billed charges,85% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,275.65,81.4,,,percent of total billed charges,81.4% of total billed charges,304.78,90,,,percent of total billed charges,90% of total billed charges,304.78,90,,,percent of total billed charges,90% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,253.98,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,128.68,314.94,
"Exc., Mal(sc,n,ha,fe,g);0.6-1.0cm-PRO",4443,CDM,981,RC,11621,HCPCS,outpatient,,,203.89,152.92,,201.9,130,,,fee schedule,130% of fee schedule,201.9,130,,,fee schedule,130% of fee schedule,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,185.05,119,,,fee schedule,119% of fee schedule,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,100% of fee schedule,183.5,90,,,percent of total billed charges,90% of total billed charges,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,152.58,100,,,fee schedule,100% of fee schedule,152.58,215.58,
"Exc., Mal(sc,n,ha,fe,g);0.6-1.0cm-PRO",4444,CDM,981,RC,11621,HCPCS,outpatient,,,203.89,152.92,,201.9,130,,,fee schedule,130% of fee schedule,201.9,130,,,fee schedule,130% of fee schedule,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,185.05,119,,,fee schedule,119% of fee schedule,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,100% of fee schedule,183.5,90,,,percent of total billed charges,90% of total billed charges,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,152.58,100,,,fee schedule,100% of fee schedule,152.58,215.58,
"Exc., Mal(sc,n,ha,fe,g);0.6-1.0cm-FAC",4445,CDM,450,RC,11621,HCPCS,outpatient,,,134.75,101.06,,121.28,90,,,percent of total billed charges,90% of total billed charges,125.32,93,,,percent of total billed charges,93% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,109.69,81.4,,,percent of total billed charges,81.4% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,101.06,75,,,percent of total billed charges,75% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,125.32,
"Exc., Mal(sc,n,ha,fe,g);0.6-1.0cm-FAC",4446,CDM,450,RC,11621,HCPCS,outpatient,,,134.75,101.06,,121.28,90,,,percent of total billed charges,90% of total billed charges,125.32,93,,,percent of total billed charges,93% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,109.69,81.4,,,percent of total billed charges,81.4% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,101.06,75,,,percent of total billed charges,75% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,125.32,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen);0.6-1.0cm",4447,CDM,521,RC,11622,HCPCS,outpatient,,,528.47,396.35,,475.62,90,,,percent of total billed charges,90% of total billed charges,491.48,93,,,percent of total billed charges,93% of total billed charges,200.82,38,,,percent of total billed charges,38% of total billed charges,200.82,38,,,percent of total billed charges,38% of total billed charges,449.2,85,,,percent of total billed charges,85% of total billed charges,200.82,38,,,percent of total billed charges,38% of total billed charges,430.17,81.4,,,percent of total billed charges,81.4% of total billed charges,475.62,90,,,percent of total billed charges,90% of total billed charges,475.62,90,,,percent of total billed charges,90% of total billed charges,200.82,38,,,percent of total billed charges,38% of total billed charges,200.82,38,,,percent of total billed charges,38% of total billed charges,200.82,38,,,percent of total billed charges,38% of total billed charges,396.35,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,200.82,491.48,
"DERM LESION RMV; MALIG (SC, NE, FE, HA, GEN); 0.6-1.0CM - PRO",4448,CDM,982,RC,11622,HCPCS,outpatient,,,318.36,238.77,,232.1,130,,,fee schedule,130% of fee schedule,232.1,130,,,fee schedule,130% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,210.26,119,,,fee schedule,119% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,100% of fee schedule,286.52,90,,,percent of total billed charges,90% of total billed charges,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,172.62,100,,,fee schedule,100% of fee schedule,172.62,287.44,
"DERM Lesion Rmv.;Malig.(sc,ne,fe,ha,gen);0.6-1.0cm-G",4449,CDM,982,RC,11622,HCPCS,outpatient,,,530.6,397.95,,232.1,130,,,fee schedule,130% of fee schedule,232.1,130,,,fee schedule,130% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,210.26,119,,,fee schedule,119% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,100% of fee schedule,477.54,90,,,percent of total billed charges,90% of total billed charges,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,172.62,100,,,fee schedule,100% of fee schedule,172.62,477.54,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen);0.6-1.0cm-PRO",4450,CDM,981,RC,11622,HCPCS,outpatient,,,318.73,239.05,,232.1,130,,,fee schedule,130% of fee schedule,232.1,130,,,fee schedule,130% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,210.26,119,,,fee schedule,119% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,100% of fee schedule,286.86,90,,,percent of total billed charges,90% of total billed charges,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,172.62,100,,,fee schedule,100% of fee schedule,172.62,287.44,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen);0.6-1.0cm-PRO",4451,CDM,981,RC,11622,HCPCS,outpatient,,,318.73,239.05,,232.1,130,,,fee schedule,130% of fee schedule,232.1,130,,,fee schedule,130% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,210.26,119,,,fee schedule,119% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,100% of fee schedule,286.86,90,,,percent of total billed charges,90% of total billed charges,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,172.62,100,,,fee schedule,100% of fee schedule,172.62,287.44,
"DERM EXC, MAL LESION INC MARG (S/N/H/F/L) - PRO",4452,CDM,982,RC,11623,HCPCS,outpatient,,,509.38,382.04,,286.99,130,,,fee schedule,130% of fee schedule,286.99,130,,,fee schedule,130% of fee schedule,213.14,100,,,fee schedule,Pays 100% Medicare OPPS,213.14,100,,,fee schedule,Pays 100% Medicare OPPS,260.96,119,,,fee schedule,119% of fee schedule,213.14,100,,,fee schedule,Pays 100% Medicare OPPS,213.14,100,,,fee schedule,100% of fee schedule,458.44,90,,,percent of total billed charges,90% of total billed charges,213.14,100,,,fee schedule,Pays 100% Medicare OPPS,213.14,100,,,fee schedule,Pays 100% Medicare OPPS,213.14,100,,,fee schedule,Pays 100% Medicare OPPS,213.14,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,213.14,100,,,fee schedule,100% of fee schedule,213.14,458.44,
"DERM EXC MAL LESION Inc MARGINS, S, NE, H, F, G - PRO",4453,CDM,982,RC,11624,HCPCS,outpatient,,,509.38,382.04,,323.95,130,,,fee schedule,130% of fee schedule,323.95,130,,,fee schedule,130% of fee schedule,241.31,100,,,fee schedule,Pays 100% Medicare OPPS,241.31,100,,,fee schedule,Pays 100% Medicare OPPS,296.06,119,,,fee schedule,119% of fee schedule,241.31,100,,,fee schedule,Pays 100% Medicare OPPS,241.31,100,,,fee schedule,100% of fee schedule,458.44,90,,,percent of total billed charges,90% of total billed charges,241.31,100,,,fee schedule,Pays 100% Medicare OPPS,241.31,100,,,fee schedule,Pays 100% Medicare OPPS,241.31,100,,,fee schedule,Pays 100% Medicare OPPS,241.31,100,,,fee schedule,Pays 100% Medicare OPPS,431.16,100,,,fee schedule,100% of fee schedule,241.31,100,,,fee schedule,100% of fee schedule,241.31,458.44,
"Excision, Mal(sc,n,ha,fe,g);< 4.0cm",4454,CDM,521,RC,11626,HCPCS,outpatient,,,698.37,523.78,,628.53,90,,,percent of total billed charges,90% of total billed charges,649.48,93,,,percent of total billed charges,93% of total billed charges,265.38,38,,,percent of total billed charges,38% of total billed charges,265.38,38,,,percent of total billed charges,38% of total billed charges,593.61,85,,,percent of total billed charges,85% of total billed charges,265.38,38,,,percent of total billed charges,38% of total billed charges,568.47,81.4,,,percent of total billed charges,81.4% of total billed charges,628.53,90,,,percent of total billed charges,90% of total billed charges,628.53,90,,,percent of total billed charges,90% of total billed charges,265.38,38,,,percent of total billed charges,38% of total billed charges,265.38,38,,,percent of total billed charges,38% of total billed charges,265.38,38,,,percent of total billed charges,38% of total billed charges,523.78,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,265.38,649.48,
"Excision, Mal(sc,n,ha,fe,g);< 4.0cm-PRO",4455,CDM,981,RC,11626,HCPCS,outpatient,,,419.5,314.63,,397.11,130,,,fee schedule,130% of fee schedule,397.11,130,,,fee schedule,130% of fee schedule,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,363.82,119,,,fee schedule,119% of fee schedule,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,100% of fee schedule,377.55,90,,,percent of total billed charges,90% of total billed charges,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,503.02,100,,,fee schedule,100% of fee schedule,294.67,100,,,fee schedule,100% of fee schedule,294.67,503.02,
"Excision, Mal(sc,n,ha,fe,g);< 4.0cm-PRO",4456,CDM,981,RC,11626,HCPCS,outpatient,,,419.5,314.63,,397.11,130,,,fee schedule,130% of fee schedule,397.11,130,,,fee schedule,130% of fee schedule,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,363.82,119,,,fee schedule,119% of fee schedule,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,100% of fee schedule,377.55,90,,,percent of total billed charges,90% of total billed charges,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,503.02,100,,,fee schedule,100% of fee schedule,294.67,100,,,fee schedule,100% of fee schedule,294.67,503.02,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.5cm or <",4457,CDM,521,RC,11640,HCPCS,outpatient,,,282.41,211.81,,254.17,90,,,percent of total billed charges,90% of total billed charges,262.64,93,,,percent of total billed charges,93% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,240.05,85,,,percent of total billed charges,85% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,229.88,81.4,,,percent of total billed charges,81.4% of total billed charges,254.17,90,,,percent of total billed charges,90% of total billed charges,254.17,90,,,percent of total billed charges,90% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,211.81,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,107.32,262.64,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.5cm or <-PRO",4458,CDM,981,RC,11640,HCPCS,outpatient,,,168.74,126.56,,167.65,130,,,fee schedule,130% of fee schedule,167.65,130,,,fee schedule,130% of fee schedule,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,155.74,119,,,fee schedule,119% of fee schedule,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,100% of fee schedule,151.87,90,,,percent of total billed charges,90% of total billed charges,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,129.52,100,,,fee schedule,100% of fee schedule,129.52,215.58,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.5cm or <-PRO",4459,CDM,981,RC,11640,HCPCS,outpatient,,,168.74,126.56,,167.65,130,,,fee schedule,130% of fee schedule,167.65,130,,,fee schedule,130% of fee schedule,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,155.74,119,,,fee schedule,119% of fee schedule,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,100% of fee schedule,151.87,90,,,percent of total billed charges,90% of total billed charges,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,129.52,100,,,fee schedule,100% of fee schedule,129.52,215.58,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.5cm or <-FAC",4460,CDM,450,RC,11640,HCPCS,outpatient,,,113.67,85.25,,102.3,90,,,percent of total billed charges,90% of total billed charges,105.71,93,,,percent of total billed charges,93% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,96.62,85,,,percent of total billed charges,85% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,92.53,81.4,,,percent of total billed charges,81.4% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,85.25,75,,,percent of total billed charges,75% of total billed charges,96.62,85,,,percent of total billed charges,85% of total billed charges,43.19,105.71,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.5cm or <-FAC",4461,CDM,450,RC,11640,HCPCS,outpatient,,,113.67,85.25,,102.3,90,,,percent of total billed charges,90% of total billed charges,105.71,93,,,percent of total billed charges,93% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,96.62,85,,,percent of total billed charges,85% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,92.53,81.4,,,percent of total billed charges,81.4% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,85.25,75,,,percent of total billed charges,75% of total billed charges,96.62,85,,,percent of total billed charges,85% of total billed charges,43.19,105.71,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.6-1.0cm",4462,CDM,521,RC,11641,HCPCS,outpatient,,,371.45,278.59,,334.31,90,,,percent of total billed charges,90% of total billed charges,345.45,93,,,percent of total billed charges,93% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,315.73,85,,,percent of total billed charges,85% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,302.36,81.4,,,percent of total billed charges,81.4% of total billed charges,334.31,90,,,percent of total billed charges,90% of total billed charges,334.31,90,,,percent of total billed charges,90% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,278.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,141.15,345.45,
"DERM EXCIS, MAL LESION (SC, N, HA, FE, G); 0.6-1.0CM - PRO",4463,CDM,982,RC,11641,HCPCS,outpatient,,,344.89,258.67,,211.69,130,,,fee schedule,130% of fee schedule,211.69,130,,,fee schedule,130% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,192.85,119,,,fee schedule,119% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,100% of fee schedule,310.4,90,,,percent of total billed charges,90% of total billed charges,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,158.76,100,,,fee schedule,100% of fee schedule,158.76,310.4,
"DERM Excis, Mal Lesion(sc,n,ha,fe,g);0.6-1.0cm-G",4464,CDM,982,RC,11641,HCPCS,outpatient,,,610.19,457.64,,211.69,130,,,fee schedule,130% of fee schedule,211.69,130,,,fee schedule,130% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,192.85,119,,,fee schedule,119% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,100% of fee schedule,549.17,90,,,percent of total billed charges,90% of total billed charges,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,158.76,100,,,fee schedule,100% of fee schedule,158.76,549.17,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.6-1.0cm-PRO",4465,CDM,981,RC,11641,HCPCS,outpatient,,,223.81,167.86,,211.69,130,,,fee schedule,130% of fee schedule,211.69,130,,,fee schedule,130% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,192.85,119,,,fee schedule,119% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,100% of fee schedule,201.43,90,,,percent of total billed charges,90% of total billed charges,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,158.76,100,,,fee schedule,100% of fee schedule,158.76,287.44,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.6-1.0cm-PRO",4466,CDM,981,RC,11641,HCPCS,outpatient,,,223.81,167.86,,211.69,130,,,fee schedule,130% of fee schedule,211.69,130,,,fee schedule,130% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,192.85,119,,,fee schedule,119% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,100% of fee schedule,201.43,90,,,percent of total billed charges,90% of total billed charges,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,158.76,100,,,fee schedule,100% of fee schedule,158.76,287.44,
"Excis, Mal Lesion(sc,n,ha,fe,g);1.1-2.0cm",4467,CDM,521,RC,11642,HCPCS,outpatient,,,435.91,326.93,,392.32,90,,,percent of total billed charges,90% of total billed charges,405.4,93,,,percent of total billed charges,93% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,354.83,81.4,,,percent of total billed charges,81.4% of total billed charges,392.32,90,,,percent of total billed charges,90% of total billed charges,392.32,90,,,percent of total billed charges,90% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,165.65,38,,,percent of total billed charges,38% of total billed charges,326.93,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,165.65,405.4,
"DERM - EXCIS, MAL LESIONS (SC, N, HA, FE, G); 1.1-2.0CM - PRO",4468,CDM,982,RC,11642,HCPCS,outpatient,,,424.48,318.36,,249.48,130,,,fee schedule,130% of fee schedule,249.48,130,,,fee schedule,130% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,226.1,119,,,fee schedule,119% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,100% of fee schedule,382.03,90,,,percent of total billed charges,90% of total billed charges,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,185.13,100,,,fee schedule,100% of fee schedule,185.13,382.03,
"DERM Excis, Mal Lesion(sc,n,ha,fe,g);1.1-2.0cm-G",4469,CDM,982,RC,11642,HCPCS,outpatient,,,764.07,573.05,,249.48,130,,,fee schedule,130% of fee schedule,249.48,130,,,fee schedule,130% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,226.1,119,,,fee schedule,119% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,100% of fee schedule,687.66,90,,,percent of total billed charges,90% of total billed charges,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,185.13,100,,,fee schedule,100% of fee schedule,185.13,687.66,
"Excis, Mal Lesion(sc,n,ha,fe,g);1.1-2.0cm-PRO",4470,CDM,981,RC,11642,HCPCS,outpatient,,,260.13,195.1,,249.48,130,,,fee schedule,130% of fee schedule,249.48,130,,,fee schedule,130% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,226.1,119,,,fee schedule,119% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,100% of fee schedule,234.12,90,,,percent of total billed charges,90% of total billed charges,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,185.13,100,,,fee schedule,100% of fee schedule,185.13,359.3,
"Excis, Mal Lesion(sc,n,ha,fe,g);1.1-2.0cm-PRO",4471,CDM,981,RC,11642,HCPCS,outpatient,,,260.13,195.1,,249.48,130,,,fee schedule,130% of fee schedule,249.48,130,,,fee schedule,130% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,226.1,119,,,fee schedule,119% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,100% of fee schedule,234.12,90,,,percent of total billed charges,90% of total billed charges,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,185.13,100,,,fee schedule,100% of fee schedule,185.13,359.3,
"Excis, Mal Lesion(sc,n,ha,fe,g);2.1-3.0cm",4472,CDM,521,RC,11643,HCPCS,outpatient,,,849.54,637.16,,764.59,90,,,percent of total billed charges,90% of total billed charges,790.07,93,,,percent of total billed charges,93% of total billed charges,322.83,38,,,percent of total billed charges,38% of total billed charges,322.83,38,,,percent of total billed charges,38% of total billed charges,722.11,85,,,percent of total billed charges,85% of total billed charges,322.83,38,,,percent of total billed charges,38% of total billed charges,691.53,81.4,,,percent of total billed charges,81.4% of total billed charges,764.59,90,,,percent of total billed charges,90% of total billed charges,764.59,90,,,percent of total billed charges,90% of total billed charges,322.83,38,,,percent of total billed charges,38% of total billed charges,322.83,38,,,percent of total billed charges,38% of total billed charges,322.83,38,,,percent of total billed charges,38% of total billed charges,637.16,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,322.83,790.07,
"Excis, Mal Lesion(sc,n,ha,fe,g);2.1-3.0cm-PRO",4473,CDM,981,RC,11643,HCPCS,outpatient,,,508.54,381.41,,312.72,130,,,fee schedule,130% of fee schedule,312.72,130,,,fee schedule,130% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,283.32,119,,,fee schedule,119% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,100% of fee schedule,457.69,90,,,percent of total billed charges,90% of total billed charges,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,431.16,100,,,fee schedule,100% of fee schedule,230.83,100,,,fee schedule,100% of fee schedule,230.83,457.69,
"Excis, Mal Lesion(sc,n,ha,fe,g);2.1-3.0cm-PRO",4474,CDM,981,RC,11643,HCPCS,outpatient,,,508.54,381.41,,312.72,130,,,fee schedule,130% of fee schedule,312.72,130,,,fee schedule,130% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,283.32,119,,,fee schedule,119% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,100% of fee schedule,457.69,90,,,percent of total billed charges,90% of total billed charges,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,431.16,100,,,fee schedule,100% of fee schedule,230.83,100,,,fee schedule,100% of fee schedule,230.83,457.69,
Lesion rem; malig head/face 3.1-4.0-Pro,4475,CDM,982,RC,11644,HCPCS,outpatient,,,828.44,621.33,,387.06,130,,,fee schedule,130% of fee schedule,387.06,130,,,fee schedule,130% of fee schedule,285.69,100,,,fee schedule,Pays 100% Medicare OPPS,285.69,100,,,fee schedule,Pays 100% Medicare OPPS,351.67,119,,,fee schedule,119% of fee schedule,285.69,100,,,fee schedule,Pays 100% Medicare OPPS,285.69,100,,,fee schedule,100% of fee schedule,745.6,90,,,percent of total billed charges,90% of total billed charges,285.69,100,,,fee schedule,Pays 100% Medicare OPPS,285.69,100,,,fee schedule,Pays 100% Medicare OPPS,285.69,100,,,fee schedule,Pays 100% Medicare OPPS,285.69,100,,,fee schedule,Pays 100% Medicare OPPS,503.02,100,,,fee schedule,100% of fee schedule,285.69,100,,,fee schedule,100% of fee schedule,285.69,745.6,
"Excis, Mal Lesion(sc,n,ha,fe,g);Over 4.0 cm",4476,CDM,521,RC,11646,HCPCS,outpatient,,,957.33,718,,861.6,90,,,percent of total billed charges,90% of total billed charges,890.32,93,,,percent of total billed charges,93% of total billed charges,363.79,38,,,percent of total billed charges,38% of total billed charges,363.79,38,,,percent of total billed charges,38% of total billed charges,813.73,85,,,percent of total billed charges,85% of total billed charges,363.79,38,,,percent of total billed charges,38% of total billed charges,779.27,81.4,,,percent of total billed charges,81.4% of total billed charges,861.6,90,,,percent of total billed charges,90% of total billed charges,861.6,90,,,percent of total billed charges,90% of total billed charges,363.79,38,,,percent of total billed charges,38% of total billed charges,363.79,38,,,percent of total billed charges,38% of total billed charges,363.79,38,,,percent of total billed charges,38% of total billed charges,718,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,363.79,890.32,
"Excis, Mal Lesion(sc,n,ha,fe,g);Over 4.0 cm-PRO",4477,CDM,981,RC,11646,HCPCS,outpatient,,,575.34,431.51,,537.47,130,,,fee schedule,130% of fee schedule,537.47,130,,,fee schedule,130% of fee schedule,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,486.54,119,,,fee schedule,119% of fee schedule,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,100% of fee schedule,517.81,90,,,percent of total billed charges,90% of total billed charges,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,393.9,100,,,fee schedule,100% of fee schedule,57.49,537.47,
"Excis, Mal Lesion(sc,n,ha,fe,g);Over 4.0 cm-PRO",4478,CDM,981,RC,11646,HCPCS,outpatient,,,575.34,431.51,,537.47,130,,,fee schedule,130% of fee schedule,537.47,130,,,fee schedule,130% of fee schedule,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,486.54,119,,,fee schedule,119% of fee schedule,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,100% of fee schedule,517.81,90,,,percent of total billed charges,90% of total billed charges,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,393.9,100,,,fee schedule,100% of fee schedule,57.49,537.47,
Debrid. of Nail(s) Any Method(s); 1-5,4479,CDM,521,RC,11720,HCPCS,outpatient,,,60.93,45.7,,54.84,90,,,percent of total billed charges,90% of total billed charges,56.66,93,,,percent of total billed charges,93% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,51.79,85,,,percent of total billed charges,85% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,49.6,81.4,,,percent of total billed charges,81.4% of total billed charges,54.84,90,,,percent of total billed charges,90% of total billed charges,54.84,90,,,percent of total billed charges,90% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,45.7,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,23.15,56.66,
Debrid. of Nail(s) Any Method(s); 1-5,4480,CDM,521,RC,11720,HCPCS,outpatient,,,60.93,45.7,,54.84,90,,,percent of total billed charges,90% of total billed charges,56.66,93,,,percent of total billed charges,93% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,51.79,85,,,percent of total billed charges,85% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,49.6,81.4,,,percent of total billed charges,81.4% of total billed charges,54.84,90,,,percent of total billed charges,90% of total billed charges,54.84,90,,,percent of total billed charges,90% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,23.15,38,,,percent of total billed charges,38% of total billed charges,45.7,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,23.15,56.66,
WND Debrid Nail 1-5-PRO,4481,CDM,982,RC,11720,HCPCS,outpatient,,,35.15,26.36,,19.89,130,,,fee schedule,130% of fee schedule,19.89,130,,,fee schedule,130% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,18,119,,,fee schedule,119% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,100% of fee schedule,31.64,90,,,percent of total billed charges,90% of total billed charges,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,14.46,100,,,fee schedule,100% of fee schedule,14.46,35.93,
Debrid. of Nail(s) Any Method(s); 1-5-PRO,4482,CDM,981,RC,11720,HCPCS,outpatient,,,35.15,26.36,,19.89,130,,,fee schedule,130% of fee schedule,19.89,130,,,fee schedule,130% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,18,119,,,fee schedule,119% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,100% of fee schedule,31.64,90,,,percent of total billed charges,90% of total billed charges,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,14.46,100,,,fee schedule,100% of fee schedule,14.46,35.93,
Debrid. of Nail(s) Any Method(s); 1-5-PRO,4483,CDM,981,RC,11720,HCPCS,outpatient,,,35.15,26.36,,19.89,130,,,fee schedule,130% of fee schedule,19.89,130,,,fee schedule,130% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,18,119,,,fee schedule,119% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,100% of fee schedule,31.64,90,,,percent of total billed charges,90% of total billed charges,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,14.46,100,,,fee schedule,100% of fee schedule,14.46,35.93,
Debrid. of Nail;Trim. Nondys.;6 or <,4484,CDM,521,RC,11721,HCPCS,outpatient,,,67.97,50.98,,61.17,90,,,percent of total billed charges,90% of total billed charges,63.21,93,,,percent of total billed charges,93% of total billed charges,25.83,38,,,percent of total billed charges,38% of total billed charges,25.83,38,,,percent of total billed charges,38% of total billed charges,57.77,85,,,percent of total billed charges,85% of total billed charges,25.83,38,,,percent of total billed charges,38% of total billed charges,55.33,81.4,,,percent of total billed charges,81.4% of total billed charges,61.17,90,,,percent of total billed charges,90% of total billed charges,61.17,90,,,percent of total billed charges,90% of total billed charges,25.83,38,,,percent of total billed charges,38% of total billed charges,25.83,38,,,percent of total billed charges,38% of total billed charges,25.83,38,,,percent of total billed charges,38% of total billed charges,50.98,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,25.83,63.21,
WND Debride Nail 6 or <-PRO,4485,CDM,982,RC,11721,HCPCS,outpatient,,,67.56,50.67,,32.75,130,,,fee schedule,130% of fee schedule,32.75,130,,,fee schedule,130% of fee schedule,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,30.89,119,,,fee schedule,119% of fee schedule,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,100% of fee schedule,60.8,90,,,percent of total billed charges,90% of total billed charges,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,23.74,100,,,fee schedule,100% of fee schedule,23.74,60.8,
Debrid. of Nail;Trim. Nondys.;6 or <-PRO,4486,CDM,981,RC,11721,HCPCS,outpatient,,,39.84,29.88,,32.75,130,,,fee schedule,130% of fee schedule,32.75,130,,,fee schedule,130% of fee schedule,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,30.89,119,,,fee schedule,119% of fee schedule,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,100% of fee schedule,35.86,90,,,percent of total billed charges,90% of total billed charges,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,23.74,100,,,fee schedule,100% of fee schedule,23.74,35.93,
Debrid. of Nail;Trim. Nondys.;6 or <-PRO,4487,CDM,981,RC,11721,HCPCS,outpatient,,,39.84,29.88,,32.75,130,,,fee schedule,130% of fee schedule,32.75,130,,,fee schedule,130% of fee schedule,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,30.89,119,,,fee schedule,119% of fee schedule,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,100% of fee schedule,35.86,90,,,percent of total billed charges,90% of total billed charges,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,23.74,100,,,fee schedule,100% of fee schedule,23.74,35.93,
Debridement of Nail; Nail Plate,4488,CDM,521,RC,11730,HCPCS,outpatient,,,146.47,109.85,,131.82,90,,,percent of total billed charges,90% of total billed charges,136.22,93,,,percent of total billed charges,93% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,119.23,81.4,,,percent of total billed charges,81.4% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,109.85,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,55.66,136.22,
Debridement of Nail; Nail Plate,4489,CDM,521,RC,11730,HCPCS,outpatient,,,146.47,109.85,,131.82,90,,,percent of total billed charges,90% of total billed charges,136.22,93,,,percent of total billed charges,93% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,124.5,85,,,percent of total billed charges,85% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,119.23,81.4,,,percent of total billed charges,81.4% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,131.82,90,,,percent of total billed charges,90% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,55.66,38,,,percent of total billed charges,38% of total billed charges,109.85,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,55.66,136.22,
WND Removal of Nail plate-PRO,4490,CDM,982,RC,11730,HCPCS,outpatient,,,157.66,118.25,,66.83,130,,,fee schedule,130% of fee schedule,66.83,130,,,fee schedule,130% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,67.66,119,,,fee schedule,119% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,100% of fee schedule,141.89,90,,,percent of total billed charges,90% of total billed charges,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,54.11,100,,,fee schedule,100% of fee schedule,35.93,141.89,
Debridement of Nail; Nail Plate-PRO,4491,CDM,981,RC,11730,HCPCS,outpatient,,,89.06,66.8,,66.83,130,,,fee schedule,130% of fee schedule,66.83,130,,,fee schedule,130% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,67.66,119,,,fee schedule,119% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,100% of fee schedule,80.15,90,,,percent of total billed charges,90% of total billed charges,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,54.11,100,,,fee schedule,100% of fee schedule,35.93,80.15,
Debridement of Nail; Nail Plate-PRO,4492,CDM,981,RC,11730,HCPCS,outpatient,,,89.06,66.8,,66.83,130,,,fee schedule,130% of fee schedule,66.83,130,,,fee schedule,130% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,67.66,119,,,fee schedule,119% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,100% of fee schedule,80.15,90,,,percent of total billed charges,90% of total billed charges,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,54.11,100,,,fee schedule,100% of fee schedule,35.93,80.15,
WND Removal of Nail plate add-on PRO,4493,CDM,982,RC,11732,HCPCS,outpatient,,,45.05,33.79,,34.53,130,,,fee schedule,130% of fee schedule,34.53,130,,,fee schedule,130% of fee schedule,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,21.47,119,,,fee schedule,119% of fee schedule,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,100% of fee schedule,40.55,90,,,percent of total billed charges,90% of total billed charges,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,7.19,100,,,fee schedule,100% of fee schedule,17.22,100,,,fee schedule,100% of fee schedule,7.19,40.55,
Debridement Nail plate ea add PRO,4494,CDM,981,RC,11732,HCPCS,outpatient,,,82.21,61.66,,34.53,130,,,fee schedule,130% of fee schedule,34.53,130,,,fee schedule,130% of fee schedule,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,21.47,119,,,fee schedule,119% of fee schedule,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,100% of fee schedule,73.99,90,,,percent of total billed charges,90% of total billed charges,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,17.22,100,,,fee schedule,Pays 100% Medicare OPPS,7.19,100,,,fee schedule,100% of fee schedule,17.22,100,,,fee schedule,100% of fee schedule,7.19,73.99,
Debrid. of Nail;Evac.;Sub.Hematoma,4495,CDM,521,RC,11740,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,29.39,71.94,
Debrid. of Nail;Evac.;Sub.Hematoma,4496,CDM,521,RC,11740,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,29.39,71.94,
Debrid. of Nail;Evac.;Sub.Hematoma,4497,CDM,521,RC,11740,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,29.39,71.94,
Debrid. of Nail;Evac.;Sub.Hematoma,4498,CDM,521,RC,11740,HCPCS,outpatient,,,77.35,58.01,,69.62,90,,,percent of total billed charges,90% of total billed charges,71.94,93,,,percent of total billed charges,93% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,65.75,85,,,percent of total billed charges,85% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,62.96,81.4,,,percent of total billed charges,81.4% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,69.62,90,,,percent of total billed charges,90% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,29.39,38,,,percent of total billed charges,38% of total billed charges,58.01,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,29.39,71.94,
WND Drain blood from under nail-PRO,4499,CDM,982,RC,11740,HCPCS,outpatient,,,56.3,42.23,,42.17,130,,,fee schedule,130% of fee schedule,42.17,130,,,fee schedule,130% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,39.23,119,,,fee schedule,119% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,100% of fee schedule,50.67,90,,,percent of total billed charges,90% of total billed charges,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,32.89,100,,,fee schedule,100% of fee schedule,32.89,50.67,
Debrid. of Nail;Evac.;Sub.Hematoma-PRO,4500,CDM,981,RC,11740,HCPCS,outpatient,,,44.53,33.4,,42.17,130,,,fee schedule,130% of fee schedule,42.17,130,,,fee schedule,130% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,39.23,119,,,fee schedule,119% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,100% of fee schedule,40.08,90,,,percent of total billed charges,90% of total billed charges,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,32.89,100,,,fee schedule,100% of fee schedule,32.89,43.12,
"Excision:Nail/Matrix, Part/Comp.Rmv.",4501,CDM,521,RC,11750,HCPCS,outpatient,,,425.37,319.03,,382.83,90,,,percent of total billed charges,90% of total billed charges,395.59,93,,,percent of total billed charges,93% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,361.56,85,,,percent of total billed charges,85% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,346.25,81.4,,,percent of total billed charges,81.4% of total billed charges,382.83,90,,,percent of total billed charges,90% of total billed charges,382.83,90,,,percent of total billed charges,90% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,319.03,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,161.64,395.59,
"Excision:Nail/Matrix, Part/Comp.Rmv.",4502,CDM,521,RC,11750,HCPCS,outpatient,,,425.37,319.03,,382.83,90,,,percent of total billed charges,90% of total billed charges,395.59,93,,,percent of total billed charges,93% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,361.56,85,,,percent of total billed charges,85% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,346.25,81.4,,,percent of total billed charges,81.4% of total billed charges,382.83,90,,,percent of total billed charges,90% of total billed charges,382.83,90,,,percent of total billed charges,90% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,319.03,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,161.64,395.59,
"Excision:Nail/Matrix, Part/Comp.Rmv.",4503,CDM,521,RC,11750,HCPCS,outpatient,,,425.37,319.03,,382.83,90,,,percent of total billed charges,90% of total billed charges,395.59,93,,,percent of total billed charges,93% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,361.56,85,,,percent of total billed charges,85% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,346.25,81.4,,,percent of total billed charges,81.4% of total billed charges,382.83,90,,,percent of total billed charges,90% of total billed charges,382.83,90,,,percent of total billed charges,90% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,161.64,38,,,percent of total billed charges,38% of total billed charges,319.03,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,161.64,395.59,
WND Removal of nail bed-G,4504,CDM,982,RC,11750,HCPCS,outpatient,,,389.44,292.08,,227.34,130,,,fee schedule,130% of fee schedule,227.34,130,,,fee schedule,130% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,126.2,119,,,fee schedule,119% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,100% of fee schedule,350.5,90,,,percent of total billed charges,90% of total billed charges,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,102.95,100,,,fee schedule,100% of fee schedule,102.95,350.5,
WND Removal of nail bed-PRO,4505,CDM,982,RC,11750,HCPCS,outpatient,,,254.29,190.72,,227.34,130,,,fee schedule,130% of fee schedule,227.34,130,,,fee schedule,130% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,126.2,119,,,fee schedule,119% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,100% of fee schedule,228.86,90,,,percent of total billed charges,90% of total billed charges,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,102.95,100,,,fee schedule,100% of fee schedule,102.95,228.86,
"Excision:Nail/Matrix, Part/Comp.Rmv.-PRO",4506,CDM,981,RC,11750,HCPCS,outpatient,,,254.29,190.72,,227.34,130,,,fee schedule,130% of fee schedule,227.34,130,,,fee schedule,130% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,126.2,119,,,fee schedule,119% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,100% of fee schedule,228.86,90,,,percent of total billed charges,90% of total billed charges,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,102.95,100,,,fee schedule,100% of fee schedule,102.95,228.86,
"Excision:Nail/Matrix, Part/Comp.Rmv.-PRO",4507,CDM,981,RC,11750,HCPCS,outpatient,,,254.29,190.72,,227.34,130,,,fee schedule,130% of fee schedule,227.34,130,,,fee schedule,130% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,126.2,119,,,fee schedule,119% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,100% of fee schedule,228.86,90,,,percent of total billed charges,90% of total billed charges,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,102.95,100,,,fee schedule,100% of fee schedule,102.95,228.86,
WND Repair of Nail Bed-PRO,4508,CDM,982,RC,11760,HCPCS,outpatient,,,225.23,168.92,,175.01,130,,,fee schedule,130% of fee schedule,175.01,130,,,fee schedule,130% of fee schedule,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,142.49,119,,,fee schedule,119% of fee schedule,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,100% of fee schedule,202.71,90,,,percent of total billed charges,90% of total billed charges,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,112.94,100,,,fee schedule,100% of fee schedule,112.94,215.58,
Repair of Nail Bed-PRO,4509,CDM,981,RC,11760,HCPCS,outpatient,,,439.21,329.41,,175.01,130,,,fee schedule,130% of fee schedule,175.01,130,,,fee schedule,130% of fee schedule,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,142.49,119,,,fee schedule,119% of fee schedule,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,100% of fee schedule,395.29,90,,,percent of total billed charges,90% of total billed charges,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,112.94,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,112.94,100,,,fee schedule,100% of fee schedule,112.94,395.29,
Debrid. Nail;Wedge Exc.of Skin;Fold,4510,CDM,521,RC,11765,HCPCS,outpatient,,,164.04,123.03,,147.64,90,,,percent of total billed charges,90% of total billed charges,152.56,93,,,percent of total billed charges,93% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,139.43,85,,,percent of total billed charges,85% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,133.53,81.4,,,percent of total billed charges,81.4% of total billed charges,147.64,90,,,percent of total billed charges,90% of total billed charges,147.64,90,,,percent of total billed charges,90% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,62.34,38,,,percent of total billed charges,38% of total billed charges,123.03,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,62.34,152.56,
Debrid. Nail;Wedge Exc.of Skin;Fold-PRO,4511,CDM,981,RC,11765,HCPCS,outpatient,,,99.59,74.69,,92.63,130,,,fee schedule,130% of fee schedule,92.63,130,,,fee schedule,130% of fee schedule,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,114.89,119,,,fee schedule,119% of fee schedule,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,100% of fee schedule,89.63,90,,,percent of total billed charges,90% of total billed charges,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,94.77,100,,,fee schedule,100% of fee schedule,89.63,143.72,
Debrid. Nail;Wedge Exc.of Skin;Fold-PRO,4512,CDM,981,RC,11765,HCPCS,outpatient,,,99.59,74.69,,92.63,130,,,fee schedule,130% of fee schedule,92.63,130,,,fee schedule,130% of fee schedule,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,114.89,119,,,fee schedule,119% of fee schedule,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,100% of fee schedule,89.63,90,,,percent of total billed charges,90% of total billed charges,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,94.77,100,,,fee schedule,100% of fee schedule,89.63,143.72,
WND Excision of nail fold toe-PRO,4513,CDM,982,RC,11765,HCPCS,outpatient,,,225.23,168.92,,92.63,130,,,fee schedule,130% of fee schedule,92.63,130,,,fee schedule,130% of fee schedule,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,114.89,119,,,fee schedule,119% of fee schedule,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,100% of fee schedule,202.71,90,,,percent of total billed charges,90% of total billed charges,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,94.77,100,,,fee schedule,100% of fee schedule,92.63,202.71,
Treatment of Lesions; Inj.up to 7 Lesions,4514,CDM,521,RC,11900,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,36.07,88.27,
Treatment of Lesions; Inj.up to 7 Lesions,4515,CDM,521,RC,11900,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,36.07,88.27,
DERM Treatment of Lesions; Inj.up to 7 Lesions-G,4516,CDM,982,RC,11900,HCPCS,outpatient,,,132.65,99.49,,43.1,130,,,fee schedule,130% of fee schedule,43.1,130,,,fee schedule,130% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,37.58,119,,,fee schedule,119% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,100% of fee schedule,119.39,90,,,percent of total billed charges,90% of total billed charges,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,30.36,100,,,fee schedule,100% of fee schedule,30.36,119.39,
DERM TX OF LESIONS; INJ. UP TO 7 LESIONS - PRO,4517,CDM,982,RC,11900,HCPCS,outpatient,,,95.51,71.63,,43.1,130,,,fee schedule,130% of fee schedule,43.1,130,,,fee schedule,130% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,37.58,119,,,fee schedule,119% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,100% of fee schedule,85.96,90,,,percent of total billed charges,90% of total billed charges,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,30.36,100,,,fee schedule,100% of fee schedule,30.36,85.96,
Treatment of Lesions; Inj.up to 7 Lesions-PRO,4518,CDM,981,RC,11900,HCPCS,outpatient,,,55.08,41.31,,43.1,130,,,fee schedule,130% of fee schedule,43.1,130,,,fee schedule,130% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,37.58,119,,,fee schedule,119% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,100% of fee schedule,49.57,90,,,percent of total billed charges,90% of total billed charges,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,30.36,100,,,fee schedule,100% of fee schedule,30.36,49.57,
Treatment of Lesions; Inj.up to 7 Lesions-PRO,4519,CDM,981,RC,11900,HCPCS,outpatient,,,55.08,41.31,,43.1,130,,,fee schedule,130% of fee schedule,43.1,130,,,fee schedule,130% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,37.58,119,,,fee schedule,119% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,100% of fee schedule,49.57,90,,,percent of total billed charges,90% of total billed charges,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,30.36,100,,,fee schedule,100% of fee schedule,30.36,49.57,
"DERM INJECTION, INTRALESIONAL; UP TO AND INCLUDING 7 LESIONS - PRO",4520,CDM,982,RC,11901,HCPCS,outpatient,,,99.76,74.82,,66.65,130,,,fee schedule,130% of fee schedule,66.65,130,,,fee schedule,130% of fee schedule,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,58.7,119,,,fee schedule,119% of fee schedule,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,100% of fee schedule,89.78,90,,,percent of total billed charges,90% of total billed charges,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,56.05,100,,,fee schedule,100% of fee schedule,46.12,100,,,fee schedule,100% of fee schedule,46.12,89.78,
"DERM INJECTION, INTRALESIONAL; UP TO AND INCLUDING 7 LESIONS - G",4521,CDM,982,RC,11901,HCPCS,outpatient,,,439.34,329.51,,66.65,130,,,fee schedule,130% of fee schedule,66.65,130,,,fee schedule,130% of fee schedule,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,58.7,119,,,fee schedule,119% of fee schedule,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,100% of fee schedule,395.41,90,,,percent of total billed charges,90% of total billed charges,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,46.12,100,,,fee schedule,Pays 100% Medicare OPPS,56.05,100,,,fee schedule,100% of fee schedule,46.12,100,,,fee schedule,100% of fee schedule,46.12,395.41,
Removal Contraceptive,4522,CDM,521,RC,11976,HCPCS,outpatient,,,240.22,180.17,,216.2,90,,,percent of total billed charges,90% of total billed charges,223.4,93,,,percent of total billed charges,93% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,204.19,85,,,percent of total billed charges,85% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,195.54,81.4,,,percent of total billed charges,81.4% of total billed charges,216.2,90,,,percent of total billed charges,90% of total billed charges,216.2,90,,,percent of total billed charges,90% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,180.17,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,91.28,223.4,
Removal Contraceptive-PRO,4523,CDM,981,RC,11976,HCPCS,outpatient,,,142.95,107.21,,128.48,130,,,fee schedule,130% of fee schedule,128.48,130,,,fee schedule,130% of fee schedule,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,117.05,119,,,fee schedule,119% of fee schedule,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,100% of fee schedule,128.66,90,,,percent of total billed charges,90% of total billed charges,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,93,100,,,fee schedule,100% of fee schedule,93,128.66,
Removal Contraceptive-PRO,4524,CDM,981,RC,11976,HCPCS,outpatient,,,142.95,107.21,,128.48,130,,,fee schedule,130% of fee schedule,128.48,130,,,fee schedule,130% of fee schedule,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,117.05,119,,,fee schedule,119% of fee schedule,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,100% of fee schedule,128.66,90,,,percent of total billed charges,90% of total billed charges,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,93,100,,,fee schedule,100% of fee schedule,93,128.66,
"Insertion, Delivery Implant",4525,CDM,521,RC,11981,HCPCS,outpatient,,,241.38,181.04,,217.24,90,,,percent of total billed charges,90% of total billed charges,224.48,93,,,percent of total billed charges,93% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,205.17,85,,,percent of total billed charges,85% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,196.48,81.4,,,percent of total billed charges,81.4% of total billed charges,217.24,90,,,percent of total billed charges,90% of total billed charges,217.24,90,,,percent of total billed charges,90% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,181.04,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,91.72,224.48,
Lac Repair Supf Nonface less than 2.5 cm,4526,CDM,521,RC,12001,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,105.08,257.17,
OR Lac Repair PRO Supf Nonface less than 2.5 cm,4527,CDM,975,RC,12001,HCPCS,outpatient,,,394.16,295.62,,59.58,130,,,fee schedule,130% of fee schedule,59.58,130,,,fee schedule,130% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,55.66,119,,,fee schedule,119% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,100% of fee schedule,354.74,90,,,percent of total billed charges,90% of total billed charges,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,44.94,100,,,fee schedule,100% of fee schedule,44.94,354.74,
WND Debrid. Nail;Wedge Exc.of Skin;Fold-PRO,4528,CDM,982,RC,12001,HCPCS,outpatient,,,135.15,101.36,,59.58,130,,,fee schedule,130% of fee schedule,59.58,130,,,fee schedule,130% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,55.66,119,,,fee schedule,119% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,100% of fee schedule,121.64,90,,,percent of total billed charges,90% of total billed charges,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,44.94,100,,,fee schedule,100% of fee schedule,44.94,121.64,
"Lac Repair, PRO Supf Nonface less than 2.5cm",4529,CDM,981,RC,12001,HCPCS,outpatient,,,165.21,123.91,,59.58,130,,,fee schedule,130% of fee schedule,59.58,130,,,fee schedule,130% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,55.66,119,,,fee schedule,119% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,100% of fee schedule,148.69,90,,,percent of total billed charges,90% of total billed charges,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,44.94,100,,,fee schedule,100% of fee schedule,44.94,148.69,
"Lac Repair, PRO Supf Nonface less than 2.5cm",4530,CDM,981,RC,12001,HCPCS,outpatient,,,165.21,123.91,,59.58,130,,,fee schedule,130% of fee schedule,59.58,130,,,fee schedule,130% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,55.66,119,,,fee schedule,119% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,100% of fee schedule,148.69,90,,,percent of total billed charges,90% of total billed charges,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,44.94,100,,,fee schedule,100% of fee schedule,44.94,148.69,
Lac Repair Supf.Nonface;2.6-7.5 cm,4531,CDM,521,RC,12002,HCPCS,outpatient,,,363.24,272.43,,326.92,90,,,percent of total billed charges,90% of total billed charges,337.81,93,,,percent of total billed charges,93% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,308.75,85,,,percent of total billed charges,85% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,295.68,81.4,,,percent of total billed charges,81.4% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,272.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,138.03,337.81,
COA Lac Repair Supf.Nonface:2.6-7.5,4532,CDM,982,RC,12002,HCPCS,outpatient,,,363.24,272.43,,78.94,130,,,fee schedule,130% of fee schedule,78.94,130,,,fee schedule,130% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,73.92,119,,,fee schedule,119% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,100% of fee schedule,326.92,90,,,percent of total billed charges,90% of total billed charges,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,58.64,100,,,fee schedule,100% of fee schedule,58.64,326.92,
WND Lac Repair-Supf.Nonface;2.6-7.5 cm-PRO,4533,CDM,982,RC,12002,HCPCS,outpatient,,,168.92,126.69,,78.94,130,,,fee schedule,130% of fee schedule,78.94,130,,,fee schedule,130% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,73.92,119,,,fee schedule,119% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,100% of fee schedule,152.03,90,,,percent of total billed charges,90% of total billed charges,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,58.64,100,,,fee schedule,100% of fee schedule,58.64,152.03,
Lac Repair-PRO Supf. Nonface;2.6-7.5 cm,4534,CDM,981,RC,12002,HCPCS,outpatient,,,219.13,164.35,,78.94,130,,,fee schedule,130% of fee schedule,78.94,130,,,fee schedule,130% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,73.92,119,,,fee schedule,119% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,100% of fee schedule,197.22,90,,,percent of total billed charges,90% of total billed charges,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,58.64,100,,,fee schedule,100% of fee schedule,58.64,197.22,
Lac Repair-PRO Supf. Nonface;2.6-7.5 cm,4535,CDM,981,RC,12002,HCPCS,outpatient,,,219.13,164.35,,78.94,130,,,fee schedule,130% of fee schedule,78.94,130,,,fee schedule,130% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,73.92,119,,,fee schedule,119% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,100% of fee schedule,197.22,90,,,percent of total billed charges,90% of total billed charges,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,58.64,100,,,fee schedule,100% of fee schedule,58.64,197.22,
Lac Repair Supf Nonface.;7.6-12.5cm [Package],4536,CDM,521,RC,12004,HCPCS,outpatient,,,363.24,272.43,,326.92,90,,,percent of total billed charges,90% of total billed charges,337.81,93,,,percent of total billed charges,93% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,308.75,85,,,percent of total billed charges,85% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,295.68,81.4,,,percent of total billed charges,81.4% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,272.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,138.03,337.81,
Lac Repair-PRO Supf.Nonface;7.6-12.5cm,4537,CDM,981,RC,12004,HCPCS,outpatient,,,453.48,340.11,,98.28,130,,,fee schedule,130% of fee schedule,98.28,130,,,fee schedule,130% of fee schedule,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,91.86,119,,,fee schedule,119% of fee schedule,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,100% of fee schedule,408.13,90,,,percent of total billed charges,90% of total billed charges,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,72.7,100,,,fee schedule,100% of fee schedule,72.7,408.13,
Lac Repair-PRO Supf.Nonface;7.6-12.5cm,4538,CDM,981,RC,12004,HCPCS,outpatient,,,453.48,340.11,,98.28,130,,,fee schedule,130% of fee schedule,98.28,130,,,fee schedule,130% of fee schedule,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,91.86,119,,,fee schedule,119% of fee schedule,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,100% of fee schedule,408.13,90,,,percent of total billed charges,90% of total billed charges,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,72.7,100,,,fee schedule,100% of fee schedule,72.7,408.13,
Lac Repair Supf.Nonface;12.6-20.0cm [Package],4539,CDM,521,RC,12005,HCPCS,outpatient,,,401.92,301.44,,361.73,90,,,percent of total billed charges,90% of total billed charges,373.79,93,,,percent of total billed charges,93% of total billed charges,152.73,38,,,percent of total billed charges,38% of total billed charges,152.73,38,,,percent of total billed charges,38% of total billed charges,341.63,85,,,percent of total billed charges,85% of total billed charges,152.73,38,,,percent of total billed charges,38% of total billed charges,327.16,81.4,,,percent of total billed charges,81.4% of total billed charges,361.73,90,,,percent of total billed charges,90% of total billed charges,361.73,90,,,percent of total billed charges,90% of total billed charges,152.73,38,,,percent of total billed charges,38% of total billed charges,152.73,38,,,percent of total billed charges,38% of total billed charges,152.73,38,,,percent of total billed charges,38% of total billed charges,301.44,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,152.73,373.79,
Lac Repair-PRO Supf.Nonface;12.6-20cm,4540,CDM,981,RC,12005,HCPCS,outpatient,,,564.79,423.59,,133.06,130,,,fee schedule,130% of fee schedule,133.06,130,,,fee schedule,130% of fee schedule,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,119.33,119,,,fee schedule,119% of fee schedule,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,100% of fee schedule,508.31,90,,,percent of total billed charges,90% of total billed charges,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,93.8,100,,,fee schedule,100% of fee schedule,93.8,508.31,
Lac Repair-PRO Supf.Nonface;12.6-20cm,4541,CDM,981,RC,12005,HCPCS,outpatient,,,564.79,423.59,,133.06,130,,,fee schedule,130% of fee schedule,133.06,130,,,fee schedule,130% of fee schedule,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,119.33,119,,,fee schedule,119% of fee schedule,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,100% of fee schedule,508.31,90,,,percent of total billed charges,90% of total billed charges,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,93.8,100,,,fee schedule,100% of fee schedule,93.8,508.31,
Lac Repair Supf.Nonface; 20.1-30.0cm [Package],4542,CDM,521,RC,12006,HCPCS,outpatient,,,509.71,382.28,,458.74,90,,,percent of total billed charges,90% of total billed charges,474.03,93,,,percent of total billed charges,93% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,433.25,85,,,percent of total billed charges,85% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,414.9,81.4,,,percent of total billed charges,81.4% of total billed charges,458.74,90,,,percent of total billed charges,90% of total billed charges,458.74,90,,,percent of total billed charges,90% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,193.69,38,,,percent of total billed charges,38% of total billed charges,382.28,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,193.69,474.03,
Lac Repair-PRO Supf.Nonface; 20.1-30.0cm,4543,CDM,981,RC,12006,HCPCS,outpatient,,,700.72,525.54,,163.01,130,,,fee schedule,130% of fee schedule,163.01,130,,,fee schedule,130% of fee schedule,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.25,119,,,fee schedule,119% of fee schedule,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,100% of fee schedule,630.65,90,,,percent of total billed charges,90% of total billed charges,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,115.52,100,,,fee schedule,100% of fee schedule,115.52,630.65,
Lac Repair-PRO Supf.Nonface; 20.1-30.0cm,4544,CDM,981,RC,12006,HCPCS,outpatient,,,700.72,525.54,,163.01,130,,,fee schedule,130% of fee schedule,163.01,130,,,fee schedule,130% of fee schedule,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.25,119,,,fee schedule,119% of fee schedule,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,100% of fee schedule,630.65,90,,,percent of total billed charges,90% of total billed charges,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,115.52,100,,,fee schedule,100% of fee schedule,115.52,630.65,
"Suture-Sup.wounds(sc,n,ax,EG,tr,fe,ha); Over 30.0cm",4545,CDM,521,RC,12007,HCPCS,outpatient,,,582.38,436.79,,524.14,90,,,percent of total billed charges,90% of total billed charges,541.61,93,,,percent of total billed charges,93% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,495.02,85,,,percent of total billed charges,85% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,474.06,81.4,,,percent of total billed charges,81.4% of total billed charges,524.14,90,,,percent of total billed charges,90% of total billed charges,524.14,90,,,percent of total billed charges,90% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,221.3,38,,,percent of total billed charges,38% of total billed charges,436.79,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,221.3,541.61,
"Suture-Sup.wounds(sc,n,ax,EG,tr,fe,ha);Over 30cm-PRO",4546,CDM,981,RC,12007,HCPCS,outpatient,,,790.95,593.21,,196.9,130,,,fee schedule,130% of fee schedule,196.9,130,,,fee schedule,130% of fee schedule,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,180.57,119,,,fee schedule,119% of fee schedule,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,100% of fee schedule,711.86,90,,,percent of total billed charges,90% of total billed charges,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,143.77,100,,,fee schedule,100% of fee schedule,143.77,711.86,
"Suture-Sup.wounds(sc,n,ax,EG,tr,fe,ha);Over 30cm-PRO",4547,CDM,981,RC,12007,HCPCS,outpatient,,,790.95,593.21,,196.9,130,,,fee schedule,130% of fee schedule,196.9,130,,,fee schedule,130% of fee schedule,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,180.57,119,,,fee schedule,119% of fee schedule,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,100% of fee schedule,711.86,90,,,percent of total billed charges,90% of total billed charges,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,143.77,100,,,fee schedule,100% of fee schedule,143.77,711.86,
Lac Repair Supf. Face/Head; <2.5 cm[Package],4548,CDM,521,RC,12011,HCPCS,outpatient,,,254.29,190.72,,228.86,90,,,percent of total billed charges,90% of total billed charges,236.49,93,,,percent of total billed charges,93% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,216.15,85,,,percent of total billed charges,85% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,206.99,81.4,,,percent of total billed charges,81.4% of total billed charges,228.86,90,,,percent of total billed charges,90% of total billed charges,228.86,90,,,percent of total billed charges,90% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,96.63,38,,,percent of total billed charges,38% of total billed charges,190.72,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,96.63,236.49,
Lac Repair Supf. Face/Head PRO; <2.5 cm,4549,CDM,981,RC,12011,HCPCS,outpatient,,,386.67,290,,74.46,130,,,fee schedule,130% of fee schedule,74.46,130,,,fee schedule,130% of fee schedule,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,69.64,119,,,fee schedule,119% of fee schedule,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,100% of fee schedule,348,90,,,percent of total billed charges,90% of total billed charges,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,55,100,,,fee schedule,100% of fee schedule,55,348,
Lac Repair Supf. Face/Head PRO; <2.5 cm,4550,CDM,981,RC,12011,HCPCS,outpatient,,,386.67,290,,74.46,130,,,fee schedule,130% of fee schedule,74.46,130,,,fee schedule,130% of fee schedule,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,69.64,119,,,fee schedule,119% of fee schedule,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,100% of fee schedule,348,90,,,percent of total billed charges,90% of total billed charges,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,55,100,,,fee schedule,100% of fee schedule,55,348,
Lac Repair Supf. Face/Head;2.6-5.0cm[Package],4551,CDM,521,RC,12013,HCPCS,outpatient,,,291.77,218.83,,262.59,90,,,percent of total billed charges,90% of total billed charges,271.35,93,,,percent of total billed charges,93% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,248,85,,,percent of total billed charges,85% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,237.5,81.4,,,percent of total billed charges,81.4% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,218.83,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,110.87,271.35,
Lac Repair Supf. Face/Head PRO; 2.6-5.0cm,4552,CDM,981,RC,12013,HCPCS,outpatient,,,426.54,319.91,,82.86,130,,,fee schedule,130% of fee schedule,82.86,130,,,fee schedule,130% of fee schedule,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,73.26,119,,,fee schedule,119% of fee schedule,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,100% of fee schedule,383.89,90,,,percent of total billed charges,90% of total billed charges,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,57.9,100,,,fee schedule,100% of fee schedule,57.9,383.89,
Lac Repair Supf. Face/Head PRO; 2.6-5.0cm,4553,CDM,981,RC,12013,HCPCS,outpatient,,,426.54,319.91,,82.86,130,,,fee schedule,130% of fee schedule,82.86,130,,,fee schedule,130% of fee schedule,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,73.26,119,,,fee schedule,119% of fee schedule,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,100% of fee schedule,383.89,90,,,percent of total billed charges,90% of total billed charges,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,57.9,100,,,fee schedule,100% of fee schedule,57.9,383.89,
Lac Repair Supf. Face/Head;5.1-7.5cm[Package],4554,CDM,521,RC,12014,HCPCS,outpatient,,,350.36,262.77,,315.32,90,,,percent of total billed charges,90% of total billed charges,325.83,93,,,percent of total billed charges,93% of total billed charges,133.14,38,,,percent of total billed charges,38% of total billed charges,133.14,38,,,percent of total billed charges,38% of total billed charges,297.81,85,,,percent of total billed charges,85% of total billed charges,133.14,38,,,percent of total billed charges,38% of total billed charges,285.19,81.4,,,percent of total billed charges,81.4% of total billed charges,315.32,90,,,percent of total billed charges,90% of total billed charges,315.32,90,,,percent of total billed charges,90% of total billed charges,133.14,38,,,percent of total billed charges,38% of total billed charges,133.14,38,,,percent of total billed charges,38% of total billed charges,133.14,38,,,percent of total billed charges,38% of total billed charges,262.77,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,133.14,325.83,
Lac Repair Supf. Face/Head PRO;5.1-7.5cm,4555,CDM,981,RC,12014,HCPCS,outpatient,,,497.99,373.49,,105.74,130,,,fee schedule,130% of fee schedule,105.74,130,,,fee schedule,130% of fee schedule,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,93.72,119,,,fee schedule,119% of fee schedule,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,100% of fee schedule,448.19,90,,,percent of total billed charges,90% of total billed charges,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,74.02,100,,,fee schedule,100% of fee schedule,74.02,448.19,
Lac Repair Supf. Face/Head PRO;5.1-7.5cm,4556,CDM,981,RC,12014,HCPCS,outpatient,,,497.99,373.49,,105.74,130,,,fee schedule,130% of fee schedule,105.74,130,,,fee schedule,130% of fee schedule,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,93.72,119,,,fee schedule,119% of fee schedule,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,100% of fee schedule,448.19,90,,,percent of total billed charges,90% of total billed charges,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,74.02,100,,,fee schedule,100% of fee schedule,74.02,448.19,
Lac Repair Supf. Face/Head;7.6-12.5cm[Package],4557,CDM,521,RC,12015,HCPCS,outpatient,,,438.24,328.68,,394.42,90,,,percent of total billed charges,90% of total billed charges,407.56,93,,,percent of total billed charges,93% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,372.5,85,,,percent of total billed charges,85% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,356.73,81.4,,,percent of total billed charges,81.4% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,328.68,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,166.53,407.56,
Lac Repair Supf. Face/Head PRO;7.6-12.5cm,4558,CDM,981,RC,12015,HCPCS,outpatient,,,625.71,469.28,,130.75,130,,,fee schedule,130% of fee schedule,130.75,130,,,fee schedule,130% of fee schedule,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,118.43,119,,,fee schedule,119% of fee schedule,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,100% of fee schedule,563.14,90,,,percent of total billed charges,90% of total billed charges,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,93.35,100,,,fee schedule,100% of fee schedule,93.35,563.14,
Lac Repair Supf. Face/Head PRO;7.6-12.5cm,4559,CDM,981,RC,12015,HCPCS,outpatient,,,625.71,469.28,,130.75,130,,,fee schedule,130% of fee schedule,130.75,130,,,fee schedule,130% of fee schedule,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,118.43,119,,,fee schedule,119% of fee schedule,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,100% of fee schedule,563.14,90,,,percent of total billed charges,90% of total billed charges,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,93.35,100,,,fee schedule,100% of fee schedule,93.35,563.14,
"Suture-Sup. wound(simple,fa,ea,ey,no,li,mm);12.6-20.0cm",4560,CDM,521,RC,12016,HCPCS,outpatient,,,534.33,400.75,,480.9,90,,,percent of total billed charges,90% of total billed charges,496.93,93,,,percent of total billed charges,93% of total billed charges,203.05,38,,,percent of total billed charges,38% of total billed charges,203.05,38,,,percent of total billed charges,38% of total billed charges,454.18,85,,,percent of total billed charges,85% of total billed charges,203.05,38,,,percent of total billed charges,38% of total billed charges,434.94,81.4,,,percent of total billed charges,81.4% of total billed charges,480.9,90,,,percent of total billed charges,90% of total billed charges,480.9,90,,,percent of total billed charges,90% of total billed charges,203.05,38,,,percent of total billed charges,38% of total billed charges,203.05,38,,,percent of total billed charges,38% of total billed charges,203.05,38,,,percent of total billed charges,38% of total billed charges,400.75,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,203.05,496.93,
"Suture-Sup.wound(simple,fa,ea,ey,no,li,mm);12.6-20cm-PRO",4561,CDM,981,RC,12016,HCPCS,outpatient,,,726.5,544.88,,178.27,130,,,fee schedule,130% of fee schedule,178.27,130,,,fee schedule,130% of fee schedule,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,160.59,119,,,fee schedule,119% of fee schedule,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,100% of fee schedule,653.85,90,,,percent of total billed charges,90% of total billed charges,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,126.75,100,,,fee schedule,100% of fee schedule,126.75,653.85,
"Suture-Sup.wound(simple,fa,ea,ey,no,li,mm);12.6-20cm-PRO",4562,CDM,981,RC,12016,HCPCS,outpatient,,,726.5,544.88,,178.27,130,,,fee schedule,130% of fee schedule,178.27,130,,,fee schedule,130% of fee schedule,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,160.59,119,,,fee schedule,119% of fee schedule,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,100% of fee schedule,653.85,90,,,percent of total billed charges,90% of total billed charges,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.75,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,126.75,100,,,fee schedule,100% of fee schedule,126.75,653.85,
Lac Repair Supf Head/Face;20.1-30.0cm,4563,CDM,521,RC,12017,HCPCS,outpatient,,,644.49,483.37,,580.04,90,,,percent of total billed charges,90% of total billed charges,599.38,93,,,percent of total billed charges,93% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,547.82,85,,,percent of total billed charges,85% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,524.61,81.4,,,percent of total billed charges,81.4% of total billed charges,580.04,90,,,percent of total billed charges,90% of total billed charges,580.04,90,,,percent of total billed charges,90% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,483.37,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,244.91,599.38,
Lac Repair Supf Head/Face PRO;20.1-30.0cm,4564,CDM,981,RC,12017,HCPCS,outpatient,,,386.67,290,,197.51,130,,,fee schedule,130% of fee schedule,197.51,130,,,fee schedule,130% of fee schedule,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,190.77,119,,,fee schedule,119% of fee schedule,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,100% of fee schedule,348,90,,,percent of total billed charges,90% of total billed charges,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,152.09,100,,,fee schedule,100% of fee schedule,152.09,348,
Lac Repair Supf Head/Face PRO;20.1-30.0cm,4565,CDM,981,RC,12017,HCPCS,outpatient,,,386.67,290,,197.51,130,,,fee schedule,130% of fee schedule,197.51,130,,,fee schedule,130% of fee schedule,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,190.77,119,,,fee schedule,119% of fee schedule,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,100% of fee schedule,348,90,,,percent of total billed charges,90% of total billed charges,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,152.09,100,,,fee schedule,100% of fee schedule,152.09,348,
Lac Repair Supf Head/Face;< 30.0cm,4566,CDM,521,RC,12018,HCPCS,outpatient,,,774.56,580.92,,697.1,90,,,percent of total billed charges,90% of total billed charges,720.34,93,,,percent of total billed charges,93% of total billed charges,294.33,38,,,percent of total billed charges,38% of total billed charges,294.33,38,,,percent of total billed charges,38% of total billed charges,658.38,85,,,percent of total billed charges,85% of total billed charges,294.33,38,,,percent of total billed charges,38% of total billed charges,630.49,81.4,,,percent of total billed charges,81.4% of total billed charges,697.1,90,,,percent of total billed charges,90% of total billed charges,697.1,90,,,percent of total billed charges,90% of total billed charges,294.33,38,,,percent of total billed charges,38% of total billed charges,294.33,38,,,percent of total billed charges,38% of total billed charges,294.33,38,,,percent of total billed charges,38% of total billed charges,580.92,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,294.33,720.34,
Lac Repair-PRO Supf Head/Face;< 30.0cm,4567,CDM,981,RC,12018,HCPCS,outpatient,,,465.2,348.9,,223.81,130,,,fee schedule,130% of fee schedule,223.81,130,,,fee schedule,130% of fee schedule,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,216.23,119,,,fee schedule,119% of fee schedule,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,100% of fee schedule,418.68,90,,,percent of total billed charges,90% of total billed charges,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,171.66,100,,,fee schedule,100% of fee schedule,171.66,418.68,
Lac Repair-PRO Supf Head/Face;< 30.0cm,4568,CDM,981,RC,12018,HCPCS,outpatient,,,465.2,348.9,,223.81,130,,,fee schedule,130% of fee schedule,223.81,130,,,fee schedule,130% of fee schedule,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,216.23,119,,,fee schedule,119% of fee schedule,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,100% of fee schedule,418.68,90,,,percent of total billed charges,90% of total billed charges,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,171.66,100,,,fee schedule,100% of fee schedule,171.66,418.68,
Sup. Wound Dehis Simp.,4569,CDM,521,RC,12020,HCPCS,outpatient,,,458.18,343.64,,412.36,90,,,percent of total billed charges,90% of total billed charges,426.11,93,,,percent of total billed charges,93% of total billed charges,174.11,38,,,percent of total billed charges,38% of total billed charges,174.11,38,,,percent of total billed charges,38% of total billed charges,389.45,85,,,percent of total billed charges,85% of total billed charges,174.11,38,,,percent of total billed charges,38% of total billed charges,372.96,81.4,,,percent of total billed charges,81.4% of total billed charges,412.36,90,,,percent of total billed charges,90% of total billed charges,412.36,90,,,percent of total billed charges,90% of total billed charges,174.11,38,,,percent of total billed charges,38% of total billed charges,174.11,38,,,percent of total billed charges,38% of total billed charges,174.11,38,,,percent of total billed charges,38% of total billed charges,343.64,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,174.11,426.11,
WND Closure wound dehis simp-PRO,4570,CDM,982,RC,12020,HCPCS,outpatient,,,394.16,295.62,,246.96,130,,,fee schedule,130% of fee schedule,246.96,130,,,fee schedule,130% of fee schedule,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,234.74,119,,,fee schedule,119% of fee schedule,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,100% of fee schedule,354.74,90,,,percent of total billed charges,90% of total billed charges,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,192.21,100,,,fee schedule,100% of fee schedule,114.98,354.74,
Sup. Wound Dehis Simp.-PRO,4571,CDM,981,RC,12020,HCPCS,outpatient,,,273.02,204.77,,246.96,130,,,fee schedule,130% of fee schedule,246.96,130,,,fee schedule,130% of fee schedule,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,234.74,119,,,fee schedule,119% of fee schedule,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,100% of fee schedule,245.72,90,,,percent of total billed charges,90% of total billed charges,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,192.21,100,,,fee schedule,100% of fee schedule,114.98,246.96,
Sup. Wound Dehis Simp.-PRO,4572,CDM,981,RC,12020,HCPCS,outpatient,,,273.02,204.77,,246.96,130,,,fee schedule,130% of fee schedule,246.96,130,,,fee schedule,130% of fee schedule,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,234.74,119,,,fee schedule,119% of fee schedule,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,100% of fee schedule,245.72,90,,,percent of total billed charges,90% of total billed charges,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,192.21,100,,,fee schedule,100% of fee schedule,114.98,246.96,
Sup. wound Dehis.; w/ Pack,4573,CDM,521,RC,12021,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.46,309.49,
WND Closure of wound dehis w/pack PRO,4574,CDM,982,RC,12021,HCPCS,outpatient,,,225.23,168.92,,183.92,130,,,fee schedule,130% of fee schedule,183.92,130,,,fee schedule,130% of fee schedule,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,173.45,119,,,fee schedule,119% of fee schedule,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,100% of fee schedule,202.71,90,,,percent of total billed charges,90% of total billed charges,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,144.34,100,,,fee schedule,100% of fee schedule,144.34,202.71,
Sup. wound Dehis.; w/ Pack-PRO,4575,CDM,981,RC,12021,HCPCS,outpatient,,,200.38,150.29,,183.92,130,,,fee schedule,130% of fee schedule,183.92,130,,,fee schedule,130% of fee schedule,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,173.45,119,,,fee schedule,119% of fee schedule,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,144.34,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,144.34,100,,,fee schedule,100% of fee schedule,144.34,183.92,
Lac Repair Intermed. Nonface;2.5cm or <[Package],4576,CDM,521,RC,12031,HCPCS,outpatient,,,353.87,265.4,,318.48,90,,,percent of total billed charges,90% of total billed charges,329.1,93,,,percent of total billed charges,93% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,300.79,85,,,percent of total billed charges,85% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,288.05,81.4,,,percent of total billed charges,81.4% of total billed charges,318.48,90,,,percent of total billed charges,90% of total billed charges,318.48,90,,,percent of total billed charges,90% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,134.47,38,,,percent of total billed charges,38% of total billed charges,265.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,134.47,329.1,
DERM LAC REPAIR INTERMED. NONFACE; 2.5CM OR < - PRO,4577,CDM,982,RC,12031,HCPCS,outpatient,,,328.97,246.73,,220.66,130,,,fee schedule,130% of fee schedule,220.66,130,,,fee schedule,130% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,189.16,119,,,fee schedule,119% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,100% of fee schedule,296.07,90,,,percent of total billed charges,90% of total billed charges,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,155.27,100,,,fee schedule,100% of fee schedule,86.23,296.07,
WND Lac Repair-Intermed. Nonface;2.5cm or < PRO,4578,CDM,982,RC,12031,HCPCS,outpatient,,,450.46,337.85,,220.66,130,,,fee schedule,130% of fee schedule,220.66,130,,,fee schedule,130% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,189.16,119,,,fee schedule,119% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,100% of fee schedule,405.41,90,,,percent of total billed charges,90% of total billed charges,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,155.27,100,,,fee schedule,100% of fee schedule,86.23,405.41,
Lac Repair-PRO Intermed. Nonface;2.5cm or <,4579,CDM,981,RC,12031,HCPCS,outpatient,,,535.49,401.62,,220.66,130,,,fee schedule,130% of fee schedule,220.66,130,,,fee schedule,130% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,189.16,119,,,fee schedule,119% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,100% of fee schedule,481.94,90,,,percent of total billed charges,90% of total billed charges,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,155.27,100,,,fee schedule,100% of fee schedule,86.23,481.94,
Lac Repair-PRO Intermed. Nonface;2.5cm or <,4580,CDM,981,RC,12031,HCPCS,outpatient,,,535.49,401.62,,220.66,130,,,fee schedule,130% of fee schedule,220.66,130,,,fee schedule,130% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,189.16,119,,,fee schedule,119% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,100% of fee schedule,481.94,90,,,percent of total billed charges,90% of total billed charges,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,155.27,100,,,fee schedule,100% of fee schedule,86.23,481.94,
Lac Repair Intermed. Nonface;2.6-7.5cm[Package],4581,CDM,521,RC,12032,HCPCS,outpatient,,,453.48,340.11,,408.13,90,,,percent of total billed charges,90% of total billed charges,421.74,93,,,percent of total billed charges,93% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,385.46,85,,,percent of total billed charges,85% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,369.13,81.4,,,percent of total billed charges,81.4% of total billed charges,408.13,90,,,percent of total billed charges,90% of total billed charges,408.13,90,,,percent of total billed charges,90% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,340.11,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,172.32,421.74,
DERM LAC REPAIR INTERMED. NONFACE; 2.6-7 - PRO,4582,CDM,982,RC,12032,HCPCS,outpatient,,,424.48,318.36,,262,130,,,fee schedule,130% of fee schedule,262,130,,,fee schedule,130% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,237.17,119,,,fee schedule,119% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,100% of fee schedule,382.03,90,,,percent of total billed charges,90% of total billed charges,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,194.35,100,,,fee schedule,100% of fee schedule,122.16,382.03,
DERM Lac Repair Intermed. Nonface;2.6-7.5cm-G,4583,CDM,982,RC,12032,HCPCS,outpatient,,,742.85,557.14,,262,130,,,fee schedule,130% of fee schedule,262,130,,,fee schedule,130% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,237.17,119,,,fee schedule,119% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,100% of fee schedule,668.57,90,,,percent of total billed charges,90% of total billed charges,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,194.35,100,,,fee schedule,100% of fee schedule,122.16,668.57,
WND Lac Repair Intermed. Nonface;2.6-7.5cm PRO,4584,CDM,982,RC,12032,HCPCS,outpatient,,,546.18,409.64,,262,130,,,fee schedule,130% of fee schedule,262,130,,,fee schedule,130% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,237.17,119,,,fee schedule,119% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,100% of fee schedule,491.56,90,,,percent of total billed charges,90% of total billed charges,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,194.35,100,,,fee schedule,100% of fee schedule,122.16,491.56,
Lac Repair-PRO Intermed. Nonface;2.6-7.5cm,4585,CDM,981,RC,12032,HCPCS,outpatient,,,715.96,536.97,,262,130,,,fee schedule,130% of fee schedule,262,130,,,fee schedule,130% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,237.17,119,,,fee schedule,119% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,100% of fee schedule,644.36,90,,,percent of total billed charges,90% of total billed charges,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,194.35,100,,,fee schedule,100% of fee schedule,122.16,644.36,
Lac Repair-PRO Intermed. Nonface;2.6-7.5cm,4586,CDM,981,RC,12032,HCPCS,outpatient,,,715.96,536.97,,262,130,,,fee schedule,130% of fee schedule,262,130,,,fee schedule,130% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,237.17,119,,,fee schedule,119% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,100% of fee schedule,644.36,90,,,percent of total billed charges,90% of total billed charges,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,194.35,100,,,fee schedule,100% of fee schedule,122.16,644.36,
Lac Repair Intermed. Nonface;7.6-12.5cm[Package],4587,CDM,521,RC,12034,HCPCS,outpatient,,,471.06,353.3,,423.95,90,,,percent of total billed charges,90% of total billed charges,438.09,93,,,percent of total billed charges,93% of total billed charges,179,38,,,percent of total billed charges,38% of total billed charges,179,38,,,percent of total billed charges,38% of total billed charges,400.4,85,,,percent of total billed charges,85% of total billed charges,179,38,,,percent of total billed charges,38% of total billed charges,383.44,81.4,,,percent of total billed charges,81.4% of total billed charges,423.95,90,,,percent of total billed charges,90% of total billed charges,423.95,90,,,percent of total billed charges,90% of total billed charges,179,38,,,percent of total billed charges,38% of total billed charges,179,38,,,percent of total billed charges,38% of total billed charges,179,38,,,percent of total billed charges,38% of total billed charges,353.3,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,179,438.09,
DERM LAC REPAIR INTERMED. NONFACE; 7.6-12.5CM - PRO,4588,CDM,982,RC,12034,HCPCS,outpatient,,,451.01,338.26,,274.81,130,,,fee schedule,130% of fee schedule,274.81,130,,,fee schedule,130% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,255.72,119,,,fee schedule,119% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,100% of fee schedule,405.91,90,,,percent of total billed charges,90% of total billed charges,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,209.08,100,,,fee schedule,100% of fee schedule,158.09,405.91,
DERM Lac Repair Intermed. Nonface;7.6-12.5cm-G,4589,CDM,982,RC,12034,HCPCS,outpatient,,,894.6,670.95,,274.81,130,,,fee schedule,130% of fee schedule,274.81,130,,,fee schedule,130% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,255.72,119,,,fee schedule,119% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,100% of fee schedule,805.14,90,,,percent of total billed charges,90% of total billed charges,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,209.08,100,,,fee schedule,100% of fee schedule,158.09,805.14,
WND Lac Repair Intermed. Nonface;7.6-12.5cm PRO,4590,CDM,982,RC,12034,HCPCS,outpatient,,,563.07,422.3,,274.81,130,,,fee schedule,130% of fee schedule,274.81,130,,,fee schedule,130% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,255.72,119,,,fee schedule,119% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,100% of fee schedule,506.76,90,,,percent of total billed charges,90% of total billed charges,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,209.08,100,,,fee schedule,100% of fee schedule,158.09,506.76,
Lac Repair-PRO Intermed. Nonface;7.6-12.5cm,4591,CDM,981,RC,12034,HCPCS,outpatient,,,895.24,671.43,,274.81,130,,,fee schedule,130% of fee schedule,274.81,130,,,fee schedule,130% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,255.72,119,,,fee schedule,119% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,100% of fee schedule,805.72,90,,,percent of total billed charges,90% of total billed charges,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,209.08,100,,,fee schedule,100% of fee schedule,158.09,805.72,
Lac Repair-PRO Intermed. Nonface;7.6-12.5cm,4592,CDM,981,RC,12034,HCPCS,outpatient,,,895.24,671.43,,274.81,130,,,fee schedule,130% of fee schedule,274.81,130,,,fee schedule,130% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,255.72,119,,,fee schedule,119% of fee schedule,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,100% of fee schedule,805.72,90,,,percent of total billed charges,90% of total billed charges,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,209.08,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,209.08,100,,,fee schedule,100% of fee schedule,158.09,805.72,
Lac Repair Intermed. Nonface;12.6-20.0cm[Package],4593,CDM,521,RC,12035,HCPCS,outpatient,,,569.49,427.12,,512.54,90,,,percent of total billed charges,90% of total billed charges,529.63,93,,,percent of total billed charges,93% of total billed charges,216.41,38,,,percent of total billed charges,38% of total billed charges,216.41,38,,,percent of total billed charges,38% of total billed charges,484.07,85,,,percent of total billed charges,85% of total billed charges,216.41,38,,,percent of total billed charges,38% of total billed charges,463.56,81.4,,,percent of total billed charges,81.4% of total billed charges,512.54,90,,,percent of total billed charges,90% of total billed charges,512.54,90,,,percent of total billed charges,90% of total billed charges,216.41,38,,,percent of total billed charges,38% of total billed charges,216.41,38,,,percent of total billed charges,38% of total billed charges,216.41,38,,,percent of total billed charges,38% of total billed charges,427.12,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,216.41,529.63,
WND Lac Repair Intermed. Nonface;12.6-20.0cm PRO,4594,CDM,982,RC,12035,HCPCS,outpatient,,,675.69,506.77,,314.35,130,,,fee schedule,130% of fee schedule,314.35,130,,,fee schedule,130% of fee schedule,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,299.51,119,,,fee schedule,119% of fee schedule,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,100% of fee schedule,608.12,90,,,percent of total billed charges,90% of total billed charges,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,244.65,100,,,fee schedule,100% of fee schedule,194.02,608.12,
Lac Repair-PRO Intermed. Nonface;12.6-20.0cm,4595,CDM,981,RC,12035,HCPCS,outpatient,,,895.24,671.43,,314.35,130,,,fee schedule,130% of fee schedule,314.35,130,,,fee schedule,130% of fee schedule,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,299.51,119,,,fee schedule,119% of fee schedule,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,100% of fee schedule,805.72,90,,,percent of total billed charges,90% of total billed charges,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,244.65,100,,,fee schedule,100% of fee schedule,194.02,805.72,
Lac Repair-PRO Intermed. Nonface;12.6-20.0cm,4596,CDM,981,RC,12035,HCPCS,outpatient,,,895.24,671.43,,314.35,130,,,fee schedule,130% of fee schedule,314.35,130,,,fee schedule,130% of fee schedule,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,299.51,119,,,fee schedule,119% of fee schedule,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,100% of fee schedule,805.72,90,,,percent of total billed charges,90% of total billed charges,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,244.65,100,,,fee schedule,100% of fee schedule,194.02,805.72,
Lac Repair Intermed. Nonface;20.1-30.0cm[Package],4597,CDM,521,RC,12036,HCPCS,outpatient,,,662.06,496.55,,595.85,90,,,percent of total billed charges,90% of total billed charges,615.72,93,,,percent of total billed charges,93% of total billed charges,251.58,38,,,percent of total billed charges,38% of total billed charges,251.58,38,,,percent of total billed charges,38% of total billed charges,562.75,85,,,percent of total billed charges,85% of total billed charges,251.58,38,,,percent of total billed charges,38% of total billed charges,538.92,81.4,,,percent of total billed charges,81.4% of total billed charges,595.85,90,,,percent of total billed charges,90% of total billed charges,595.85,90,,,percent of total billed charges,90% of total billed charges,251.58,38,,,percent of total billed charges,38% of total billed charges,251.58,38,,,percent of total billed charges,38% of total billed charges,251.58,38,,,percent of total billed charges,38% of total billed charges,496.55,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,251.58,615.72,
WND Lac Repair Intermed Nonface;20.1-30cm PRO,4598,CDM,982,RC,12036,HCPCS,outpatient,,,816.48,612.36,,359.66,130,,,fee schedule,130% of fee schedule,359.66,130,,,fee schedule,130% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,350.94,119,,,fee schedule,119% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,100% of fee schedule,734.83,90,,,percent of total billed charges,90% of total billed charges,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,284.52,100,,,fee schedule,100% of fee schedule,229.95,734.83,
Lac Repair-PRO Intermed. Nonface; 20.1-30cm,4599,CDM,981,RC,12036,HCPCS,outpatient,,,987.8,740.85,,359.66,130,,,fee schedule,130% of fee schedule,359.66,130,,,fee schedule,130% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,350.94,119,,,fee schedule,119% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,100% of fee schedule,889.02,90,,,percent of total billed charges,90% of total billed charges,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,284.52,100,,,fee schedule,100% of fee schedule,229.95,889.02,
Lac Repair-PRO Intermed. Nonface; 20.1-30cm,4600,CDM,981,RC,12036,HCPCS,outpatient,,,987.8,740.85,,359.66,130,,,fee schedule,130% of fee schedule,359.66,130,,,fee schedule,130% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,350.94,119,,,fee schedule,119% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,100% of fee schedule,889.02,90,,,percent of total billed charges,90% of total billed charges,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,284.52,100,,,fee schedule,100% of fee schedule,229.95,889.02,
Lac Repair-PRO Intermed. Nonface; 20.1-30cm,4601,CDM,981,RC,12036,HCPCS,outpatient,,,987.8,740.85,,359.66,130,,,fee schedule,130% of fee schedule,359.66,130,,,fee schedule,130% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,350.94,119,,,fee schedule,119% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,100% of fee schedule,889.02,90,,,percent of total billed charges,90% of total billed charges,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,284.52,100,,,fee schedule,100% of fee schedule,229.95,889.02,
Lac Repair Intermed. Nonface;< 30.0cm[Package],4602,CDM,521,RC,12037,HCPCS,outpatient,,,771.03,578.27,,693.93,90,,,percent of total billed charges,90% of total billed charges,717.06,93,,,percent of total billed charges,93% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,655.38,85,,,percent of total billed charges,85% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,627.62,81.4,,,percent of total billed charges,81.4% of total billed charges,693.93,90,,,percent of total billed charges,90% of total billed charges,693.93,90,,,percent of total billed charges,90% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,578.27,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,292.99,717.06,
WND Lac Repair- Intermed Nonface< 30.0cm PRO,4603,CDM,982,RC,12037,HCPCS,outpatient,,,900.94,675.71,,416.03,130,,,fee schedule,130% of fee schedule,416.03,130,,,fee schedule,130% of fee schedule,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,410.09,119,,,fee schedule,119% of fee schedule,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,100% of fee schedule,810.85,90,,,percent of total billed charges,90% of total billed charges,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,265.88,100,,,fee schedule,100% of fee schedule,330.28,100,,,fee schedule,100% of fee schedule,265.88,810.85,
Lac Repair-PRO Intermed. Nonface;< 30.0cm,4604,CDM,981,RC,12037,HCPCS,outpatient,,,1103.81,827.86,,416.03,130,,,fee schedule,130% of fee schedule,416.03,130,,,fee schedule,130% of fee schedule,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,410.09,119,,,fee schedule,119% of fee schedule,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,100% of fee schedule,993.43,90,,,percent of total billed charges,90% of total billed charges,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,265.88,100,,,fee schedule,100% of fee schedule,330.28,100,,,fee schedule,100% of fee schedule,265.88,993.43,
Lac Repair-PRO Intermed. Nonface;< 30.0cm,4605,CDM,981,RC,12037,HCPCS,outpatient,,,1103.81,827.86,,416.03,130,,,fee schedule,130% of fee schedule,416.03,130,,,fee schedule,130% of fee schedule,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,410.09,119,,,fee schedule,119% of fee schedule,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,100% of fee schedule,993.43,90,,,percent of total billed charges,90% of total billed charges,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,265.88,100,,,fee schedule,100% of fee schedule,330.28,100,,,fee schedule,100% of fee schedule,265.88,993.43,
Lac Repair Intermed. Head/Face;2.5 cm or <[Package],4606,CDM,521,RC,12041,HCPCS,outpatient,,,381.99,286.49,,343.79,90,,,percent of total billed charges,90% of total billed charges,355.25,93,,,percent of total billed charges,93% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,310.94,81.4,,,percent of total billed charges,81.4% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,286.49,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,145.16,355.25,
DERM LAC REPAIR INTERMED. HEAD/FACE; 2.5CM OR < - PRO,4607,CDM,982,RC,12041,HCPCS,outpatient,,,297.14,222.86,,233.92,130,,,fee schedule,130% of fee schedule,233.92,130,,,fee schedule,130% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,119,,,fee schedule,119% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,100% of fee schedule,267.43,90,,,percent of total billed charges,90% of total billed charges,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,147.92,100,,,fee schedule,100% of fee schedule,100.6,267.43,
DERM LAC REPAIR INTERMED. HEAD/FACE; 2.5CM OR < - G,4608,CDM,982,RC,12041,HCPCS,outpatient,,,827.74,620.81,,233.92,130,,,fee schedule,130% of fee schedule,233.92,130,,,fee schedule,130% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,119,,,fee schedule,119% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,100% of fee schedule,744.97,90,,,percent of total billed charges,90% of total billed charges,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,147.92,100,,,fee schedule,100% of fee schedule,100.6,744.97,
WND Lac Repair Intermed Head/Face;2.5cm/< PRO,4609,CDM,982,RC,12041,HCPCS,outpatient,,,394.16,295.62,,233.92,130,,,fee schedule,130% of fee schedule,233.92,130,,,fee schedule,130% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,119,,,fee schedule,119% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,100% of fee schedule,354.74,90,,,percent of total billed charges,90% of total billed charges,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,147.92,100,,,fee schedule,100% of fee schedule,100.6,354.74,
Lac Repair-PRO Intermed. Head/Face;2.5cm or <,4610,CDM,981,RC,12041,HCPCS,outpatient,,,569.49,427.12,,233.92,130,,,fee schedule,130% of fee schedule,233.92,130,,,fee schedule,130% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,119,,,fee schedule,119% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,100% of fee schedule,512.54,90,,,percent of total billed charges,90% of total billed charges,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,147.92,100,,,fee schedule,100% of fee schedule,100.6,512.54,
Lac Repair-PRO Intermed. Head/Face;2.5cm or <,4611,CDM,981,RC,12041,HCPCS,outpatient,,,569.49,427.12,,233.92,130,,,fee schedule,130% of fee schedule,233.92,130,,,fee schedule,130% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,119,,,fee schedule,119% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,100% of fee schedule,512.54,90,,,percent of total billed charges,90% of total billed charges,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,147.92,100,,,fee schedule,100% of fee schedule,100.6,512.54,
Lac Repair-PRO Intermed. Head/Face;2.5cm or <,4612,CDM,981,RC,12041,HCPCS,outpatient,,,569.49,427.12,,233.92,130,,,fee schedule,130% of fee schedule,233.92,130,,,fee schedule,130% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,119,,,fee schedule,119% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,100% of fee schedule,512.54,90,,,percent of total billed charges,90% of total billed charges,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,147.92,100,,,fee schedule,100% of fee schedule,100.6,512.54,
Lac Repair Intermed. Head/Face;2.6-7.5cm[Package],4613,CDM,521,RC,12042,HCPCS,outpatient,,,453.48,340.11,,408.13,90,,,percent of total billed charges,90% of total billed charges,421.74,93,,,percent of total billed charges,93% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,385.46,85,,,percent of total billed charges,85% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,369.13,81.4,,,percent of total billed charges,81.4% of total billed charges,408.13,90,,,percent of total billed charges,90% of total billed charges,408.13,90,,,percent of total billed charges,90% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,340.11,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,172.32,421.74,
DERM LAC REPAIR INTERMED. HEAD/FACE; 2.6-7.5CM - PRO,4614,CDM,982,RC,12042,HCPCS,outpatient,,,424.48,318.36,,269.65,130,,,fee schedule,130% of fee schedule,269.65,130,,,fee schedule,130% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,244.55,119,,,fee schedule,119% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,100% of fee schedule,382.03,90,,,percent of total billed charges,90% of total billed charges,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,136.53,100,,,fee schedule,100% of fee schedule,199.46,100,,,fee schedule,100% of fee schedule,136.53,382.03,
DERM Lac Repair FAC Intermed. Head/Face;2.6-7.5cm-G,4615,CDM,982,RC,12042,HCPCS,outpatient,,,753.45,565.09,,269.65,130,,,fee schedule,130% of fee schedule,269.65,130,,,fee schedule,130% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,244.55,119,,,fee schedule,119% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,100% of fee schedule,678.11,90,,,percent of total billed charges,90% of total billed charges,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,136.53,100,,,fee schedule,100% of fee schedule,199.46,100,,,fee schedule,100% of fee schedule,136.53,678.11,
WND Lac Repair-Intermed. Head/Face;2.6-7.5 PRO,4616,CDM,982,RC,12042,HCPCS,outpatient,,,450.46,337.85,,269.65,130,,,fee schedule,130% of fee schedule,269.65,130,,,fee schedule,130% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,244.55,119,,,fee schedule,119% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,100% of fee schedule,405.41,90,,,percent of total billed charges,90% of total billed charges,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,136.53,100,,,fee schedule,100% of fee schedule,199.46,100,,,fee schedule,100% of fee schedule,136.53,405.41,
Lac Repair-PRO Intermed. Head/Face;2.6-7.5cm,4617,CDM,981,RC,12042,HCPCS,outpatient,,,674.94,506.21,,269.65,130,,,fee schedule,130% of fee schedule,269.65,130,,,fee schedule,130% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,244.55,119,,,fee schedule,119% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,100% of fee schedule,607.45,90,,,percent of total billed charges,90% of total billed charges,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,136.53,100,,,fee schedule,100% of fee schedule,199.46,100,,,fee schedule,100% of fee schedule,136.53,607.45,
Lac Repair-PRO Intermed. Head/Face;2.6-7.5cm,4618,CDM,981,RC,12042,HCPCS,outpatient,,,674.94,506.21,,269.65,130,,,fee schedule,130% of fee schedule,269.65,130,,,fee schedule,130% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,244.55,119,,,fee schedule,119% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,100% of fee schedule,607.45,90,,,percent of total billed charges,90% of total billed charges,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,136.53,100,,,fee schedule,100% of fee schedule,199.46,100,,,fee schedule,100% of fee schedule,136.53,607.45,
Lac Repair Intermed. Head/Face;7.6-12.5cm[Package],4619,CDM,521,RC,12044,HCPCS,outpatient,,,493.32,369.99,,443.99,90,,,percent of total billed charges,90% of total billed charges,458.79,93,,,percent of total billed charges,93% of total billed charges,187.46,38,,,percent of total billed charges,38% of total billed charges,187.46,38,,,percent of total billed charges,38% of total billed charges,419.32,85,,,percent of total billed charges,85% of total billed charges,187.46,38,,,percent of total billed charges,38% of total billed charges,401.56,81.4,,,percent of total billed charges,81.4% of total billed charges,443.99,90,,,percent of total billed charges,90% of total billed charges,443.99,90,,,percent of total billed charges,90% of total billed charges,187.46,38,,,percent of total billed charges,38% of total billed charges,187.46,38,,,percent of total billed charges,38% of total billed charges,187.46,38,,,percent of total billed charges,38% of total billed charges,369.99,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,187.46,458.79,
DERM LAC REPAIR INTERMED. HEAD/FACE; 7.6-12.5CM - PRO,4620,CDM,982,RC,12044,HCPCS,outpatient,,,461.62,346.22,,284.87,130,,,fee schedule,130% of fee schedule,284.87,130,,,fee schedule,130% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,266.23,119,,,fee schedule,119% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,100% of fee schedule,415.46,90,,,percent of total billed charges,90% of total billed charges,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,217.3,100,,,fee schedule,100% of fee schedule,172.46,415.46,
WND Lac Repair Intermed Head/Face7.6-12.5cm PRO,4621,CDM,982,RC,12044,HCPCS,outpatient,,,506.77,380.08,,284.87,130,,,fee schedule,130% of fee schedule,284.87,130,,,fee schedule,130% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,266.23,119,,,fee schedule,119% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,100% of fee schedule,456.09,90,,,percent of total billed charges,90% of total billed charges,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,217.3,100,,,fee schedule,100% of fee schedule,172.46,456.09,
Lac Repair-PRO Intermed. Head/Face;7.6-12.5cm,4622,CDM,981,RC,12044,HCPCS,outpatient,,,493.32,369.99,,284.87,130,,,fee schedule,130% of fee schedule,284.87,130,,,fee schedule,130% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,266.23,119,,,fee schedule,119% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,100% of fee schedule,443.99,90,,,percent of total billed charges,90% of total billed charges,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,217.3,100,,,fee schedule,100% of fee schedule,172.46,443.99,
Lac Repair-PRO Intermed. Head/Face;7.6-12.5cm,4623,CDM,981,RC,12044,HCPCS,outpatient,,,493.32,369.99,,284.87,130,,,fee schedule,130% of fee schedule,284.87,130,,,fee schedule,130% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,266.23,119,,,fee schedule,119% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,100% of fee schedule,443.99,90,,,percent of total billed charges,90% of total billed charges,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,217.3,100,,,fee schedule,100% of fee schedule,172.46,443.99,
Lac Repair Intermed. Head/Face;12.6-20cm[Package],4624,CDM,521,RC,12045,HCPCS,outpatient,,,591.74,443.81,,532.57,90,,,percent of total billed charges,90% of total billed charges,550.32,93,,,percent of total billed charges,93% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,481.68,81.4,,,percent of total billed charges,81.4% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,443.81,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,224.86,550.32,
WND Lac Repair Intermed Head/Face12.6-20cm PRO,4625,CDM,982,RC,12045,HCPCS,outpatient,,,675.69,506.77,,320.49,130,,,fee schedule,130% of fee schedule,320.49,130,,,fee schedule,130% of fee schedule,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,335.43,119,,,fee schedule,119% of fee schedule,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,100% of fee schedule,608.12,90,,,percent of total billed charges,90% of total billed charges,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,208.39,100,,,fee schedule,100% of fee schedule,279.95,100,,,fee schedule,100% of fee schedule,208.39,608.12,
Lac Repair-PRO Intermed. Head/Face;12.6-20cm,4626,CDM,981,RC,12045,HCPCS,outpatient,,,906.95,680.21,,320.49,130,,,fee schedule,130% of fee schedule,320.49,130,,,fee schedule,130% of fee schedule,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,335.43,119,,,fee schedule,119% of fee schedule,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,100% of fee schedule,816.26,90,,,percent of total billed charges,90% of total billed charges,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,208.39,100,,,fee schedule,100% of fee schedule,279.95,100,,,fee schedule,100% of fee schedule,208.39,816.26,
Lac Repair-PRO Intermed. Head/Face;12.6-20cm,4627,CDM,981,RC,12045,HCPCS,outpatient,,,906.95,680.21,,320.49,130,,,fee schedule,130% of fee schedule,320.49,130,,,fee schedule,130% of fee schedule,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,335.43,119,,,fee schedule,119% of fee schedule,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,100% of fee schedule,816.26,90,,,percent of total billed charges,90% of total billed charges,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,208.39,100,,,fee schedule,100% of fee schedule,279.95,100,,,fee schedule,100% of fee schedule,208.39,816.26,
Lac Repair Intermed. Head/Face;20.1-30.0cm[Package],4628,CDM,521,RC,12046,HCPCS,outpatient,,,690.18,517.64,,621.16,90,,,percent of total billed charges,90% of total billed charges,641.87,93,,,percent of total billed charges,93% of total billed charges,262.27,38,,,percent of total billed charges,38% of total billed charges,262.27,38,,,percent of total billed charges,38% of total billed charges,586.65,85,,,percent of total billed charges,85% of total billed charges,262.27,38,,,percent of total billed charges,38% of total billed charges,561.81,81.4,,,percent of total billed charges,81.4% of total billed charges,621.16,90,,,percent of total billed charges,90% of total billed charges,621.16,90,,,percent of total billed charges,90% of total billed charges,262.27,38,,,percent of total billed charges,38% of total billed charges,262.27,38,,,percent of total billed charges,38% of total billed charges,262.27,38,,,percent of total billed charges,38% of total billed charges,517.64,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,262.27,641.87,
WND Lac Repair-Intermed Head/Face;20.1-30 PRO,4629,CDM,982,RC,12046,HCPCS,outpatient,,,788.32,591.24,,380.47,130,,,fee schedule,130% of fee schedule,380.47,130,,,fee schedule,130% of fee schedule,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,391.01,119,,,fee schedule,119% of fee schedule,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,100% of fee schedule,709.49,90,,,percent of total billed charges,90% of total billed charges,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,321.85,100,,,fee schedule,100% of fee schedule,244.32,709.49,
Lac Repair-PRO Intermed. Head/Face;20.1-30.0cm,4630,CDM,981,RC,12046,HCPCS,outpatient,,,1069.84,802.38,,380.47,130,,,fee schedule,130% of fee schedule,380.47,130,,,fee schedule,130% of fee schedule,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,391.01,119,,,fee schedule,119% of fee schedule,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,100% of fee schedule,962.86,90,,,percent of total billed charges,90% of total billed charges,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,321.85,100,,,fee schedule,100% of fee schedule,244.32,962.86,
Lac Repair-PRO Intermed. Head/Face;20.1-30.0cm,4631,CDM,981,RC,12046,HCPCS,outpatient,,,1069.84,802.38,,380.47,130,,,fee schedule,130% of fee schedule,380.47,130,,,fee schedule,130% of fee schedule,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,391.01,119,,,fee schedule,119% of fee schedule,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,100% of fee schedule,962.86,90,,,percent of total billed charges,90% of total billed charges,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,321.85,100,,,fee schedule,100% of fee schedule,244.32,962.86,
Lac Repair Intermed. Head/Face;< 30.0cm[Package],4632,CDM,521,RC,12047,HCPCS,outpatient,,,771.03,578.27,,693.93,90,,,percent of total billed charges,90% of total billed charges,717.06,93,,,percent of total billed charges,93% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,655.38,85,,,percent of total billed charges,85% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,627.62,81.4,,,percent of total billed charges,81.4% of total billed charges,693.93,90,,,percent of total billed charges,90% of total billed charges,693.93,90,,,percent of total billed charges,90% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,292.99,38,,,percent of total billed charges,38% of total billed charges,578.27,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,292.99,717.06,
WND Lac Repair-Intermed. Head/Face;< 30.0cm PRO,4633,CDM,982,RC,12047,HCPCS,outpatient,,,900.94,675.71,,403.22,130,,,fee schedule,130% of fee schedule,403.22,130,,,fee schedule,130% of fee schedule,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,435.73,119,,,fee schedule,119% of fee schedule,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,100% of fee schedule,810.85,90,,,percent of total billed charges,90% of total billed charges,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,280.25,100,,,fee schedule,100% of fee schedule,357.12,100,,,fee schedule,100% of fee schedule,280.25,810.85,
Lac Repair-PRO Intermed. Head/Face;< 30.0cm,4634,CDM,981,RC,12047,HCPCS,outpatient,,,1144.83,858.62,,403.22,130,,,fee schedule,130% of fee schedule,403.22,130,,,fee schedule,130% of fee schedule,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,435.73,119,,,fee schedule,119% of fee schedule,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,100% of fee schedule,1030.35,90,,,percent of total billed charges,90% of total billed charges,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,280.25,100,,,fee schedule,100% of fee schedule,357.12,100,,,fee schedule,100% of fee schedule,280.25,1030.35,
Lac Repair-PRO Intermed. Head/Face;< 30.0cm,4635,CDM,981,RC,12047,HCPCS,outpatient,,,1144.83,858.62,,403.22,130,,,fee schedule,130% of fee schedule,403.22,130,,,fee schedule,130% of fee schedule,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,435.73,119,,,fee schedule,119% of fee schedule,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,100% of fee schedule,1030.35,90,,,percent of total billed charges,90% of total billed charges,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,280.25,100,,,fee schedule,100% of fee schedule,357.12,100,,,fee schedule,100% of fee schedule,280.25,1030.35,
Lac Repair Intermed. Face;2.5cm or <[Package],4636,CDM,521,RC,12051,HCPCS,outpatient,,,419.5,314.63,,377.55,90,,,percent of total billed charges,90% of total billed charges,390.14,93,,,percent of total billed charges,93% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,356.58,85,,,percent of total billed charges,85% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,341.47,81.4,,,percent of total billed charges,81.4% of total billed charges,377.55,90,,,percent of total billed charges,90% of total billed charges,377.55,90,,,percent of total billed charges,90% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,314.63,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,159.41,390.14,
DERM LAC REPAIR INTERMED. FACE; 2.5CM OR < - PRO,4637,CDM,982,RC,12051,HCPCS,outpatient,,,371.42,278.57,,246.43,130,,,fee schedule,130% of fee schedule,246.43,130,,,fee schedule,130% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,210.32,119,,,fee schedule,119% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,100% of fee schedule,334.28,90,,,percent of total billed charges,90% of total billed charges,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,173.2,100,,,fee schedule,100% of fee schedule,114.98,334.28,
DERM Lac Repair Intermed. Face;2.5cm or <-G,4638,CDM,982,RC,12051,HCPCS,outpatient,,,683.42,512.57,,246.43,130,,,fee schedule,130% of fee schedule,246.43,130,,,fee schedule,130% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,210.32,119,,,fee schedule,119% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,100% of fee schedule,615.08,90,,,percent of total billed charges,90% of total billed charges,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,173.2,100,,,fee schedule,100% of fee schedule,114.98,615.08,
WND Lac Repair Intermed Face;2.5cm/< PRO,4639,CDM,982,RC,12051,HCPCS,outpatient,,,450.46,337.85,,246.43,130,,,fee schedule,130% of fee schedule,246.43,130,,,fee schedule,130% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,210.32,119,,,fee schedule,119% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,100% of fee schedule,405.41,90,,,percent of total billed charges,90% of total billed charges,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,173.2,100,,,fee schedule,100% of fee schedule,114.98,405.41,
Lac Repair-PRO Intermed. Face;2.5cm or <,4640,CDM,981,RC,12051,HCPCS,outpatient,,,629.26,471.95,,246.43,130,,,fee schedule,130% of fee schedule,246.43,130,,,fee schedule,130% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,210.32,119,,,fee schedule,119% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,100% of fee schedule,566.33,90,,,percent of total billed charges,90% of total billed charges,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,173.2,100,,,fee schedule,100% of fee schedule,114.98,566.33,
Lac Repair-PRO Intermed. Face;2.5cm or <,4641,CDM,981,RC,12051,HCPCS,outpatient,,,629.26,471.95,,246.43,130,,,fee schedule,130% of fee schedule,246.43,130,,,fee schedule,130% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,210.32,119,,,fee schedule,119% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,100% of fee schedule,566.33,90,,,percent of total billed charges,90% of total billed charges,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,173.2,100,,,fee schedule,100% of fee schedule,114.98,566.33,
Lac Repair Intermed. Face;2.6-5.0cm[Package],4642,CDM,521,RC,12052,HCPCS,outpatient,,,419.5,314.63,,377.55,90,,,percent of total billed charges,90% of total billed charges,390.14,93,,,percent of total billed charges,93% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,356.58,85,,,percent of total billed charges,85% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,341.47,81.4,,,percent of total billed charges,81.4% of total billed charges,377.55,90,,,percent of total billed charges,90% of total billed charges,377.55,90,,,percent of total billed charges,90% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,159.41,38,,,percent of total billed charges,38% of total billed charges,314.63,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,159.41,390.14,
DERM LAC REPAIR INTERMED. FACE; 2.6-5.0CM - PRO,4643,CDM,982,RC,12052,HCPCS,outpatient,,,530.6,397.95,,295.95,130,,,fee schedule,130% of fee schedule,295.95,130,,,fee schedule,130% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,248.82,119,,,fee schedule,119% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,100% of fee schedule,477.54,90,,,percent of total billed charges,90% of total billed charges,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,203.62,100,,,fee schedule,100% of fee schedule,158.09,477.54,
DERM Lac Repair Intermed. Face;2.6-5.0cm-G,4644,CDM,982,RC,12052,HCPCS,outpatient,,,689.79,517.34,,295.95,130,,,fee schedule,130% of fee schedule,295.95,130,,,fee schedule,130% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,248.82,119,,,fee schedule,119% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,100% of fee schedule,620.81,90,,,percent of total billed charges,90% of total billed charges,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,203.62,100,,,fee schedule,100% of fee schedule,158.09,620.81,
WND Lac Repair-Intermed Face;2.6-5cm PRO,4645,CDM,982,RC,12052,HCPCS,outpatient,,,506.77,380.08,,295.95,130,,,fee schedule,130% of fee schedule,295.95,130,,,fee schedule,130% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,248.82,119,,,fee schedule,119% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,100% of fee schedule,456.09,90,,,percent of total billed charges,90% of total billed charges,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,203.62,100,,,fee schedule,100% of fee schedule,158.09,456.09,
Lac Repair-PRO Intermed. Face;2.6-5.0cm,4646,CDM,981,RC,12052,HCPCS,outpatient,,,694.88,521.16,,295.95,130,,,fee schedule,130% of fee schedule,295.95,130,,,fee schedule,130% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,248.82,119,,,fee schedule,119% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,100% of fee schedule,625.39,90,,,percent of total billed charges,90% of total billed charges,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,203.62,100,,,fee schedule,100% of fee schedule,158.09,625.39,
Lac Repair-PRO Intermed. Face;2.6-5.0cm,4647,CDM,981,RC,12052,HCPCS,outpatient,,,694.88,521.16,,295.95,130,,,fee schedule,130% of fee schedule,295.95,130,,,fee schedule,130% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,248.82,119,,,fee schedule,119% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,100% of fee schedule,625.39,90,,,percent of total billed charges,90% of total billed charges,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,203.62,100,,,fee schedule,100% of fee schedule,158.09,625.39,
Lac Repair Intermed. Face;5.1-7.5cm[Package],4648,CDM,521,RC,12053,HCPCS,outpatient,,,338.64,253.98,,304.78,90,,,percent of total billed charges,90% of total billed charges,314.94,93,,,percent of total billed charges,93% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,287.84,85,,,percent of total billed charges,85% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,275.65,81.4,,,percent of total billed charges,81.4% of total billed charges,304.78,90,,,percent of total billed charges,90% of total billed charges,304.78,90,,,percent of total billed charges,90% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,253.98,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,128.68,314.94,
DERM LAC REPAIR INTERMED. FACE; 5.1-7.5CM - PRO,4649,CDM,982,RC,12053,HCPCS,outpatient,,,445.71,334.28,,291.41,130,,,fee schedule,130% of fee schedule,291.41,130,,,fee schedule,130% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,268.31,119,,,fee schedule,119% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,100% of fee schedule,401.14,90,,,percent of total billed charges,90% of total billed charges,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,219.37,100,,,fee schedule,100% of fee schedule,201.21,401.14,
WND Lac Repair Intermed. Face;5.1-7.5cm PRO,4650,CDM,982,RC,12053,HCPCS,outpatient,,,563.07,422.3,,291.41,130,,,fee schedule,130% of fee schedule,291.41,130,,,fee schedule,130% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,268.31,119,,,fee schedule,119% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,100% of fee schedule,506.76,90,,,percent of total billed charges,90% of total billed charges,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,219.37,100,,,fee schedule,100% of fee schedule,201.21,506.76,
Lac Repair-PRO Intermed. Face;5.1-7.5cm,4651,CDM,981,RC,12053,HCPCS,outpatient,,,756.96,567.72,,291.41,130,,,fee schedule,130% of fee schedule,291.41,130,,,fee schedule,130% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,268.31,119,,,fee schedule,119% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,100% of fee schedule,681.26,90,,,percent of total billed charges,90% of total billed charges,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,219.37,100,,,fee schedule,100% of fee schedule,201.21,681.26,
Lac Repair-PRO Intermed. Face;5.1-7.5cm,4652,CDM,981,RC,12053,HCPCS,outpatient,,,756.96,567.72,,291.41,130,,,fee schedule,130% of fee schedule,291.41,130,,,fee schedule,130% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,268.31,119,,,fee schedule,119% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,100% of fee schedule,681.26,90,,,percent of total billed charges,90% of total billed charges,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,219.37,100,,,fee schedule,100% of fee schedule,201.21,681.26,
Lac Repair Intermed. Face;7.6-12.5cm[Package],4653,CDM,521,RC,12054,HCPCS,outpatient,,,338.64,253.98,,304.78,90,,,percent of total billed charges,90% of total billed charges,314.94,93,,,percent of total billed charges,93% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,287.84,85,,,percent of total billed charges,85% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,275.65,81.4,,,percent of total billed charges,81.4% of total billed charges,304.78,90,,,percent of total billed charges,90% of total billed charges,304.78,90,,,percent of total billed charges,90% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,128.68,38,,,percent of total billed charges,38% of total billed charges,253.98,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,128.68,314.94,
DERM Lac Repair Intermed. Face;7.6-12.5cm-G,4654,CDM,982,RC,12054,HCPCS,outpatient,,,900.93,675.7,,304.1,130,,,fee schedule,130% of fee schedule,304.1,130,,,fee schedule,130% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,273.77,119,,,fee schedule,119% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,100% of fee schedule,810.84,90,,,percent of total billed charges,90% of total billed charges,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,222.73,100,,,fee schedule,100% of fee schedule,222.73,810.84,
WND Lac Repair Intermed Face 7.6-12.5cm PRO,4655,CDM,982,RC,12054,HCPCS,outpatient,,,619.38,464.54,,304.1,130,,,fee schedule,130% of fee schedule,304.1,130,,,fee schedule,130% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,273.77,119,,,fee schedule,119% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,100% of fee schedule,557.44,90,,,percent of total billed charges,90% of total billed charges,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,222.73,100,,,fee schedule,100% of fee schedule,222.73,557.44,
Lac Repair-PRO Intermed. Face;7.6-12.5cm,4656,CDM,981,RC,12054,HCPCS,outpatient,,,813.22,609.92,,304.1,130,,,fee schedule,130% of fee schedule,304.1,130,,,fee schedule,130% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,273.77,119,,,fee schedule,119% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,100% of fee schedule,731.9,90,,,percent of total billed charges,90% of total billed charges,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,222.73,100,,,fee schedule,100% of fee schedule,222.73,731.9,
Lac Repair-PRO Intermed. Face;7.6-12.5cm,4657,CDM,981,RC,12054,HCPCS,outpatient,,,813.22,609.92,,304.1,130,,,fee schedule,130% of fee schedule,304.1,130,,,fee schedule,130% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,273.77,119,,,fee schedule,119% of fee schedule,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,100% of fee schedule,731.9,90,,,percent of total billed charges,90% of total billed charges,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,222.73,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,222.73,100,,,fee schedule,100% of fee schedule,222.73,731.9,
Lac Repair Intermed. Face;12.6-20.0cm[Package],4658,CDM,521,RC,12055,HCPCS,outpatient,,,660.89,495.67,,594.8,90,,,percent of total billed charges,90% of total billed charges,614.63,93,,,percent of total billed charges,93% of total billed charges,251.14,38,,,percent of total billed charges,38% of total billed charges,251.14,38,,,percent of total billed charges,38% of total billed charges,561.76,85,,,percent of total billed charges,85% of total billed charges,251.14,38,,,percent of total billed charges,38% of total billed charges,537.96,81.4,,,percent of total billed charges,81.4% of total billed charges,594.8,90,,,percent of total billed charges,90% of total billed charges,594.8,90,,,percent of total billed charges,90% of total billed charges,251.14,38,,,percent of total billed charges,38% of total billed charges,251.14,38,,,percent of total billed charges,38% of total billed charges,251.14,38,,,percent of total billed charges,38% of total billed charges,495.67,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,251.14,614.63,
WND Lac Repair Intermed Face 12.6-20cm PRO,4659,CDM,982,RC,12055,HCPCS,outpatient,,,844.63,633.47,,362.13,130,,,fee schedule,130% of fee schedule,362.13,130,,,fee schedule,130% of fee schedule,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,373.47,119,,,fee schedule,119% of fee schedule,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,100% of fee schedule,760.17,90,,,percent of total billed charges,90% of total billed charges,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,304.2,100,,,fee schedule,100% of fee schedule,287.44,760.17,
Lac Repair-PRO Intermed. Face;12.6-20.0cm,4660,CDM,981,RC,12055,HCPCS,outpatient,,,990.13,742.6,,362.13,130,,,fee schedule,130% of fee schedule,362.13,130,,,fee schedule,130% of fee schedule,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,373.47,119,,,fee schedule,119% of fee schedule,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,100% of fee schedule,891.12,90,,,percent of total billed charges,90% of total billed charges,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,304.2,100,,,fee schedule,100% of fee schedule,287.44,891.12,
Lac Repair-PRO Intermed. Face;12.6-20.0cm,4661,CDM,981,RC,12055,HCPCS,outpatient,,,990.13,742.6,,362.13,130,,,fee schedule,130% of fee schedule,362.13,130,,,fee schedule,130% of fee schedule,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,373.47,119,,,fee schedule,119% of fee schedule,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,100% of fee schedule,891.12,90,,,percent of total billed charges,90% of total billed charges,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,304.2,100,,,fee schedule,100% of fee schedule,287.44,891.12,
WND Lac Repair Intermed. Face;20.1-30cm-PRO,4662,CDM,982,RC,12056,HCPCS,outpatient,,,1013.54,760.16,,481.29,130,,,fee schedule,130% of fee schedule,481.29,130,,,fee schedule,130% of fee schedule,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,479.87,119,,,fee schedule,119% of fee schedule,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,100% of fee schedule,912.19,90,,,percent of total billed charges,90% of total billed charges,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,330.56,100,,,fee schedule,100% of fee schedule,391.89,100,,,fee schedule,100% of fee schedule,330.56,912.19,
Lac Repair Intermed. Face;20.1-30cm-PRO,4663,CDM,981,RC,12056,HCPCS,outpatient,,,1220.98,915.74,,481.29,130,,,fee schedule,130% of fee schedule,481.29,130,,,fee schedule,130% of fee schedule,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,479.87,119,,,fee schedule,119% of fee schedule,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,100% of fee schedule,1098.88,90,,,percent of total billed charges,90% of total billed charges,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,391.89,100,,,fee schedule,Pays 100% Medicare OPPS,330.56,100,,,fee schedule,100% of fee schedule,391.89,100,,,fee schedule,100% of fee schedule,330.56,1098.88,
Lac Repair Int. Face; over 30.0 cm - PRO,4664,CDM,981,RC,12057,HCPCS,outpatient,,,1380.67,1035.5,,513.03,130,,,fee schedule,130% of fee schedule,513.03,130,,,fee schedule,130% of fee schedule,426.36,100,,,fee schedule,Pays 100% Medicare OPPS,426.36,100,,,fee schedule,Pays 100% Medicare OPPS,530.5,119,,,fee schedule,119% of fee schedule,426.36,100,,,fee schedule,Pays 100% Medicare OPPS,426.36,100,,,fee schedule,100% of fee schedule,1242.6,90,,,percent of total billed charges,90% of total billed charges,426.36,100,,,fee schedule,Pays 100% Medicare OPPS,426.36,100,,,fee schedule,Pays 100% Medicare OPPS,426.36,100,,,fee schedule,Pays 100% Medicare OPPS,426.36,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,426.36,100,,,fee schedule,100% of fee schedule,426.36,1242.6,
DERM LAC REPAIR CMPLX. TRUNK; 1.1-2C - PRO,4665,CDM,982,RC,13100,HCPCS,outpatient,,,435.09,326.32,,313.3,130,,,fee schedule,130% of fee schedule,313.3,130,,,fee schedule,130% of fee schedule,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,251.58,119,,,fee schedule,119% of fee schedule,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,100% of fee schedule,391.58,90,,,percent of total billed charges,90% of total billed charges,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,203.96,100,,,fee schedule,100% of fee schedule,107.79,391.58,
Lac Repair Cmplx. Trunk; 1.1 cm-2.5 cm-PRO,4666,CDM,981,RC,13100,HCPCS,outpatient,,,743.26,557.45,,313.3,130,,,fee schedule,130% of fee schedule,313.3,130,,,fee schedule,130% of fee schedule,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,251.58,119,,,fee schedule,119% of fee schedule,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,100% of fee schedule,668.93,90,,,percent of total billed charges,90% of total billed charges,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,203.96,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,203.96,100,,,fee schedule,100% of fee schedule,107.79,668.93,
Lac Repair Cmplx. Trunk; 2.6 cm-7.5 cm-PRO,4667,CDM,981,RC,13101,HCPCS,outpatient,,,878.4,658.8,,383.16,130,,,fee schedule,130% of fee schedule,383.16,130,,,fee schedule,130% of fee schedule,252.31,100,,,fee schedule,Pays 100% Medicare OPPS,252.31,100,,,fee schedule,Pays 100% Medicare OPPS,309.65,119,,,fee schedule,119% of fee schedule,252.31,100,,,fee schedule,Pays 100% Medicare OPPS,252.31,100,,,fee schedule,100% of fee schedule,790.56,90,,,percent of total billed charges,90% of total billed charges,252.31,100,,,fee schedule,Pays 100% Medicare OPPS,252.31,100,,,fee schedule,Pays 100% Medicare OPPS,252.31,100,,,fee schedule,Pays 100% Medicare OPPS,252.31,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,252.31,100,,,fee schedule,100% of fee schedule,229.95,790.56,
Lac Repair Cmplx. Trunk; addtl. 5cm< - PRO,4668,CDM,981,RC,13102,HCPCS,outpatient,,,284.92,213.69,,101.83,130,,,fee schedule,130% of fee schedule,101.83,130,,,fee schedule,130% of fee schedule,71.91,100,,,fee schedule,Pays 100% Medicare OPPS,71.91,100,,,fee schedule,Pays 100% Medicare OPPS,90.42,119,,,fee schedule,119% of fee schedule,71.91,100,,,fee schedule,Pays 100% Medicare OPPS,71.91,100,,,fee schedule,100% of fee schedule,256.43,90,,,percent of total billed charges,90% of total billed charges,71.91,100,,,fee schedule,Pays 100% Medicare OPPS,71.91,100,,,fee schedule,Pays 100% Medicare OPPS,71.91,100,,,fee schedule,Pays 100% Medicare OPPS,71.91,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,71.91,100,,,fee schedule,100% of fee schedule,71.91,256.43,
"Lac Repair Cmplx.(sc,ar,lg); 1.1cm-2.5cm-PRO",4669,CDM,981,RC,13120,HCPCS,outpatient,,,818.72,614.04,,329.81,130,,,fee schedule,130% of fee schedule,329.81,130,,,fee schedule,130% of fee schedule,236.8,100,,,fee schedule,Pays 100% Medicare OPPS,236.8,100,,,fee schedule,Pays 100% Medicare OPPS,289.68,119,,,fee schedule,119% of fee schedule,236.8,100,,,fee schedule,Pays 100% Medicare OPPS,236.8,100,,,fee schedule,100% of fee schedule,736.85,90,,,percent of total billed charges,90% of total billed charges,236.8,100,,,fee schedule,Pays 100% Medicare OPPS,236.8,100,,,fee schedule,Pays 100% Medicare OPPS,236.8,100,,,fee schedule,Pays 100% Medicare OPPS,236.8,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,236.8,100,,,fee schedule,100% of fee schedule,215.58,736.85,
"Suture,Complex(sc,a,l);2.6-7.5cm[Package]",4670,CDM,521,RC,13121,HCPCS,outpatient,,,753.44,565.08,,678.1,90,,,percent of total billed charges,90% of total billed charges,700.7,93,,,percent of total billed charges,93% of total billed charges,286.31,38,,,percent of total billed charges,38% of total billed charges,286.31,38,,,percent of total billed charges,38% of total billed charges,640.42,85,,,percent of total billed charges,85% of total billed charges,286.31,38,,,percent of total billed charges,38% of total billed charges,613.3,81.4,,,percent of total billed charges,81.4% of total billed charges,678.1,90,,,percent of total billed charges,90% of total billed charges,678.1,90,,,percent of total billed charges,90% of total billed charges,286.31,38,,,percent of total billed charges,38% of total billed charges,286.31,38,,,percent of total billed charges,38% of total billed charges,286.31,38,,,percent of total billed charges,38% of total billed charges,565.08,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,286.31,700.7,
"Suture,Complex(sa,a,l);2.6-7.5cm-PRO",4671,CDM,981,RC,13121,HCPCS,outpatient,,,1025.29,768.97,,441.47,130,,,fee schedule,130% of fee schedule,441.47,130,,,fee schedule,130% of fee schedule,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,324.69,119,,,fee schedule,119% of fee schedule,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,100% of fee schedule,922.76,90,,,percent of total billed charges,90% of total billed charges,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,261.25,100,,,fee schedule,100% of fee schedule,261.25,922.76,
"Suture,Complex(sa,a,l);2.6-7.5cm-PRO",4672,CDM,981,RC,13121,HCPCS,outpatient,,,1025.29,768.97,,441.47,130,,,fee schedule,130% of fee schedule,441.47,130,,,fee schedule,130% of fee schedule,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,324.69,119,,,fee schedule,119% of fee schedule,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,100% of fee schedule,922.76,90,,,percent of total billed charges,90% of total billed charges,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,261.25,100,,,fee schedule,100% of fee schedule,261.25,922.76,
"Suture,Cmplx(sa,a,l);Each Add. 5cm or <[Package]",4673,CDM,521,RC,13122,HCPCS,outpatient,,,208.57,156.43,,187.71,90,,,percent of total billed charges,90% of total billed charges,193.97,93,,,percent of total billed charges,93% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,177.28,85,,,percent of total billed charges,85% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,169.78,81.4,,,percent of total billed charges,81.4% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,156.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,79.26,193.97,
"Suture,Cmplx(sa,a,l);Each Add. 5cm or <-PRO",4674,CDM,981,RC,13122,HCPCS,outpatient,,,292.94,219.71,,116.43,130,,,fee schedule,130% of fee schedule,116.43,130,,,fee schedule,130% of fee schedule,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,104.27,119,,,fee schedule,119% of fee schedule,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,100% of fee schedule,263.65,90,,,percent of total billed charges,90% of total billed charges,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,83.09,100,,,fee schedule,100% of fee schedule,83.09,263.65,
"Suture,Cmplx(sa,a,l);Each Add. 5cm or <-PRO",4675,CDM,981,RC,13122,HCPCS,outpatient,,,292.94,219.71,,116.43,130,,,fee schedule,130% of fee schedule,116.43,130,,,fee schedule,130% of fee schedule,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,104.27,119,,,fee schedule,119% of fee schedule,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,100% of fee schedule,263.65,90,,,percent of total billed charges,90% of total billed charges,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,83.09,100,,,fee schedule,100% of fee schedule,83.09,263.65,
"Repair complx face, nect,gen,extrem 1.1-2.5cm PRO",4676,CDM,981,RC,13131,HCPCS,outpatient,,,603.05,452.29,,370.7,130,,,fee schedule,130% of fee schedule,370.7,130,,,fee schedule,130% of fee schedule,245.3,100,,,fee schedule,Pays 100% Medicare OPPS,245.3,100,,,fee schedule,Pays 100% Medicare OPPS,304.66,119,,,fee schedule,119% of fee schedule,245.3,100,,,fee schedule,Pays 100% Medicare OPPS,245.3,100,,,fee schedule,100% of fee schedule,542.75,90,,,percent of total billed charges,90% of total billed charges,245.3,100,,,fee schedule,Pays 100% Medicare OPPS,245.3,100,,,fee schedule,Pays 100% Medicare OPPS,245.3,100,,,fee schedule,Pays 100% Medicare OPPS,245.3,100,,,fee schedule,Pays 100% Medicare OPPS,251.51,100,,,fee schedule,100% of fee schedule,245.3,100,,,fee schedule,100% of fee schedule,245.3,542.75,
"DERM REPAIR COMPX LAC FACE/NECK EXT, GEN 2.6C-7.5C - PRO",4677,CDM,982,RC,13132,HCPCS,outpatient,,,636.72,477.54,,634.6,130,,,fee schedule,130% of fee schedule,634.6,130,,,fee schedule,130% of fee schedule,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,381.26,119,,,fee schedule,119% of fee schedule,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,100% of fee schedule,573.05,90,,,percent of total billed charges,90% of total billed charges,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,337.74,100,,,fee schedule,100% of fee schedule,307.16,100,,,fee schedule,100% of fee schedule,307.16,634.6,
"Repair compx lac face/neck ext, gen  2.6 c- 7.5 c PRO",4678,CDM,981,RC,13132,HCPCS,outpatient,,,1318.24,988.68,,634.6,130,,,fee schedule,130% of fee schedule,634.6,130,,,fee schedule,130% of fee schedule,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,381.26,119,,,fee schedule,119% of fee schedule,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,100% of fee schedule,1186.42,90,,,percent of total billed charges,90% of total billed charges,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,307.16,100,,,fee schedule,Pays 100% Medicare OPPS,337.74,100,,,fee schedule,100% of fee schedule,307.16,100,,,fee schedule,100% of fee schedule,307.16,1186.42,
PRO LACERATION COMPLEX HAND/DDD EA ADD 5 CM OR LESS,4679,CDM,975,RC,13133,HCPCS,outpatient,,,315.21,236.41,,180.13,130,,,fee schedule,130% of fee schedule,180.13,130,,,fee schedule,130% of fee schedule,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,159.1,119,,,fee schedule,119% of fee schedule,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,100% of fee schedule,283.69,90,,,percent of total billed charges,90% of total billed charges,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,125.64,100,,,fee schedule,100% of fee schedule,125.64,283.69,
PRO LACERATION COMPLEX HAND/DDD EA ADD 5 CM OR LESS,4680,CDM,975,RC,13133,HCPCS,outpatient,,,315.21,236.41,,180.13,130,,,fee schedule,130% of fee schedule,180.13,130,,,fee schedule,130% of fee schedule,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,159.1,119,,,fee schedule,119% of fee schedule,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,100% of fee schedule,283.69,90,,,percent of total billed charges,90% of total billed charges,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,125.64,100,,,fee schedule,100% of fee schedule,125.64,283.69,
Lac Repair Cmplx Face; 1.1cm-2.5cm-PRO,4681,CDM,981,RC,13151,HCPCS,outpatient,,,985.39,739.04,,427.22,130,,,fee schedule,130% of fee schedule,427.22,130,,,fee schedule,130% of fee schedule,282.3,100,,,fee schedule,Pays 100% Medicare OPPS,282.3,100,,,fee schedule,Pays 100% Medicare OPPS,349.94,119,,,fee schedule,119% of fee schedule,282.3,100,,,fee schedule,Pays 100% Medicare OPPS,282.3,100,,,fee schedule,100% of fee schedule,886.85,90,,,percent of total billed charges,90% of total billed charges,282.3,100,,,fee schedule,Pays 100% Medicare OPPS,282.3,100,,,fee schedule,Pays 100% Medicare OPPS,282.3,100,,,fee schedule,Pays 100% Medicare OPPS,282.3,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,282.3,100,,,fee schedule,100% of fee schedule,282.3,886.85,
Lac Repair Cmplx Face; 2.6cm-7.5cm-PRO,4682,CDM,981,RC,13152,HCPCS,outpatient,,,1182.48,886.86,,572.56,130,,,fee schedule,130% of fee schedule,572.56,130,,,fee schedule,130% of fee schedule,339.96,100,,,fee schedule,Pays 100% Medicare OPPS,339.96,100,,,fee schedule,Pays 100% Medicare OPPS,421.34,119,,,fee schedule,119% of fee schedule,339.96,100,,,fee schedule,Pays 100% Medicare OPPS,339.96,100,,,fee schedule,100% of fee schedule,1064.23,90,,,percent of total billed charges,90% of total billed charges,339.96,100,,,fee schedule,Pays 100% Medicare OPPS,339.96,100,,,fee schedule,Pays 100% Medicare OPPS,339.96,100,,,fee schedule,Pays 100% Medicare OPPS,339.96,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,339.96,100,,,fee schedule,100% of fee schedule,339.96,1064.23,
Lac Repair Cmplx Face; addtional 5cm< - PRO,4683,CDM,981,RC,13153,HCPCS,outpatient,,,451.58,338.69,,194.22,130,,,fee schedule,130% of fee schedule,194.22,130,,,fee schedule,130% of fee schedule,137.38,100,,,fee schedule,Pays 100% Medicare OPPS,137.38,100,,,fee schedule,Pays 100% Medicare OPPS,173.1,119,,,fee schedule,119% of fee schedule,137.38,100,,,fee schedule,Pays 100% Medicare OPPS,137.38,100,,,fee schedule,100% of fee schedule,406.42,90,,,percent of total billed charges,90% of total billed charges,137.38,100,,,fee schedule,Pays 100% Medicare OPPS,137.38,100,,,fee schedule,Pays 100% Medicare OPPS,137.38,100,,,fee schedule,Pays 100% Medicare OPPS,137.38,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,137.38,100,,,fee schedule,100% of fee schedule,137.38,406.42,
FULL GRAFT/INCL DIR CLS 20CM<,4684,CDM,982,RC,15220,HCPCS,outpatient,,,1736.58,1302.44,,834.94,130,,,fee schedule,130% of fee schedule,834.94,130,,,fee schedule,130% of fee schedule,623.42,100,,,fee schedule,Pays 100% Medicare OPPS,623.42,100,,,fee schedule,Pays 100% Medicare OPPS,757.91,119,,,fee schedule,119% of fee schedule,623.42,100,,,fee schedule,Pays 100% Medicare OPPS,623.42,100,,,fee schedule,100% of fee schedule,1562.92,90,,,percent of total billed charges,90% of total billed charges,623.42,100,,,fee schedule,Pays 100% Medicare OPPS,623.42,100,,,fee schedule,Pays 100% Medicare OPPS,623.42,100,,,fee schedule,Pays 100% Medicare OPPS,623.42,100,,,fee schedule,Pays 100% Medicare OPPS,452.72,100,,,fee schedule,100% of fee schedule,623.42,100,,,fee schedule,100% of fee schedule,452.72,1562.92,
OR PRO FULL THICKNESS GRAFT,4685,CDM,975,RC,15240,HCPCS,outpatient,,,1959.2,1469.4,,1086.68,130,,,fee schedule,130% of fee schedule,1086.68,130,,,fee schedule,130% of fee schedule,813.79,100,,,fee schedule,Pays 100% Medicare OPPS,813.79,100,,,fee schedule,Pays 100% Medicare OPPS,986.71,119,,,fee schedule,119% of fee schedule,813.79,100,,,fee schedule,Pays 100% Medicare OPPS,813.79,100,,,fee schedule,100% of fee schedule,1763.28,90,,,percent of total billed charges,90% of total billed charges,813.79,100,,,fee schedule,Pays 100% Medicare OPPS,813.79,100,,,fee schedule,Pays 100% Medicare OPPS,813.79,100,,,fee schedule,Pays 100% Medicare OPPS,813.79,100,,,fee schedule,Pays 100% Medicare OPPS,682.67,100,,,fee schedule,100% of fee schedule,813.79,100,,,fee schedule,100% of fee schedule,682.67,1763.28,
skin graft app trnk/arm/leg up to 100 sqcm-G,4686,CDM,982,RC,15271,HCPCS,outpatient,,,3418.23,2563.67,,2734.58,80,,,percent of total billed charges,90% of total billed charges,2734.58,80,,,percent of total billed charges,93% of total billed charges,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,105.29,119,,,fee schedule,119% of fee schedule,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,100% of fee schedule,3076.41,90,,,percent of total billed charges,90% of total billed charges,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,83.71,100,,,fee schedule,100% of fee schedule,83.71,3076.41,
skin graft app trnk/arm/leg up to 100 sqcm-PRO,4687,CDM,982,RC,15271,HCPCS,outpatient,,,215.3,161.48,,172.24,80,,,percent of total billed charges,90% of total billed charges,172.24,80,,,percent of total billed charges,93% of total billed charges,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,105.29,119,,,fee schedule,119% of fee schedule,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,100% of fee schedule,193.77,90,,,percent of total billed charges,90% of total billed charges,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,83.71,100,,,fee schedule,100% of fee schedule,83.71,193.77,
"WND APPLICATION OF SKIN SUBSTITUE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS - PRO",4688,CDM,982,RC,15275,HCPCS,outpatient,,,530.6,397.95,,424.48,80,,,percent of total billed charges,90% of total billed charges,424.48,80,,,percent of total billed charges,93% of total billed charges,93.42,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,Pays 100% Medicare OPPS,118.36,119,,,fee schedule,119% of fee schedule,93.42,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,477.54,90,,,percent of total billed charges,90% of total billed charges,93.42,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,93.42,100,,,fee schedule,100% of fee schedule,93.42,477.54,
Burn Init. Trmt,4689,CDM,521,RC,16000,HCPCS,outpatient,,,113.67,85.25,,102.3,90,,,percent of total billed charges,90% of total billed charges,105.71,93,,,percent of total billed charges,93% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,96.62,85,,,percent of total billed charges,85% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,92.53,81.4,,,percent of total billed charges,81.4% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,85.25,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,43.19,105.71,
WND Burn init Trmt- PRO,4690,CDM,982,RC,16000,HCPCS,outpatient,,,135.15,101.36,,61.89,130,,,fee schedule,130% of fee schedule,61.89,130,,,fee schedule,130% of fee schedule,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.07,119,,,fee schedule,119% of fee schedule,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,100% of fee schedule,121.64,90,,,percent of total billed charges,90% of total billed charges,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,45.83,100,,,fee schedule,100% of fee schedule,35.93,121.64,
Burn Init. Trmt-PRO,4691,CDM,981,RC,16000,HCPCS,outpatient,,,69.14,51.86,,61.89,130,,,fee schedule,130% of fee schedule,61.89,130,,,fee schedule,130% of fee schedule,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.07,119,,,fee schedule,119% of fee schedule,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,100% of fee schedule,62.23,90,,,percent of total billed charges,90% of total billed charges,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,45.83,100,,,fee schedule,100% of fee schedule,35.93,62.23,
Burn Init. Trmt-PRO,4692,CDM,981,RC,16000,HCPCS,outpatient,,,69.14,51.86,,61.89,130,,,fee schedule,130% of fee schedule,61.89,130,,,fee schedule,130% of fee schedule,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.07,119,,,fee schedule,119% of fee schedule,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,100% of fee schedule,62.23,90,,,percent of total billed charges,90% of total billed charges,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,45.83,100,,,fee schedule,100% of fee schedule,35.93,62.23,
"Burn, Debride <5%",4693,CDM,521,RC,16020,HCPCS,outpatient,,,137.09,102.82,,123.38,90,,,percent of total billed charges,90% of total billed charges,127.49,93,,,percent of total billed charges,93% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,116.53,85,,,percent of total billed charges,85% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,111.59,81.4,,,percent of total billed charges,81.4% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,123.38,90,,,percent of total billed charges,90% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,52.09,38,,,percent of total billed charges,38% of total billed charges,102.82,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,52.09,127.49,
"WND Burn, Debride <5%-PRO",4694,CDM,982,RC,16020,HCPCS,outpatient,,,157.66,118.25,,77.14,130,,,fee schedule,130% of fee schedule,77.14,130,,,fee schedule,130% of fee schedule,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,67.59,119,,,fee schedule,119% of fee schedule,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,100% of fee schedule,141.89,90,,,percent of total billed charges,90% of total billed charges,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.59,100,,,fee schedule,100% of fee schedule,43.12,141.89,
"Burn, Debride <5%-PRO",4695,CDM,981,RC,16020,HCPCS,outpatient,,,83.21,62.41,,77.14,130,,,fee schedule,130% of fee schedule,77.14,130,,,fee schedule,130% of fee schedule,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,67.59,119,,,fee schedule,119% of fee schedule,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,100% of fee schedule,74.89,90,,,percent of total billed charges,90% of total billed charges,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.59,100,,,fee schedule,100% of fee schedule,43.12,77.14,
"Burn, Debride <5%-PRO",4696,CDM,981,RC,16020,HCPCS,outpatient,,,83.21,62.41,,77.14,130,,,fee schedule,130% of fee schedule,77.14,130,,,fee schedule,130% of fee schedule,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,67.59,119,,,fee schedule,119% of fee schedule,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,100% of fee schedule,74.89,90,,,percent of total billed charges,90% of total billed charges,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.59,100,,,fee schedule,100% of fee schedule,43.12,77.14,
WND Burn Debride 5%-10% (med.) - G,4697,CDM,982,RC,16025,HCPCS,outpatient,,,591.24,443.43,,154.78,130,,,fee schedule,130% of fee schedule,154.78,130,,,fee schedule,130% of fee schedule,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,137.06,119,,,fee schedule,119% of fee schedule,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,100% of fee schedule,532.12,90,,,percent of total billed charges,90% of total billed charges,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,111.73,100,,,fee schedule,100% of fee schedule,71.86,532.12,
WND Burn Debride 5%-10% (med.) - PRO,4698,CDM,982,RC,16025,HCPCS,outpatient,,,309.69,232.27,,154.78,130,,,fee schedule,130% of fee schedule,154.78,130,,,fee schedule,130% of fee schedule,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,137.06,119,,,fee schedule,119% of fee schedule,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,100% of fee schedule,278.72,90,,,percent of total billed charges,90% of total billed charges,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,111.73,100,,,fee schedule,100% of fee schedule,71.86,278.72,
Burn Debride 5%-10% (med.) - PRO,4699,CDM,981,RC,16025,HCPCS,outpatient,,,345.74,259.31,,154.78,130,,,fee schedule,130% of fee schedule,154.78,130,,,fee schedule,130% of fee schedule,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,137.06,119,,,fee schedule,119% of fee schedule,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,100% of fee schedule,311.17,90,,,percent of total billed charges,90% of total billed charges,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,111.73,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,111.73,100,,,fee schedule,100% of fee schedule,71.86,311.17,
Burn; Large> 10%,4700,CDM,521,RC,16030,HCPCS,outpatient,,,321.07,240.8,,288.96,90,,,percent of total billed charges,90% of total billed charges,298.6,93,,,percent of total billed charges,93% of total billed charges,122.01,38,,,percent of total billed charges,38% of total billed charges,122.01,38,,,percent of total billed charges,38% of total billed charges,272.91,85,,,percent of total billed charges,85% of total billed charges,122.01,38,,,percent of total billed charges,38% of total billed charges,261.35,81.4,,,percent of total billed charges,81.4% of total billed charges,288.96,90,,,percent of total billed charges,90% of total billed charges,288.96,90,,,percent of total billed charges,90% of total billed charges,122.01,38,,,percent of total billed charges,38% of total billed charges,122.01,38,,,percent of total billed charges,38% of total billed charges,122.01,38,,,percent of total billed charges,38% of total billed charges,240.8,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,122.01,298.6,
WND Burn; Large> 10%- PRO,4701,CDM,982,RC,16030,HCPCS,outpatient,,,281.54,211.16,,176.01,130,,,fee schedule,130% of fee schedule,176.01,130,,,fee schedule,130% of fee schedule,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,165.37,119,,,fee schedule,119% of fee schedule,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,100% of fee schedule,253.39,90,,,percent of total billed charges,90% of total billed charges,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,132.52,100,,,fee schedule,100% of fee schedule,132.52,253.39,
Burn; Large> 10%-PRO,4702,CDM,981,RC,16030,HCPCS,outpatient,,,193.34,145.01,,176.01,130,,,fee schedule,130% of fee schedule,176.01,130,,,fee schedule,130% of fee schedule,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,165.37,119,,,fee schedule,119% of fee schedule,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,100% of fee schedule,174.01,90,,,percent of total billed charges,90% of total billed charges,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,132.52,100,,,fee schedule,100% of fee schedule,132.52,176.01,
Burn; Large> 10%-PRO,4703,CDM,981,RC,16030,HCPCS,outpatient,,,193.34,145.01,,176.01,130,,,fee schedule,130% of fee schedule,176.01,130,,,fee schedule,130% of fee schedule,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,165.37,119,,,fee schedule,119% of fee schedule,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,100% of fee schedule,174.01,90,,,percent of total billed charges,90% of total billed charges,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,132.52,100,,,fee schedule,100% of fee schedule,132.52,176.01,
Cryo-1st Lesion,4704,CDM,521,RC,17000,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,61.45,150.39,
DERM Cryo-1st Lesion-G,4705,CDM,982,RC,17000,HCPCS,outpatient,,,168.73,126.55,,74.79,130,,,fee schedule,130% of fee schedule,74.79,130,,,fee schedule,130% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.68,119,,,fee schedule,119% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,100% of fee schedule,151.86,90,,,percent of total billed charges,90% of total billed charges,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.55,100,,,fee schedule,100% of fee schedule,43.12,151.86,
WND Cryo-1st Lesion-PRO,4706,CDM,982,RC,17000,HCPCS,outpatient,,,95.72,71.79,,74.79,130,,,fee schedule,130% of fee schedule,74.79,130,,,fee schedule,130% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.68,119,,,fee schedule,119% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,100% of fee schedule,86.15,90,,,percent of total billed charges,90% of total billed charges,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.55,100,,,fee schedule,100% of fee schedule,43.12,86.15,
WND Cryo-1st Lesion-G,4707,CDM,982,RC,17000,HCPCS,outpatient,,,168.92,126.69,,74.79,130,,,fee schedule,130% of fee schedule,74.79,130,,,fee schedule,130% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.68,119,,,fee schedule,119% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,100% of fee schedule,152.03,90,,,percent of total billed charges,90% of total billed charges,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.55,100,,,fee schedule,100% of fee schedule,43.12,152.03,
DERM CYRO 1ST LESION - PRO,4708,CDM,982,RC,17000,HCPCS,outpatient,,,95.51,71.63,,74.79,130,,,fee schedule,130% of fee schedule,74.79,130,,,fee schedule,130% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.68,119,,,fee schedule,119% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,100% of fee schedule,85.96,90,,,percent of total billed charges,90% of total billed charges,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.55,100,,,fee schedule,100% of fee schedule,43.12,85.96,
Cryo-1st Lesion-PRO,4709,CDM,981,RC,17000,HCPCS,outpatient,,,96.09,72.07,,74.79,130,,,fee schedule,130% of fee schedule,74.79,130,,,fee schedule,130% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.68,119,,,fee schedule,119% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,100% of fee schedule,86.48,90,,,percent of total billed charges,90% of total billed charges,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.55,100,,,fee schedule,100% of fee schedule,43.12,86.48,
Cryo-1st Lesion-PRO,4710,CDM,981,RC,17000,HCPCS,outpatient,,,96.09,72.07,,74.79,130,,,fee schedule,130% of fee schedule,74.79,130,,,fee schedule,130% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.68,119,,,fee schedule,119% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,100% of fee schedule,86.48,90,,,percent of total billed charges,90% of total billed charges,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.55,100,,,fee schedule,100% of fee schedule,43.12,86.48,
Cryo:2-14 Lesions,4711,CDM,521,RC,17003,HCPCS,outpatient,,,23.42,17.57,,21.08,90,,,percent of total billed charges,90% of total billed charges,21.78,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.91,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.06,81.4,,,percent of total billed charges,81.4% of total billed charges,21.08,90,,,percent of total billed charges,90% of total billed charges,21.08,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,8.9,21.78,
DERM Cryo:2-14 Lesions-G,4712,CDM,982,RC,17003,HCPCS,outpatient,,,16.98,12.74,,5.77,130,,,fee schedule,130% of fee schedule,5.77,130,,,fee schedule,130% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.59,119,,,fee schedule,119% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,100% of fee schedule,15.28,90,,,percent of total billed charges,90% of total billed charges,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.07,100,,,fee schedule,100% of fee schedule,2.07,15.28,
WND Cryo:2-14 Lesions-PRO,4713,CDM,982,RC,17003,HCPCS,outpatient,,,5.63,4.22,,5.77,130,,,fee schedule,130% of fee schedule,5.77,130,,,fee schedule,130% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.59,119,,,fee schedule,119% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,100% of fee schedule,5.07,90,,,percent of total billed charges,90% of total billed charges,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.07,100,,,fee schedule,100% of fee schedule,2.07,5.77,
DERM CRYO 2-14 LESIONS - PRO,4714,CDM,982,RC,17003,HCPCS,outpatient,,,8.49,6.37,,5.77,130,,,fee schedule,130% of fee schedule,5.77,130,,,fee schedule,130% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.59,119,,,fee schedule,119% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,100% of fee schedule,7.64,90,,,percent of total billed charges,90% of total billed charges,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.07,100,,,fee schedule,100% of fee schedule,2.07,7.64,
Cryo:2-14 Lesions-PRO,4715,CDM,981,RC,17003,HCPCS,outpatient,,,11.72,8.79,,5.77,130,,,fee schedule,130% of fee schedule,5.77,130,,,fee schedule,130% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.59,119,,,fee schedule,119% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,100% of fee schedule,10.55,90,,,percent of total billed charges,90% of total billed charges,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.07,100,,,fee schedule,100% of fee schedule,2.07,10.55,
Cryo:2-14 Lesions-PRO,4716,CDM,981,RC,17003,HCPCS,outpatient,,,11.72,8.79,,5.77,130,,,fee schedule,130% of fee schedule,5.77,130,,,fee schedule,130% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.59,119,,,fee schedule,119% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,100% of fee schedule,10.55,90,,,percent of total billed charges,90% of total billed charges,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.07,100,,,fee schedule,100% of fee schedule,2.07,10.55,
Cryo Lesions 15+,4717,CDM,521,RC,17004,HCPCS,outpatient,,,561.3,420.98,,505.17,90,,,percent of total billed charges,90% of total billed charges,522.01,93,,,percent of total billed charges,93% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,477.11,85,,,percent of total billed charges,85% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,456.9,81.4,,,percent of total billed charges,81.4% of total billed charges,505.17,90,,,percent of total billed charges,90% of total billed charges,505.17,90,,,percent of total billed charges,90% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,420.98,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,213.29,522.01,
DERM CRYO LESIONS 15+ - PRO,4718,CDM,982,RC,17004,HCPCS,outpatient,,,265.3,198.98,,176.9,130,,,fee schedule,130% of fee schedule,176.9,130,,,fee schedule,130% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,121.17,119,,,fee schedule,119% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,100% of fee schedule,238.77,90,,,percent of total billed charges,90% of total billed charges,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,101.41,100,,,fee schedule,100% of fee schedule,101.41,238.77,
DERM Cryo Lesions 15+-G,4719,CDM,982,RC,17004,HCPCS,outpatient,,,424.48,318.36,,176.9,130,,,fee schedule,130% of fee schedule,176.9,130,,,fee schedule,130% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,121.17,119,,,fee schedule,119% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,100% of fee schedule,382.03,90,,,percent of total billed charges,90% of total billed charges,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,101.41,100,,,fee schedule,100% of fee schedule,101.41,382.03,
WND Cryo Lesions 15+-PRO,4720,CDM,982,RC,17004,HCPCS,outpatient,,,281.54,211.16,,176.9,130,,,fee schedule,130% of fee schedule,176.9,130,,,fee schedule,130% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,121.17,119,,,fee schedule,119% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,100% of fee schedule,253.39,90,,,percent of total billed charges,90% of total billed charges,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,101.41,100,,,fee schedule,100% of fee schedule,101.41,253.39,
Cryo Lesions 15+-PRO,4721,CDM,981,RC,17004,HCPCS,outpatient,,,336.29,252.22,,176.9,130,,,fee schedule,130% of fee schedule,176.9,130,,,fee schedule,130% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,121.17,119,,,fee schedule,119% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,100% of fee schedule,302.66,90,,,percent of total billed charges,90% of total billed charges,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,101.41,100,,,fee schedule,100% of fee schedule,101.41,302.66,
Cryo Lesions 15+-PRO,4722,CDM,981,RC,17004,HCPCS,outpatient,,,336.29,252.22,,176.9,130,,,fee schedule,130% of fee schedule,176.9,130,,,fee schedule,130% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,121.17,119,,,fee schedule,119% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,100% of fee schedule,302.66,90,,,percent of total billed charges,90% of total billed charges,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,101.41,100,,,fee schedule,100% of fee schedule,101.41,302.66,
Wart Removal;up to 14 Lesions,4723,CDM,521,RC,17110,HCPCS,outpatient,,,188.67,141.5,,169.8,90,,,percent of total billed charges,90% of total billed charges,175.46,93,,,percent of total billed charges,93% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,160.37,85,,,percent of total billed charges,85% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,153.58,81.4,,,percent of total billed charges,81.4% of total billed charges,169.8,90,,,percent of total billed charges,90% of total billed charges,169.8,90,,,percent of total billed charges,90% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,141.5,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,71.69,175.46,
DERM Wart Removal;up to 14 Lesions-G,4724,CDM,982,RC,17110,HCPCS,outpatient,,,275.91,206.93,,92.51,130,,,fee schedule,130% of fee schedule,92.51,130,,,fee schedule,130% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,83.3,119,,,fee schedule,119% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,100% of fee schedule,248.32,90,,,percent of total billed charges,90% of total billed charges,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,69.49,100,,,fee schedule,100% of fee schedule,28.74,248.32,
WND Wart Removal;up to 14 Lesions-PRO,4725,CDM,982,RC,17110,HCPCS,outpatient,,,157.66,118.25,,92.51,130,,,fee schedule,130% of fee schedule,92.51,130,,,fee schedule,130% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,83.3,119,,,fee schedule,119% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,100% of fee schedule,141.89,90,,,percent of total billed charges,90% of total billed charges,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,69.49,100,,,fee schedule,100% of fee schedule,28.74,141.89,
DERM WART REMOVAL; UP TO 14 LESIONS - PRO,4726,CDM,982,RC,17110,HCPCS,outpatient,,,169.79,127.34,,92.51,130,,,fee schedule,130% of fee schedule,92.51,130,,,fee schedule,130% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,83.3,119,,,fee schedule,119% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,100% of fee schedule,152.81,90,,,percent of total billed charges,90% of total billed charges,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,69.49,100,,,fee schedule,100% of fee schedule,28.74,152.81,
Wart Removal;up to 14 Lesions-PRO,4727,CDM,981,RC,17110,HCPCS,outpatient,,,112.5,84.38,,92.51,130,,,fee schedule,130% of fee schedule,92.51,130,,,fee schedule,130% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,83.3,119,,,fee schedule,119% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,100% of fee schedule,101.25,90,,,percent of total billed charges,90% of total billed charges,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,69.49,100,,,fee schedule,100% of fee schedule,28.74,101.25,
Wart Removal;up to 14 Lesions-PRO,4728,CDM,981,RC,17110,HCPCS,outpatient,,,112.5,84.38,,92.51,130,,,fee schedule,130% of fee schedule,92.51,130,,,fee schedule,130% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,83.3,119,,,fee schedule,119% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,100% of fee schedule,101.25,90,,,percent of total billed charges,90% of total billed charges,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,69.49,100,,,fee schedule,100% of fee schedule,28.74,101.25,
DERM Destruction Benign Lesion 15/> -G,4729,CDM,982,RC,17111,HCPCS,outpatient,,,291.83,218.87,,114.24,130,,,fee schedule,130% of fee schedule,114.24,130,,,fee schedule,130% of fee schedule,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,101.94,119,,,fee schedule,119% of fee schedule,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,100% of fee schedule,262.65,90,,,percent of total billed charges,90% of total billed charges,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,84.83,100,,,fee schedule,100% of fee schedule,84.83,262.65,
DERM DESTRUCTION BENIGN LESION 15/> - PRO,4730,CDM,982,RC,17111,HCPCS,outpatient,,,244.08,183.06,,114.24,130,,,fee schedule,130% of fee schedule,114.24,130,,,fee schedule,130% of fee schedule,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,101.94,119,,,fee schedule,119% of fee schedule,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,100% of fee schedule,219.67,90,,,percent of total billed charges,90% of total billed charges,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,84.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,84.83,100,,,fee schedule,100% of fee schedule,84.83,219.67,
Chem. Cauterize of Gran Tissue,4731,CDM,521,RC,17250,HCPCS,outpatient,,,89.06,66.8,,80.15,90,,,percent of total billed charges,90% of total billed charges,82.83,93,,,percent of total billed charges,93% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,75.7,85,,,percent of total billed charges,85% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,72.49,81.4,,,percent of total billed charges,81.4% of total billed charges,80.15,90,,,percent of total billed charges,90% of total billed charges,80.15,90,,,percent of total billed charges,90% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,33.84,38,,,percent of total billed charges,38% of total billed charges,66.8,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,33.84,82.83,
WND Chem. Cauterize of Gran Tissue-PRO,4732,CDM,982,RC,17250,HCPCS,outpatient,,,84.46,63.35,,48.15,130,,,fee schedule,130% of fee schedule,48.15,130,,,fee schedule,130% of fee schedule,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,46.26,119,,,fee schedule,119% of fee schedule,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,100% of fee schedule,76.01,90,,,percent of total billed charges,90% of total billed charges,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.04,100,,,fee schedule,100% of fee schedule,38.04,76.01,
Chem. Cauterize of Gran Tissue-PRO,4733,CDM,981,RC,17250,HCPCS,outpatient,,,51.55,38.66,,48.15,130,,,fee schedule,130% of fee schedule,48.15,130,,,fee schedule,130% of fee schedule,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,46.26,119,,,fee schedule,119% of fee schedule,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,100% of fee schedule,46.4,90,,,percent of total billed charges,90% of total billed charges,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.04,100,,,fee schedule,100% of fee schedule,38.04,48.15,
Chem. Cauterize of Gran Tissue-PRO,4734,CDM,981,RC,17250,HCPCS,outpatient,,,51.55,38.66,,48.15,130,,,fee schedule,130% of fee schedule,48.15,130,,,fee schedule,130% of fee schedule,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,46.26,119,,,fee schedule,119% of fee schedule,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,100% of fee schedule,46.4,90,,,percent of total billed charges,90% of total billed charges,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.04,100,,,fee schedule,100% of fee schedule,38.04,48.15,
Malignant Lesion Destruc. .5 or <;Trunk Ext.,4735,CDM,521,RC,17260,HCPCS,outpatient,,,240.22,180.17,,216.2,90,,,percent of total billed charges,90% of total billed charges,223.4,93,,,percent of total billed charges,93% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,204.19,85,,,percent of total billed charges,85% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,195.54,81.4,,,percent of total billed charges,81.4% of total billed charges,216.2,90,,,percent of total billed charges,90% of total billed charges,216.2,90,,,percent of total billed charges,90% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,91.28,38,,,percent of total billed charges,38% of total billed charges,180.17,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,91.28,223.4,
DERM MALIGNANT LESION DESTRUC. .5 OR <; TRUNK EXT. - PRO,4736,CDM,982,RC,17260,HCPCS,outpatient,,,148.57,111.43,,91.46,130,,,fee schedule,130% of fee schedule,91.46,130,,,fee schedule,130% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,86.87,119,,,fee schedule,119% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,100% of fee schedule,133.71,90,,,percent of total billed charges,90% of total billed charges,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,72.4,100,,,fee schedule,100% of fee schedule,72.4,133.71,
DERM Malignant Lesion Destruc. .5 or <;Trunk Ext.-G,4737,CDM,982,RC,17260,HCPCS,outpatient,,,222.85,167.14,,91.46,130,,,fee schedule,130% of fee schedule,91.46,130,,,fee schedule,130% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,86.87,119,,,fee schedule,119% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,100% of fee schedule,200.57,90,,,percent of total billed charges,90% of total billed charges,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,72.4,100,,,fee schedule,100% of fee schedule,72.4,200.57,
Malignant Lesion Destruc. .5 or <;Trunk Ext.-PRO,4738,CDM,981,RC,17260,HCPCS,outpatient,,,142.95,107.21,,91.46,130,,,fee schedule,130% of fee schedule,91.46,130,,,fee schedule,130% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,86.87,119,,,fee schedule,119% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,100% of fee schedule,128.66,90,,,percent of total billed charges,90% of total billed charges,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,72.4,100,,,fee schedule,100% of fee schedule,72.4,128.66,
Malignant Lesion Destruc. .5 or <;Trunk Ext.-PRO,4739,CDM,981,RC,17260,HCPCS,outpatient,,,142.95,107.21,,91.46,130,,,fee schedule,130% of fee schedule,91.46,130,,,fee schedule,130% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,86.87,119,,,fee schedule,119% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,100% of fee schedule,128.66,90,,,percent of total billed charges,90% of total billed charges,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,72.4,100,,,fee schedule,100% of fee schedule,72.4,128.66,
Malignant Lesion Destruc. 0.6-1.0cm;Trunk Ext.[Package],4740,CDM,521,RC,17261,HCPCS,outpatient,,,297.64,223.23,,267.88,90,,,percent of total billed charges,90% of total billed charges,276.81,93,,,percent of total billed charges,93% of total billed charges,113.1,38,,,percent of total billed charges,38% of total billed charges,113.1,38,,,percent of total billed charges,38% of total billed charges,252.99,85,,,percent of total billed charges,85% of total billed charges,113.1,38,,,percent of total billed charges,38% of total billed charges,242.28,81.4,,,percent of total billed charges,81.4% of total billed charges,267.88,90,,,percent of total billed charges,90% of total billed charges,267.88,90,,,percent of total billed charges,90% of total billed charges,113.1,38,,,percent of total billed charges,38% of total billed charges,113.1,38,,,percent of total billed charges,38% of total billed charges,113.1,38,,,percent of total billed charges,38% of total billed charges,223.23,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,113.1,276.81,
DERM MALIGNANT LESION DESTRUC. 0.6-1.0CM; TRUNK EXT - PRO,4741,CDM,982,RC,17261,HCPCS,outpatient,,,196.32,147.24,,124.05,130,,,fee schedule,130% of fee schedule,124.05,130,,,fee schedule,130% of fee schedule,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,119,,,fee schedule,119% of fee schedule,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,100% of fee schedule,176.69,90,,,percent of total billed charges,90% of total billed charges,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,89.83,100,,,fee schedule,100% of fee schedule,88.55,100,,,fee schedule,100% of fee schedule,88.55,176.69,
DERM Malignant Lesion Destruc. 0.6-1.0cm;Trunk Ext.-G,4742,CDM,982,RC,17261,HCPCS,outpatient,,,390.53,292.9,,124.05,130,,,fee schedule,130% of fee schedule,124.05,130,,,fee schedule,130% of fee schedule,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,119,,,fee schedule,119% of fee schedule,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,100% of fee schedule,351.48,90,,,percent of total billed charges,90% of total billed charges,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,89.83,100,,,fee schedule,100% of fee schedule,88.55,100,,,fee schedule,100% of fee schedule,88.55,351.48,
Malignant Lesion Destruc. 0.6-1.0cm;Trunk Ext.-PRO,4743,CDM,981,RC,17261,HCPCS,outpatient,,,178.11,133.58,,124.05,130,,,fee schedule,130% of fee schedule,124.05,130,,,fee schedule,130% of fee schedule,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,119,,,fee schedule,119% of fee schedule,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,100% of fee schedule,160.3,90,,,percent of total billed charges,90% of total billed charges,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,88.55,100,,,fee schedule,Pays 100% Medicare OPPS,89.83,100,,,fee schedule,100% of fee schedule,88.55,100,,,fee schedule,100% of fee schedule,88.55,160.3,
Malignant Lesion Destruc. 1.1-2.0cm;Trunk Ext[Package],4744,CDM,521,RC,17262,HCPCS,outpatient,,,359.74,269.81,,323.77,90,,,percent of total billed charges,90% of total billed charges,334.56,93,,,percent of total billed charges,93% of total billed charges,136.7,38,,,percent of total billed charges,38% of total billed charges,136.7,38,,,percent of total billed charges,38% of total billed charges,305.78,85,,,percent of total billed charges,85% of total billed charges,136.7,38,,,percent of total billed charges,38% of total billed charges,292.83,81.4,,,percent of total billed charges,81.4% of total billed charges,323.77,90,,,percent of total billed charges,90% of total billed charges,323.77,90,,,percent of total billed charges,90% of total billed charges,136.7,38,,,percent of total billed charges,38% of total billed charges,136.7,38,,,percent of total billed charges,38% of total billed charges,136.7,38,,,percent of total billed charges,38% of total billed charges,269.81,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,136.7,334.56,
DERM MALIGNANT LESION DESTRUC. 1.1-2.0CM;TRUNK EXT - PRO,4745,CDM,982,RC,17262,HCPCS,outpatient,,,237.71,178.28,,158.29,130,,,fee schedule,130% of fee schedule,158.29,130,,,fee schedule,130% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,138.39,119,,,fee schedule,119% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,100% of fee schedule,213.94,90,,,percent of total billed charges,90% of total billed charges,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,112.67,100,,,fee schedule,100% of fee schedule,107.79,213.94,
DERM Malignant Lesion Destruc. 1.1-2.0cm;Trunk Ext-G,4746,CDM,982,RC,17262,HCPCS,outpatient,,,768.32,576.24,,158.29,130,,,fee schedule,130% of fee schedule,158.29,130,,,fee schedule,130% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,138.39,119,,,fee schedule,119% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,100% of fee schedule,691.49,90,,,percent of total billed charges,90% of total billed charges,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,112.67,100,,,fee schedule,100% of fee schedule,107.79,691.49,
Malignant Lesion Destruc. 1.1-2.0cm;Trunk Ext-PRO,4747,CDM,981,RC,17262,HCPCS,outpatient,,,216.79,162.59,,158.29,130,,,fee schedule,130% of fee schedule,158.29,130,,,fee schedule,130% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,138.39,119,,,fee schedule,119% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,100% of fee schedule,195.11,90,,,percent of total billed charges,90% of total billed charges,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,112.67,100,,,fee schedule,100% of fee schedule,107.79,195.11,
Malignant Lesion Destruc. 1.1-2.0cm;Trunk Ext-PRO,4748,CDM,981,RC,17262,HCPCS,outpatient,,,216.79,162.59,,158.29,130,,,fee schedule,130% of fee schedule,158.29,130,,,fee schedule,130% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,138.39,119,,,fee schedule,119% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,100% of fee schedule,195.11,90,,,percent of total billed charges,90% of total billed charges,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,112.67,100,,,fee schedule,100% of fee schedule,107.79,195.11,
"DERM EXC MAL LESION INC MARG (T,EXT) - PRO",4749,CDM,982,RC,17263,HCPCS,outpatient,,,265.3,198.98,,175.15,130,,,fee schedule,130% of fee schedule,175.15,130,,,fee schedule,130% of fee schedule,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,153.89,119,,,fee schedule,119% of fee schedule,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,100% of fee schedule,238.77,90,,,percent of total billed charges,90% of total billed charges,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,124.37,100,,,fee schedule,100% of fee schedule,122.16,238.77,
"DERM Exc Mal Lesion Inc Marg (T,EXT) - G",4750,CDM,982,RC,17263,HCPCS,outpatient,,,615.5,461.63,,175.15,130,,,fee schedule,130% of fee schedule,175.15,130,,,fee schedule,130% of fee schedule,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,153.89,119,,,fee schedule,119% of fee schedule,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,100% of fee schedule,553.95,90,,,percent of total billed charges,90% of total billed charges,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,124.37,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,124.37,100,,,fee schedule,100% of fee schedule,122.16,553.95,
"Derm Destr mal lesion, tr, ext 3.1-4cm - PRO",4751,CDM,982,RC,17264,HCPCS,outpatient,,,281.22,210.92,,186.63,130,,,fee schedule,130% of fee schedule,186.63,130,,,fee schedule,130% of fee schedule,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,164.27,119,,,fee schedule,119% of fee schedule,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,100% of fee schedule,253.1,90,,,percent of total billed charges,90% of total billed charges,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,132.59,100,,,fee schedule,100% of fee schedule,132.59,253.1,
"Derm Destr mal lesion, tr, ext 3.1-4cm -G",4752,CDM,982,RC,17264,HCPCS,outpatient,,,939.17,704.38,,186.63,130,,,fee schedule,130% of fee schedule,186.63,130,,,fee schedule,130% of fee schedule,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,164.27,119,,,fee schedule,119% of fee schedule,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,100% of fee schedule,845.25,90,,,percent of total billed charges,90% of total billed charges,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,132.59,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,132.59,100,,,fee schedule,100% of fee schedule,132.59,845.25,
"DERM DESTRUCT MALIG LESION - TRUNK, ARM, LEG >4CM - PRO",4753,CDM,982,RC,17266,HCPCS,outpatient,,,254.69,191.02,,218.15,130,,,fee schedule,130% of fee schedule,218.15,130,,,fee schedule,130% of fee schedule,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,193.59,119,,,fee schedule,119% of fee schedule,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,100% of fee schedule,229.22,90,,,percent of total billed charges,90% of total billed charges,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,156.1,100,,,fee schedule,100% of fee schedule,156.1,229.22,
"DERM DESTRUCT MALIG LESION - TRUNK, ARM, LEG >4CM - G",4754,CDM,982,RC,17266,HCPCS,outpatient,,,594.27,445.7,,218.15,130,,,fee schedule,130% of fee schedule,218.15,130,,,fee schedule,130% of fee schedule,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,193.59,119,,,fee schedule,119% of fee schedule,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,100% of fee schedule,534.84,90,,,percent of total billed charges,90% of total billed charges,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,156.1,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,156.1,100,,,fee schedule,100% of fee schedule,156.1,534.84,
DERM DESTRUCT MAL LESION SC/N/H/F/G - PRO,4755,CDM,982,RC,17271,HCPCS,outpatient,,,227.1,170.33,,151.13,130,,,fee schedule,130% of fee schedule,151.13,130,,,fee schedule,130% of fee schedule,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,131.08,119,,,fee schedule,119% of fee schedule,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,100% of fee schedule,204.39,90,,,percent of total billed charges,90% of total billed charges,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,107.56,100,,,fee schedule,100% of fee schedule,107.56,204.39,
DERM DESTRUCT MAL LESION SC/N/H/F/G - G,4756,CDM,982,RC,17271,HCPCS,outpatient,,,556.07,417.05,,151.13,130,,,fee schedule,130% of fee schedule,151.13,130,,,fee schedule,130% of fee schedule,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,131.08,119,,,fee schedule,119% of fee schedule,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,100% of fee schedule,500.46,90,,,percent of total billed charges,90% of total billed charges,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,107.56,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,107.56,100,,,fee schedule,100% of fee schedule,107.56,500.46,
DERM DESTRUCT - SKIN LESION - PRO,4757,CDM,982,RC,17272,HCPCS,outpatient,,,265.3,198.98,,174.28,130,,,fee schedule,130% of fee schedule,174.28,130,,,fee schedule,130% of fee schedule,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,119,,,fee schedule,119% of fee schedule,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,100% of fee schedule,238.77,90,,,percent of total billed charges,90% of total billed charges,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,123.33,100,,,fee schedule,100% of fee schedule,123.33,238.77,
DERM Destruct - Skin Lesion - G,4758,CDM,982,RC,17272,HCPCS,outpatient,,,477.54,358.16,,174.28,130,,,fee schedule,130% of fee schedule,174.28,130,,,fee schedule,130% of fee schedule,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,119,,,fee schedule,119% of fee schedule,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,100% of fee schedule,429.79,90,,,percent of total billed charges,90% of total billed charges,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,123.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,123.33,100,,,fee schedule,100% of fee schedule,123.33,429.79,
DERM dest. MAL lesion face-PRO,4759,CDM,982,RC,17280,HCPCS,outpatient,,,313.37,235.03,,123.12,130,,,fee schedule,130% of fee schedule,123.12,130,,,fee schedule,130% of fee schedule,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,107.68,119,,,fee schedule,119% of fee schedule,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,100% of fee schedule,282.03,90,,,percent of total billed charges,90% of total billed charges,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,88.19,100,,,fee schedule,100% of fee schedule,88.19,282.03,
DERM dest. MAL lesion face-G,4760,CDM,982,RC,17280,HCPCS,outpatient,,,537.88,403.41,,123.12,130,,,fee schedule,130% of fee schedule,123.12,130,,,fee schedule,130% of fee schedule,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,107.68,119,,,fee schedule,119% of fee schedule,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,100% of fee schedule,484.09,90,,,percent of total billed charges,90% of total billed charges,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,88.19,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,88.19,100,,,fee schedule,100% of fee schedule,88.19,484.09,
"Derm Destr, mal lesion f, head, .6-1 cm - PRO",4761,CDM,982,RC,17281,HCPCS,outpatient,,,254.69,191.02,,169.78,130,,,fee schedule,130% of fee schedule,169.78,130,,,fee schedule,130% of fee schedule,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,147.88,119,,,fee schedule,119% of fee schedule,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,100% of fee schedule,229.22,90,,,percent of total billed charges,90% of total billed charges,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,120.56,100,,,fee schedule,100% of fee schedule,120.56,229.22,
"Derm Destr, mal lesion f, head 2.1-3cm -G",4762,CDM,982,RC,17281,HCPCS,outpatient,,,912.63,684.47,,169.78,130,,,fee schedule,130% of fee schedule,169.78,130,,,fee schedule,130% of fee schedule,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,147.88,119,,,fee schedule,119% of fee schedule,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,100% of fee schedule,821.37,90,,,percent of total billed charges,90% of total billed charges,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,120.56,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,120.56,100,,,fee schedule,100% of fee schedule,120.56,821.37,
"Derm Destr, mal lesion f, head 2.1-3cm - PRO",4763,CDM,982,RC,17283,HCPCS,outpatient,,,530.6,397.95,,244.87,130,,,fee schedule,130% of fee schedule,244.87,130,,,fee schedule,130% of fee schedule,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,215.19,119,,,fee schedule,119% of fee schedule,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,100% of fee schedule,477.54,90,,,percent of total billed charges,90% of total billed charges,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,273.07,100,,,fee schedule,100% of fee schedule,172.91,100,,,fee schedule,100% of fee schedule,172.91,477.54,
"Derm Destr, mal lesion f, head 2.1-3cm - G",4764,CDM,982,RC,17283,HCPCS,outpatient,,,1188.56,891.42,,244.87,130,,,fee schedule,130% of fee schedule,244.87,130,,,fee schedule,130% of fee schedule,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,215.19,119,,,fee schedule,119% of fee schedule,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,100% of fee schedule,1069.7,90,,,percent of total billed charges,90% of total billed charges,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,172.91,100,,,fee schedule,Pays 100% Medicare OPPS,273.07,100,,,fee schedule,100% of fee schedule,172.91,100,,,fee schedule,100% of fee schedule,172.91,1069.7,
Acne/Hair Removal Cryo.,4765,CDM,521,RC,17340,HCPCS,outpatient,,,152.34,114.26,,137.11,90,,,percent of total billed charges,90% of total billed charges,141.68,93,,,percent of total billed charges,93% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,129.49,85,,,percent of total billed charges,85% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,124,81.4,,,percent of total billed charges,81.4% of total billed charges,137.11,90,,,percent of total billed charges,90% of total billed charges,137.11,90,,,percent of total billed charges,90% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,57.89,38,,,percent of total billed charges,38% of total billed charges,114.26,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,57.89,141.68,
Acne/Hair Removal Cryo.-PRO,4766,CDM,981,RC,17340,HCPCS,outpatient,,,90.22,67.67,,64.92,130,,,fee schedule,130% of fee schedule,64.92,130,,,fee schedule,130% of fee schedule,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,60.96,119,,,fee schedule,119% of fee schedule,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,100% of fee schedule,81.2,90,,,percent of total billed charges,90% of total billed charges,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,50.27,100,,,fee schedule,100% of fee schedule,21.56,81.2,
Acne/Hair Removal Cryo.-PRO,4767,CDM,981,RC,17340,HCPCS,outpatient,,,90.22,67.67,,64.92,130,,,fee schedule,130% of fee schedule,64.92,130,,,fee schedule,130% of fee schedule,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,60.96,119,,,fee schedule,119% of fee schedule,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,100% of fee schedule,81.2,90,,,percent of total billed charges,90% of total billed charges,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,50.27,100,,,fee schedule,100% of fee schedule,21.56,81.2,
INCISION OF SOFT TISSUE ABSCESS (SUPERFICIAL),4768,CDM,983,RC,20000,HCPCS,outpatient,,,479.25,359.44,,383.4,80,,,percent of total billed charges,90% of total billed charges,383.4,80,,,percent of total billed charges,93% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,431.33,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,28.74,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,28.74,431.33,
Explore penetrating wound to extremety-PRO,4769,CDM,981,RC,20103,HCPCS,outpatient,,,1259.65,944.74,,463.87,130,,,fee schedule,130% of fee schedule,463.87,130,,,fee schedule,130% of fee schedule,349.94,100,,,fee schedule,Pays 100% Medicare OPPS,349.94,100,,,fee schedule,Pays 100% Medicare OPPS,431.23,119,,,fee schedule,119% of fee schedule,349.94,100,,,fee schedule,Pays 100% Medicare OPPS,349.94,100,,,fee schedule,100% of fee schedule,1133.69,90,,,percent of total billed charges,90% of total billed charges,349.94,100,,,fee schedule,Pays 100% Medicare OPPS,349.94,100,,,fee schedule,Pays 100% Medicare OPPS,349.94,100,,,fee schedule,Pays 100% Medicare OPPS,349.94,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,349.94,100,,,fee schedule,100% of fee schedule,349.94,1133.69,
FB Rmv. Muscle/Tenon Sheath,4770,CDM,521,RC,20520,HCPCS,outpatient,,,396.05,297.04,,356.45,90,,,percent of total billed charges,90% of total billed charges,368.33,93,,,percent of total billed charges,93% of total billed charges,150.5,38,,,percent of total billed charges,38% of total billed charges,150.5,38,,,percent of total billed charges,38% of total billed charges,336.64,85,,,percent of total billed charges,85% of total billed charges,150.5,38,,,percent of total billed charges,38% of total billed charges,322.38,81.4,,,percent of total billed charges,81.4% of total billed charges,356.45,90,,,percent of total billed charges,90% of total billed charges,356.45,90,,,percent of total billed charges,90% of total billed charges,150.5,38,,,percent of total billed charges,38% of total billed charges,150.5,38,,,percent of total billed charges,38% of total billed charges,150.5,38,,,percent of total billed charges,38% of total billed charges,297.04,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,150.5,368.33,
FB Rmv. Muscle/Tenon Sheath-PRO,4771,CDM,981,RC,20520,HCPCS,outpatient,,,237.86,178.4,,191.27,130,,,fee schedule,130% of fee schedule,191.27,130,,,fee schedule,130% of fee schedule,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,182.97,119,,,fee schedule,119% of fee schedule,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,100% of fee schedule,214.07,90,,,percent of total billed charges,90% of total billed charges,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,151.34,100,,,fee schedule,100% of fee schedule,86.23,214.07,
FB Rmv. Muscle/Tenon Sheath-PRO,4772,CDM,981,RC,20520,HCPCS,outpatient,,,237.86,178.4,,191.27,130,,,fee schedule,130% of fee schedule,191.27,130,,,fee schedule,130% of fee schedule,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,182.97,119,,,fee schedule,119% of fee schedule,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,100% of fee schedule,214.07,90,,,percent of total billed charges,90% of total billed charges,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,151.34,100,,,fee schedule,100% of fee schedule,86.23,214.07,
FBR-From Finger / deep complicated-PRO,4773,CDM,981,RC,20525,HCPCS,outpatient,,,1089.75,817.31,,329.32,130,,,fee schedule,130% of fee schedule,329.32,130,,,fee schedule,130% of fee schedule,251.97,100,,,fee schedule,Pays 100% Medicare OPPS,251.97,100,,,fee schedule,Pays 100% Medicare OPPS,307,119,,,fee schedule,119% of fee schedule,251.97,100,,,fee schedule,Pays 100% Medicare OPPS,251.97,100,,,fee schedule,100% of fee schedule,980.78,90,,,percent of total billed charges,90% of total billed charges,251.97,100,,,fee schedule,Pays 100% Medicare OPPS,251.97,100,,,fee schedule,Pays 100% Medicare OPPS,251.97,100,,,fee schedule,Pays 100% Medicare OPPS,251.97,100,,,fee schedule,Pays 100% Medicare OPPS,323.37,100,,,fee schedule,100% of fee schedule,251.97,100,,,fee schedule,100% of fee schedule,251.97,980.78,
Inj. Tendon/Ligament[Package],4774,CDM,521,RC,20550,HCPCS,outpatient,,,140.62,105.47,,126.56,90,,,percent of total billed charges,90% of total billed charges,130.78,93,,,percent of total billed charges,93% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,114.46,81.4,,,percent of total billed charges,81.4% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,105.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,53.44,130.78,
Inj. Tendon/Ligament[Package],4775,CDM,521,RC,20550,HCPCS,outpatient,,,140.62,105.47,,126.56,90,,,percent of total billed charges,90% of total billed charges,130.78,93,,,percent of total billed charges,93% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,114.46,81.4,,,percent of total billed charges,81.4% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,105.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,53.44,130.78,
Inj. Tendon/Ligament[Package],4776,CDM,521,RC,20550,HCPCS,outpatient,,,140.62,105.47,,126.56,90,,,percent of total billed charges,90% of total billed charges,130.78,93,,,percent of total billed charges,93% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,114.46,81.4,,,percent of total billed charges,81.4% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,105.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,53.44,130.78,
Inj. Tendon/Ligament-PRO,4777,CDM,982,RC,20550,HCPCS,outpatient,,,85.54,64.16,,54.57,130,,,fee schedule,130% of fee schedule,54.57,130,,,fee schedule,130% of fee schedule,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,48.56,119,,,fee schedule,119% of fee schedule,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,100% of fee schedule,76.99,90,,,percent of total billed charges,90% of total billed charges,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,39.27,100,,,fee schedule,100% of fee schedule,28.74,76.99,
Inj. Tendon/Ligament-PRO,4778,CDM,982,RC,20550,HCPCS,outpatient,,,85.54,64.16,,54.57,130,,,fee schedule,130% of fee schedule,54.57,130,,,fee schedule,130% of fee schedule,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,48.56,119,,,fee schedule,119% of fee schedule,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,100% of fee schedule,76.99,90,,,percent of total billed charges,90% of total billed charges,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,39.27,100,,,fee schedule,100% of fee schedule,28.74,76.99,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4779,CDM,521,RC,20552,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4780,CDM,521,RC,20552,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4781,CDM,521,RC,20552,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4782,CDM,521,RC,20552,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4783,CDM,521,RC,20552,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4784,CDM,521,RC,20552,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
PM INJ TRIGGER POINT 1/2 MUSCL PRO,4785,CDM,988,RC,20552,HCPCS,outpatient,,,162.36,121.77,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,146.12,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,146.12,
PM INJ TRIGGER POINT 1/2 MUSCL -G,4786,CDM,982,RC,20552,HCPCS,outpatient,,,205.66,154.25,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,185.09,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,185.09,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-PRO,4787,CDM,981,RC,20552,HCPCS,outpatient,,,132.43,99.32,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,119.19,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,119.19,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-PRO,4788,CDM,981,RC,20552,HCPCS,outpatient,,,132.43,99.32,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,119.19,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,119.19,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-PRO,4789,CDM,981,RC,20552,HCPCS,outpatient,,,132.43,99.32,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,119.19,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,119.19,
INJ; Trig pts-3 or < muscles,4790,CDM,521,RC,20553,HCPCS,outpatient,,,356.21,267.16,,320.59,90,,,percent of total billed charges,90% of total billed charges,331.28,93,,,percent of total billed charges,93% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,302.78,85,,,percent of total billed charges,85% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,289.95,81.4,,,percent of total billed charges,81.4% of total billed charges,320.59,90,,,percent of total billed charges,90% of total billed charges,320.59,90,,,percent of total billed charges,90% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,267.16,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,135.36,331.28,
PM I & D complex post op IP,4791,CDM,988,RC,20553,HCPCS,outpatient,,,135.3,101.48,,56.45,130,,,fee schedule,130% of fee schedule,56.45,130,,,fee schedule,130% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,53.9,119,,,fee schedule,119% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,100% of fee schedule,121.77,90,,,percent of total billed charges,90% of total billed charges,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,42.83,100,,,fee schedule,100% of fee schedule,42.83,121.77,
PM INJECT TRIGGER POINTS 3/> PRO,4792,CDM,988,RC,20553,HCPCS,outpatient,,,378.85,284.14,,56.45,130,,,fee schedule,130% of fee schedule,56.45,130,,,fee schedule,130% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,53.9,119,,,fee schedule,119% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,100% of fee schedule,340.97,90,,,percent of total billed charges,90% of total billed charges,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,42.83,100,,,fee schedule,100% of fee schedule,42.83,340.97,
PM INJECT TRIGGER POINTS 3/> -G,4793,CDM,982,RC,20553,HCPCS,outpatient,,,476.28,357.21,,56.45,130,,,fee schedule,130% of fee schedule,56.45,130,,,fee schedule,130% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,53.9,119,,,fee schedule,119% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,100% of fee schedule,428.65,90,,,percent of total billed charges,90% of total billed charges,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,42.83,100,,,fee schedule,100% of fee schedule,42.83,428.65,
INJ; Trig pts-3 or < muscles-PRO,4794,CDM,981,RC,20553,HCPCS,outpatient,,,235.53,176.65,,56.45,130,,,fee schedule,130% of fee schedule,56.45,130,,,fee schedule,130% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,53.9,119,,,fee schedule,119% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,100% of fee schedule,211.98,90,,,percent of total billed charges,90% of total billed charges,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,42.83,100,,,fee schedule,100% of fee schedule,42.83,211.98,
INJ; Trig pts-3 or < muscles-PRO,4795,CDM,981,RC,20553,HCPCS,outpatient,,,235.53,176.65,,56.45,130,,,fee schedule,130% of fee schedule,56.45,130,,,fee schedule,130% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,53.9,119,,,fee schedule,119% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,100% of fee schedule,211.98,90,,,percent of total billed charges,90% of total billed charges,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,42.83,100,,,fee schedule,100% of fee schedule,42.83,211.98,
Asp/Inj.; Joint small joint,4796,CDM,521,RC,20600,HCPCS,outpatient,,,148.81,111.61,,133.93,90,,,percent of total billed charges,90% of total billed charges,138.39,93,,,percent of total billed charges,93% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,126.49,85,,,percent of total billed charges,85% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,121.13,81.4,,,percent of total billed charges,81.4% of total billed charges,133.93,90,,,percent of total billed charges,90% of total billed charges,133.93,90,,,percent of total billed charges,90% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,111.61,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,56.55,138.39,
Asp/Inj.; Joint small joint,4797,CDM,521,RC,20600,HCPCS,outpatient,,,148.81,111.61,,133.93,90,,,percent of total billed charges,90% of total billed charges,138.39,93,,,percent of total billed charges,93% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,126.49,85,,,percent of total billed charges,85% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,121.13,81.4,,,percent of total billed charges,81.4% of total billed charges,133.93,90,,,percent of total billed charges,90% of total billed charges,133.93,90,,,percent of total billed charges,90% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,56.55,38,,,percent of total billed charges,38% of total billed charges,111.61,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,56.55,138.39,
ORTHO Asp/Inj-small joint (w/o ultra)-G,4798,CDM,982,RC,20600,HCPCS,outpatient,,,353.78,265.34,,51.1,130,,,fee schedule,130% of fee schedule,51.1,130,,,fee schedule,130% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,44.7,119,,,fee schedule,119% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,100% of fee schedule,318.4,90,,,percent of total billed charges,90% of total billed charges,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,35.66,100,,,fee schedule,100% of fee schedule,21.56,318.4,
Asp/Inj-small joint (w/o ultra)-PRO,4799,CDM,981,RC,20600,HCPCS,outpatient,,,84.37,63.28,,51.1,130,,,fee schedule,130% of fee schedule,51.1,130,,,fee schedule,130% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,44.7,119,,,fee schedule,119% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,100% of fee schedule,75.93,90,,,percent of total billed charges,90% of total billed charges,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,35.66,100,,,fee schedule,100% of fee schedule,21.56,75.93,
Asp/Inj-small joint (w/o ultra)-PRO,4800,CDM,981,RC,20600,HCPCS,outpatient,,,84.37,63.28,,51.1,130,,,fee schedule,130% of fee schedule,51.1,130,,,fee schedule,130% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,44.7,119,,,fee schedule,119% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,100% of fee schedule,75.93,90,,,percent of total billed charges,90% of total billed charges,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,35.66,100,,,fee schedule,100% of fee schedule,21.56,75.93,
Asp/Inj-small joint (w/ultra)-PRO,4801,CDM,981,RC,20604,HCPCS,outpatient,,,167.8,125.85,,134.24,80,,,percent of total billed charges,90% of total billed charges,134.24,80,,,percent of total billed charges,93% of total billed charges,46.17,100,,,fee schedule,Pays 100% Medicare OPPS,46.17,100,,,fee schedule,Pays 100% Medicare OPPS,56.8,119,,,fee schedule,119% of fee schedule,46.17,100,,,fee schedule,Pays 100% Medicare OPPS,46.17,100,,,fee schedule,100% of fee schedule,151.02,90,,,percent of total billed charges,90% of total billed charges,46.17,100,,,fee schedule,Pays 100% Medicare OPPS,46.17,100,,,fee schedule,Pays 100% Medicare OPPS,46.17,100,,,fee schedule,Pays 100% Medicare OPPS,46.17,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,46.17,100,,,fee schedule,100% of fee schedule,46.17,151.02,
"Asp./Inj joint; Inter.(w,el,an)",4802,CDM,521,RC,20605,HCPCS,outpatient,,,237.86,178.4,,214.07,90,,,percent of total billed charges,90% of total billed charges,221.21,93,,,percent of total billed charges,93% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,202.18,85,,,percent of total billed charges,85% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,193.62,81.4,,,percent of total billed charges,81.4% of total billed charges,214.07,90,,,percent of total billed charges,90% of total billed charges,214.07,90,,,percent of total billed charges,90% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,178.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,90.39,221.21,
"Asp./Inj joint; Inter.(w,el,an)",4803,CDM,521,RC,20605,HCPCS,outpatient,,,237.86,178.4,,214.07,90,,,percent of total billed charges,90% of total billed charges,221.21,93,,,percent of total billed charges,93% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,202.18,85,,,percent of total billed charges,85% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,193.62,81.4,,,percent of total billed charges,81.4% of total billed charges,214.07,90,,,percent of total billed charges,90% of total billed charges,214.07,90,,,percent of total billed charges,90% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,90.39,38,,,percent of total billed charges,38% of total billed charges,178.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,90.39,221.21,
"Asp./Inj joint; BILATERAL Inter.(w,el,an) PRO",4804,CDM,982,RC,20605,HCPCS,outpatient,,,283.57,212.68,,53.76,130,,,fee schedule,130% of fee schedule,53.76,130,,,fee schedule,130% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,46.45,119,,,fee schedule,119% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,100% of fee schedule,255.21,90,,,percent of total billed charges,90% of total billed charges,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,37.24,100,,,fee schedule,100% of fee schedule,28.74,255.21,
"Asp./Inj joint; BILATERAL Inter.(w,el,an) PRO",4805,CDM,982,RC,20605,HCPCS,outpatient,,,283.57,212.68,,53.76,130,,,fee schedule,130% of fee schedule,53.76,130,,,fee schedule,130% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,46.45,119,,,fee schedule,119% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,100% of fee schedule,255.21,90,,,percent of total billed charges,90% of total billed charges,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,37.24,100,,,fee schedule,100% of fee schedule,28.74,255.21,
"ORTHO - Asp./Inj joint; Inter.(w,el,an)-G",4806,CDM,982,RC,20605,HCPCS,outpatient,,,411.95,308.96,,53.76,130,,,fee schedule,130% of fee schedule,53.76,130,,,fee schedule,130% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,46.45,119,,,fee schedule,119% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,100% of fee schedule,370.76,90,,,percent of total billed charges,90% of total billed charges,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,37.24,100,,,fee schedule,100% of fee schedule,28.74,370.76,
"PM - Asp./Inj joint; Inter.(w,el,an)-G",4807,CDM,982,RC,20605,HCPCS,outpatient,,,411.95,308.96,,53.76,130,,,fee schedule,130% of fee schedule,53.76,130,,,fee schedule,130% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,46.45,119,,,fee schedule,119% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,100% of fee schedule,370.76,90,,,percent of total billed charges,90% of total billed charges,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,37.24,100,,,fee schedule,100% of fee schedule,28.74,370.76,
Asp/Inj-Intermed Jnt (w/o ultra)-PRO,4808,CDM,981,RC,20605,HCPCS,outpatient,,,141.79,106.34,,53.76,130,,,fee schedule,130% of fee schedule,53.76,130,,,fee schedule,130% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,46.45,119,,,fee schedule,119% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,100% of fee schedule,127.61,90,,,percent of total billed charges,90% of total billed charges,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,37.24,100,,,fee schedule,100% of fee schedule,28.74,127.61,
Asp/Inj-Intermed Jnt (w/o ultra)-PRO,4809,CDM,981,RC,20605,HCPCS,outpatient,,,141.79,106.34,,53.76,130,,,fee schedule,130% of fee schedule,53.76,130,,,fee schedule,130% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,46.45,119,,,fee schedule,119% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,100% of fee schedule,127.61,90,,,percent of total billed charges,90% of total billed charges,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,37.24,100,,,fee schedule,100% of fee schedule,28.74,127.61,
Asp/Inj-Intermed Jnt (w/ultra)-PRO,4810,CDM,981,RC,20606,HCPCS,outpatient,,,186.94,140.21,,149.55,80,,,percent of total billed charges,90% of total billed charges,149.55,80,,,percent of total billed charges,93% of total billed charges,52.24,100,,,fee schedule,Pays 100% Medicare OPPS,52.24,100,,,fee schedule,Pays 100% Medicare OPPS,65.4,119,,,fee schedule,119% of fee schedule,52.24,100,,,fee schedule,Pays 100% Medicare OPPS,52.24,100,,,fee schedule,100% of fee schedule,168.25,90,,,percent of total billed charges,90% of total billed charges,52.24,100,,,fee schedule,Pays 100% Medicare OPPS,52.24,100,,,fee schedule,Pays 100% Medicare OPPS,52.24,100,,,fee schedule,Pays 100% Medicare OPPS,52.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,52.24,100,,,fee schedule,100% of fee schedule,52.24,168.25,
"Asp./Inj Joint; Major(s,h,k)",4811,CDM,521,RC,20610,HCPCS,outpatient,,,268.34,201.26,,241.51,90,,,percent of total billed charges,90% of total billed charges,249.56,93,,,percent of total billed charges,93% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,228.09,85,,,percent of total billed charges,85% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,218.43,81.4,,,percent of total billed charges,81.4% of total billed charges,241.51,90,,,percent of total billed charges,90% of total billed charges,241.51,90,,,percent of total billed charges,90% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,201.26,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,101.97,249.56,
"Asp./Inj Joint; Major(s,h,k)",4812,CDM,521,RC,20610,HCPCS,outpatient,,,268.34,201.26,,241.51,90,,,percent of total billed charges,90% of total billed charges,249.56,93,,,percent of total billed charges,93% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,228.09,85,,,percent of total billed charges,85% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,218.43,81.4,,,percent of total billed charges,81.4% of total billed charges,241.51,90,,,percent of total billed charges,90% of total billed charges,241.51,90,,,percent of total billed charges,90% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,101.97,38,,,percent of total billed charges,38% of total billed charges,201.26,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,101.97,249.56,
"COA ASP/INJ Joint, Major(s,h,k)",4813,CDM,982,RC,20610,HCPCS,outpatient,,,268.34,201.26,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,241.51,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,241.51,
"Asp./Inj Joint; Major(s,h,k) BILATERAL PRO",4814,CDM,982,RC,20610,HCPCS,outpatient,,,328.09,246.07,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,295.28,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,295.28,
"Asp./Inj Joint; Major(s,h,k) BILATERAL PRO",4815,CDM,982,RC,20610,HCPCS,outpatient,,,328.09,246.07,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,295.28,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,295.28,
"ORTHO Asp./Inj Joint; Major(s,h,k)-G",4816,CDM,982,RC,20610,HCPCS,outpatient,,,434.2,325.65,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,390.78,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,390.78,
"PM Arthrocentesis, aspiration and/or injection, major joint or bursa PRO",4817,CDM,988,RC,20610,HCPCS,outpatient,,,327.42,245.57,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,294.68,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,294.68,
Asp/Inj-Major joint (w/o ultra)-PRO,4818,CDM,981,RC,20610,HCPCS,outpatient,,,164.04,123.03,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,147.64,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,147.64,
Asp/Inj-Major joint (w/o ultra)-PRO,4819,CDM,981,RC,20610,HCPCS,outpatient,,,164.04,123.03,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,147.64,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,147.64,
"Bilateral Asp/Inj joint, major (k,",4820,CDM,981,RC,20610,HCPCS,outpatient,,,1.12,0.84,,1.46,130,,,fee schedule,130% of fee schedule,1.46,130,,,fee schedule,130% of fee schedule,1.12,100,,,fee schedule,Pays 100% Medicare OPPS,1.12,100,,,fee schedule,Pays 100% Medicare OPPS,1.33,119,,,fee schedule,119% of fee schedule,1.12,100,,,fee schedule,Pays 100% Medicare OPPS,1.12,100,,,fee schedule,100% of fee schedule,1.01,90,,,percent of total billed charges,90% of total billed charges,1.12,100,,,fee schedule,Pays 100% Medicare OPPS,1.12,100,,,fee schedule,Pays 100% Medicare OPPS,1.12,100,,,fee schedule,Pays 100% Medicare OPPS,1.12,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,1.12,100,,,fee schedule,100% of fee schedule,1.01,43.12,
Asp/Inj-Major joint (w/ultra)-PRO,4821,CDM,981,RC,20611,HCPCS,outpatient,,,165.61,124.21,,132.49,80,,,percent of total billed charges,90% of total billed charges,132.49,80,,,percent of total billed charges,93% of total billed charges,60.2,100,,,fee schedule,Pays 100% Medicare OPPS,60.2,100,,,fee schedule,Pays 100% Medicare OPPS,74.47,119,,,fee schedule,119% of fee schedule,60.2,100,,,fee schedule,Pays 100% Medicare OPPS,60.2,100,,,fee schedule,100% of fee schedule,149.05,90,,,percent of total billed charges,90% of total billed charges,60.2,100,,,fee schedule,Pays 100% Medicare OPPS,60.2,100,,,fee schedule,Pays 100% Medicare OPPS,60.2,100,,,fee schedule,Pays 100% Medicare OPPS,60.2,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,60.2,100,,,fee schedule,100% of fee schedule,60.2,149.05,
Asp/Inj. of Ganglion,4822,CDM,521,RC,20612,HCPCS,outpatient,,,158.18,118.64,,142.36,90,,,percent of total billed charges,90% of total billed charges,147.11,93,,,percent of total billed charges,93% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,134.45,85,,,percent of total billed charges,85% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,128.76,81.4,,,percent of total billed charges,81.4% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,118.64,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,60.11,147.11,
Asp/Inj. of Ganglion-PRO,4823,CDM,981,RC,20612,HCPCS,outpatient,,,96.09,72.07,,55.09,130,,,fee schedule,130% of fee schedule,55.09,130,,,fee schedule,130% of fee schedule,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,51.3,119,,,fee schedule,119% of fee schedule,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,100% of fee schedule,86.48,90,,,percent of total billed charges,90% of total billed charges,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,41.48,100,,,fee schedule,100% of fee schedule,41.48,86.48,
Asp/Inj. of Ganglion-PRO,4824,CDM,981,RC,20612,HCPCS,outpatient,,,96.09,72.07,,55.09,130,,,fee schedule,130% of fee schedule,55.09,130,,,fee schedule,130% of fee schedule,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,51.3,119,,,fee schedule,119% of fee schedule,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,100% of fee schedule,86.48,90,,,percent of total billed charges,90% of total billed charges,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,41.48,100,,,fee schedule,100% of fee schedule,41.48,86.48,
Pin removal - distal plalanx-pro,4825,CDM,975,RC,20670,HCPCS,outpatient,,,850.04,637.53,,195.53,130,,,fee schedule,130% of fee schedule,195.53,130,,,fee schedule,130% of fee schedule,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,181.36,119,,,fee schedule,119% of fee schedule,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,100% of fee schedule,765.04,90,,,percent of total billed charges,90% of total billed charges,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,149.02,100,,,fee schedule,100% of fee schedule,107.79,765.04,
REMOVAL OF IMPLANT(SUPERFICIAL),4826,CDM,982,RC,20670,HCPCS,outpatient,,,1100.29,825.22,,195.53,130,,,fee schedule,130% of fee schedule,195.53,130,,,fee schedule,130% of fee schedule,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,181.36,119,,,fee schedule,119% of fee schedule,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,100% of fee schedule,990.26,90,,,percent of total billed charges,90% of total billed charges,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,149.02,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,149.02,100,,,fee schedule,100% of fee schedule,107.79,990.26,
FRX/DIS-Clsd.Nasal W/O Manip.,4827,CDM,521,RC,21310,HCPCS,outpatient,,,405.42,304.07,,364.88,90,,,percent of total billed charges,90% of total billed charges,377.04,93,,,percent of total billed charges,93% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,344.61,85,,,percent of total billed charges,85% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,330.01,81.4,,,percent of total billed charges,81.4% of total billed charges,364.88,90,,,percent of total billed charges,90% of total billed charges,364.88,90,,,percent of total billed charges,90% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,154.06,38,,,percent of total billed charges,38% of total billed charges,304.07,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,154.06,377.04,
FRX/DIS-Clsd.Nasal W/O Manip.-PRO,4828,CDM,981,RC,21310,HCPCS,outpatient,,,243.73,182.8,,36.91,130,,,fee schedule,130% of fee schedule,36.91,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,34.06,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,219.36,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,93.42,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,34.06,219.36,
FRX/DIS-Closed Nasal W/O Stabilize,4829,CDM,521,RC,21315,HCPCS,outpatient,,,643.29,482.47,,578.96,90,,,percent of total billed charges,90% of total billed charges,598.26,93,,,percent of total billed charges,93% of total billed charges,244.45,38,,,percent of total billed charges,38% of total billed charges,244.45,38,,,percent of total billed charges,38% of total billed charges,546.8,85,,,percent of total billed charges,85% of total billed charges,244.45,38,,,percent of total billed charges,38% of total billed charges,523.64,81.4,,,percent of total billed charges,81.4% of total billed charges,578.96,90,,,percent of total billed charges,90% of total billed charges,578.96,90,,,percent of total billed charges,90% of total billed charges,244.45,38,,,percent of total billed charges,38% of total billed charges,244.45,38,,,percent of total billed charges,38% of total billed charges,244.45,38,,,percent of total billed charges,38% of total billed charges,482.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,244.45,598.26,
Closed Eye Socket Fracture-PRO,4830,CDM,981,RC,21400,HCPCS,outpatient,,,323.42,242.57,,203.88,130,,,fee schedule,130% of fee schedule,203.88,130,,,fee schedule,130% of fee schedule,175.17,100,,,fee schedule,Pays 100% Medicare OPPS,175.17,100,,,fee schedule,Pays 100% Medicare OPPS,200.02,119,,,fee schedule,119% of fee schedule,175.17,100,,,fee schedule,Pays 100% Medicare OPPS,175.17,100,,,fee schedule,100% of fee schedule,291.08,90,,,percent of total billed charges,90% of total billed charges,175.17,100,,,fee schedule,Pays 100% Medicare OPPS,175.17,100,,,fee schedule,Pays 100% Medicare OPPS,175.17,100,,,fee schedule,Pays 100% Medicare OPPS,175.17,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,175.17,100,,,fee schedule,100% of fee schedule,93.42,291.08,
FRX/DIS-Mandible W/O Manip.,4831,CDM,521,RC,21450,HCPCS,outpatient,,,1156.55,867.41,,1040.9,90,,,percent of total billed charges,90% of total billed charges,1075.59,93,,,percent of total billed charges,93% of total billed charges,439.49,38,,,percent of total billed charges,38% of total billed charges,439.49,38,,,percent of total billed charges,38% of total billed charges,983.07,85,,,percent of total billed charges,85% of total billed charges,439.49,38,,,percent of total billed charges,38% of total billed charges,941.43,81.4,,,percent of total billed charges,81.4% of total billed charges,1040.9,90,,,percent of total billed charges,90% of total billed charges,1040.9,90,,,percent of total billed charges,90% of total billed charges,439.49,38,,,percent of total billed charges,38% of total billed charges,439.49,38,,,percent of total billed charges,38% of total billed charges,439.49,38,,,percent of total billed charges,38% of total billed charges,867.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,439.49,1075.59,
FRX/DIS-Mandible W/O Manip.-PRO,4832,CDM,981,RC,21450,HCPCS,outpatient,,,693.7,520.28,,641.55,130,,,fee schedule,130% of fee schedule,641.55,130,,,fee schedule,130% of fee schedule,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,587.46,119,,,fee schedule,119% of fee schedule,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,100% of fee schedule,624.33,90,,,percent of total billed charges,90% of total billed charges,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,505.85,100,,,fee schedule,100% of fee schedule,93.42,641.55,
FRX/DIS-Mandible W/O Manip.-PRO,4833,CDM,981,RC,21450,HCPCS,outpatient,,,693.7,520.28,,641.55,130,,,fee schedule,130% of fee schedule,641.55,130,,,fee schedule,130% of fee schedule,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,587.46,119,,,fee schedule,119% of fee schedule,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,100% of fee schedule,624.33,90,,,percent of total billed charges,90% of total billed charges,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,505.85,100,,,fee schedule,100% of fee schedule,93.42,641.55,
Dislocation TX jaw PRO,4834,CDM,981,RC,21480,HCPCS,outpatient,,,301.63,226.22,,42.8,130,,,fee schedule,130% of fee schedule,42.8,130,,,fee schedule,130% of fee schedule,31.13,100,,,fee schedule,Pays 100% Medicare OPPS,31.13,100,,,fee schedule,Pays 100% Medicare OPPS,39.34,119,,,fee schedule,119% of fee schedule,31.13,100,,,fee schedule,Pays 100% Medicare OPPS,31.13,100,,,fee schedule,100% of fee schedule,271.47,90,,,percent of total billed charges,90% of total billed charges,31.13,100,,,fee schedule,Pays 100% Medicare OPPS,31.13,100,,,fee schedule,Pays 100% Medicare OPPS,31.13,100,,,fee schedule,Pays 100% Medicare OPPS,31.13,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,31.13,100,,,fee schedule,100% of fee schedule,31.13,287.44,
Derm Exc tumor soft tissN.T.F<5cm-G,4835,CDM,982,RC,21556,HCPCS,outpatient,,,4386,3289.5,,710.26,130,,,fee schedule,130% of fee schedule,710.26,130,,,fee schedule,130% of fee schedule,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,656.55,119,,,fee schedule,119% of fee schedule,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,100% of fee schedule,3947.4,90,,,percent of total billed charges,90% of total billed charges,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,543.86,100,,,fee schedule,100% of fee schedule,179.65,3947.4,
Derm Exc tumor soft tissN.T.F<5cm PRO,4836,CDM,982,RC,21556,HCPCS,outpatient,,,765,573.75,,710.26,130,,,fee schedule,130% of fee schedule,710.26,130,,,fee schedule,130% of fee schedule,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,656.55,119,,,fee schedule,119% of fee schedule,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,100% of fee schedule,688.5,90,,,percent of total billed charges,90% of total billed charges,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,543.86,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,543.86,100,,,fee schedule,100% of fee schedule,179.65,710.26,
FXR- Sternum Closed,4837,CDM,521,RC,21820,HCPCS,outpatient,,,575.34,431.51,,517.81,90,,,percent of total billed charges,90% of total billed charges,535.07,93,,,percent of total billed charges,93% of total billed charges,218.63,38,,,percent of total billed charges,38% of total billed charges,218.63,38,,,percent of total billed charges,38% of total billed charges,489.04,85,,,percent of total billed charges,85% of total billed charges,218.63,38,,,percent of total billed charges,38% of total billed charges,468.33,81.4,,,percent of total billed charges,81.4% of total billed charges,517.81,90,,,percent of total billed charges,90% of total billed charges,517.81,90,,,percent of total billed charges,90% of total billed charges,218.63,38,,,percent of total billed charges,38% of total billed charges,218.63,38,,,percent of total billed charges,38% of total billed charges,218.63,38,,,percent of total billed charges,38% of total billed charges,431.51,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,218.63,535.07,
FXR-Sternum Closed-PRO,4838,CDM,981,RC,21820,HCPCS,outpatient,,,345.68,259.26,,188.18,130,,,fee schedule,130% of fee schedule,188.18,130,,,fee schedule,130% of fee schedule,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,180.69,119,,,fee schedule,119% of fee schedule,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,100% of fee schedule,311.11,90,,,percent of total billed charges,90% of total billed charges,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,156.43,100,,,fee schedule,100% of fee schedule,156.43,311.11,
FXR-Sternum Closed-PRO,4839,CDM,981,RC,21820,HCPCS,outpatient,,,345.68,259.26,,188.18,130,,,fee schedule,130% of fee schedule,188.18,130,,,fee schedule,130% of fee schedule,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,180.69,119,,,fee schedule,119% of fee schedule,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,100% of fee schedule,311.11,90,,,percent of total billed charges,90% of total billed charges,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,156.43,100,,,fee schedule,100% of fee schedule,156.43,311.11,
FRX-Closed Vert W/O manip,4840,CDM,521,RC,22310,HCPCS,outpatient,,,628.07,471.05,,565.26,90,,,percent of total billed charges,90% of total billed charges,584.11,93,,,percent of total billed charges,93% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,533.86,85,,,percent of total billed charges,85% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,511.25,81.4,,,percent of total billed charges,81.4% of total billed charges,565.26,90,,,percent of total billed charges,90% of total billed charges,565.26,90,,,percent of total billed charges,90% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,471.05,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,238.67,584.11,
FBR-Shoulder; subcutaneous-PRO,4841,CDM,981,RC,23330,HCPCS,outpatient,,,501.51,376.13,,196.91,130,,,fee schedule,130% of fee schedule,196.91,130,,,fee schedule,130% of fee schedule,172.9,100,,,fee schedule,Pays 100% Medicare OPPS,172.9,100,,,fee schedule,Pays 100% Medicare OPPS,207.27,119,,,fee schedule,119% of fee schedule,172.9,100,,,fee schedule,Pays 100% Medicare OPPS,172.9,100,,,fee schedule,100% of fee schedule,451.36,90,,,percent of total billed charges,90% of total billed charges,172.9,100,,,fee schedule,Pays 100% Medicare OPPS,172.9,100,,,fee schedule,Pays 100% Medicare OPPS,172.9,100,,,fee schedule,Pays 100% Medicare OPPS,172.9,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,172.9,100,,,fee schedule,100% of fee schedule,172.9,451.36,
Soft tissue FB removal - Shoulder - Deep-PRO,4842,CDM,981,RC,23333,HCPCS,outpatient,,,1098.01,823.51,,878.41,80,,,percent of total billed charges,90% of total billed charges,878.41,80,,,percent of total billed charges,93% of total billed charges,489.73,100,,,fee schedule,Pays 100% Medicare OPPS,489.73,100,,,fee schedule,Pays 100% Medicare OPPS,577.98,119,,,fee schedule,119% of fee schedule,489.73,100,,,fee schedule,Pays 100% Medicare OPPS,489.73,100,,,fee schedule,100% of fee schedule,988.21,90,,,percent of total billed charges,90% of total billed charges,489.73,100,,,fee schedule,Pays 100% Medicare OPPS,489.73,100,,,fee schedule,Pays 100% Medicare OPPS,489.73,100,,,fee schedule,Pays 100% Medicare OPPS,489.73,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,489.73,100,,,fee schedule,100% of fee schedule,489.73,988.21,
FRX CLSD Clavicular[Package],4843,CDM,521,RC,23500,HCPCS,outpatient,,,492.15,369.11,,442.94,90,,,percent of total billed charges,90% of total billed charges,457.7,93,,,percent of total billed charges,93% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,418.33,85,,,percent of total billed charges,85% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,400.61,81.4,,,percent of total billed charges,81.4% of total billed charges,442.94,90,,,percent of total billed charges,90% of total billed charges,442.94,90,,,percent of total billed charges,90% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,369.11,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,187.02,457.7,
FRX-Clavicle clsd (w/o manip)-PRO,4844,CDM,981,RC,23500,HCPCS,outpatient,,,552.03,414.02,,285.1,130,,,fee schedule,130% of fee schedule,285.1,130,,,fee schedule,130% of fee schedule,243.7,100,,,fee schedule,Pays 100% Medicare OPPS,243.7,100,,,fee schedule,Pays 100% Medicare OPPS,280.65,119,,,fee schedule,119% of fee schedule,243.7,100,,,fee schedule,Pays 100% Medicare OPPS,243.7,100,,,fee schedule,100% of fee schedule,496.83,90,,,percent of total billed charges,90% of total billed charges,243.7,100,,,fee schedule,Pays 100% Medicare OPPS,243.7,100,,,fee schedule,Pays 100% Medicare OPPS,243.7,100,,,fee schedule,Pays 100% Medicare OPPS,243.7,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,243.7,100,,,fee schedule,100% of fee schedule,93.42,496.83,
Closed Fracture Reduction- Clavicular-PRO,4845,CDM,981,RC,23505,HCPCS,outpatient,,,827.72,620.79,,431.55,130,,,fee schedule,130% of fee schedule,431.55,130,,,fee schedule,130% of fee schedule,351.72,100,,,fee schedule,Pays 100% Medicare OPPS,351.72,100,,,fee schedule,Pays 100% Medicare OPPS,416.73,119,,,fee schedule,119% of fee schedule,351.72,100,,,fee schedule,Pays 100% Medicare OPPS,351.72,100,,,fee schedule,100% of fee schedule,744.95,90,,,percent of total billed charges,90% of total billed charges,351.72,100,,,fee schedule,Pays 100% Medicare OPPS,351.72,100,,,fee schedule,Pays 100% Medicare OPPS,351.72,100,,,fee schedule,Pays 100% Medicare OPPS,351.72,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,351.72,100,,,fee schedule,100% of fee schedule,215.58,744.95,
Dislocate Shoulder-Sternocl.W/O manip,4846,CDM,521,RC,23520,HCPCS,outpatient,,,519.09,389.32,,467.18,90,,,percent of total billed charges,90% of total billed charges,482.75,93,,,percent of total billed charges,93% of total billed charges,197.25,38,,,percent of total billed charges,38% of total billed charges,197.25,38,,,percent of total billed charges,38% of total billed charges,441.23,85,,,percent of total billed charges,85% of total billed charges,197.25,38,,,percent of total billed charges,38% of total billed charges,422.54,81.4,,,percent of total billed charges,81.4% of total billed charges,467.18,90,,,percent of total billed charges,90% of total billed charges,467.18,90,,,percent of total billed charges,90% of total billed charges,197.25,38,,,percent of total billed charges,38% of total billed charges,197.25,38,,,percent of total billed charges,38% of total billed charges,197.25,38,,,percent of total billed charges,38% of total billed charges,389.32,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,197.25,482.75,
Dislocate Shoulder-Sternocl.W/O Manip.-PRO,4847,CDM,981,RC,23520,HCPCS,outpatient,,,512.06,384.05,,303.98,130,,,fee schedule,130% of fee schedule,303.98,130,,,fee schedule,130% of fee schedule,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,294.56,119,,,fee schedule,119% of fee schedule,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,100% of fee schedule,460.85,90,,,percent of total billed charges,90% of total billed charges,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,253.9,100,,,fee schedule,100% of fee schedule,93.42,460.85,
Dislocate Shoulder-Sternocl.W/O Manip.-PRO,4848,CDM,981,RC,23520,HCPCS,outpatient,,,512.06,384.05,,303.98,130,,,fee schedule,130% of fee schedule,303.98,130,,,fee schedule,130% of fee schedule,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,294.56,119,,,fee schedule,119% of fee schedule,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,100% of fee schedule,460.85,90,,,percent of total billed charges,90% of total billed charges,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,253.9,100,,,fee schedule,100% of fee schedule,93.42,460.85,
FX Scapular Closed,4849,CDM,521,RC,23570,HCPCS,outpatient,,,544.88,408.66,,490.39,90,,,percent of total billed charges,90% of total billed charges,506.74,93,,,percent of total billed charges,93% of total billed charges,207.05,38,,,percent of total billed charges,38% of total billed charges,207.05,38,,,percent of total billed charges,38% of total billed charges,463.15,85,,,percent of total billed charges,85% of total billed charges,207.05,38,,,percent of total billed charges,38% of total billed charges,443.53,81.4,,,percent of total billed charges,81.4% of total billed charges,490.39,90,,,percent of total billed charges,90% of total billed charges,490.39,90,,,percent of total billed charges,90% of total billed charges,207.05,38,,,percent of total billed charges,38% of total billed charges,207.05,38,,,percent of total billed charges,38% of total billed charges,207.05,38,,,percent of total billed charges,38% of total billed charges,408.66,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,207.05,506.74,
FX prox_hum W/O Manip,4850,CDM,521,RC,23600,HCPCS,outpatient,,,689.02,516.77,,620.12,90,,,percent of total billed charges,90% of total billed charges,640.79,93,,,percent of total billed charges,93% of total billed charges,261.83,38,,,percent of total billed charges,38% of total billed charges,261.83,38,,,percent of total billed charges,38% of total billed charges,585.67,85,,,percent of total billed charges,85% of total billed charges,261.83,38,,,percent of total billed charges,38% of total billed charges,560.86,81.4,,,percent of total billed charges,81.4% of total billed charges,620.12,90,,,percent of total billed charges,90% of total billed charges,620.12,90,,,percent of total billed charges,90% of total billed charges,261.83,38,,,percent of total billed charges,38% of total billed charges,261.83,38,,,percent of total billed charges,38% of total billed charges,261.83,38,,,percent of total billed charges,38% of total billed charges,516.77,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,261.83,640.79,
FRX-prox humerus clsd (w/o manip)-PRO,4851,CDM,981,RC,23600,HCPCS,outpatient,,,717.66,538.25,,393.59,130,,,fee schedule,130% of fee schedule,393.59,130,,,fee schedule,130% of fee schedule,336.66,100,,,fee schedule,Pays 100% Medicare OPPS,336.66,100,,,fee schedule,Pays 100% Medicare OPPS,388.33,119,,,fee schedule,119% of fee schedule,336.66,100,,,fee schedule,Pays 100% Medicare OPPS,336.66,100,,,fee schedule,100% of fee schedule,645.89,90,,,percent of total billed charges,90% of total billed charges,336.66,100,,,fee schedule,Pays 100% Medicare OPPS,336.66,100,,,fee schedule,Pays 100% Medicare OPPS,336.66,100,,,fee schedule,Pays 100% Medicare OPPS,336.66,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,336.66,100,,,fee schedule,100% of fee schedule,143.72,645.89,
Closed Frx Red-Prox Hum (w/man.) - PRO,4852,CDM,981,RC,23605,HCPCS,outpatient,,,1087.87,815.9,,558.32,130,,,fee schedule,130% of fee schedule,558.32,130,,,fee schedule,130% of fee schedule,448.67,100,,,fee schedule,Pays 100% Medicare OPPS,448.67,100,,,fee schedule,Pays 100% Medicare OPPS,531.23,119,,,fee schedule,119% of fee schedule,448.67,100,,,fee schedule,Pays 100% Medicare OPPS,448.67,100,,,fee schedule,100% of fee schedule,979.08,90,,,percent of total billed charges,90% of total billed charges,448.67,100,,,fee schedule,Pays 100% Medicare OPPS,448.67,100,,,fee schedule,Pays 100% Medicare OPPS,448.67,100,,,fee schedule,Pays 100% Medicare OPPS,448.67,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,448.67,100,,,fee schedule,100% of fee schedule,359.3,979.08,
"Disloc.-Shoulder W/ Manip,W/O anes",4853,CDM,521,RC,23650,HCPCS,outpatient,,,629.26,471.95,,566.33,90,,,percent of total billed charges,90% of total billed charges,585.21,93,,,percent of total billed charges,93% of total billed charges,239.12,38,,,percent of total billed charges,38% of total billed charges,239.12,38,,,percent of total billed charges,38% of total billed charges,534.87,85,,,percent of total billed charges,85% of total billed charges,239.12,38,,,percent of total billed charges,38% of total billed charges,512.22,81.4,,,percent of total billed charges,81.4% of total billed charges,566.33,90,,,percent of total billed charges,90% of total billed charges,566.33,90,,,percent of total billed charges,90% of total billed charges,239.12,38,,,percent of total billed charges,38% of total billed charges,239.12,38,,,percent of total billed charges,38% of total billed charges,239.12,38,,,percent of total billed charges,38% of total billed charges,471.95,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,239.12,585.21,
"Disloc.-Shoulder W/ Manip,W/O anes-PRO",4854,CDM,981,RC,23650,HCPCS,outpatient,,,377.3,282.98,,359.15,130,,,fee schedule,130% of fee schedule,359.15,130,,,fee schedule,130% of fee schedule,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,362.19,119,,,fee schedule,119% of fee schedule,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,100% of fee schedule,339.57,90,,,percent of total billed charges,90% of total billed charges,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,316.15,100,,,fee schedule,100% of fee schedule,179.65,362.19,
"Disloc.-Shoulder W/ Manip,W/O anes-PRO",4855,CDM,981,RC,23650,HCPCS,outpatient,,,377.3,282.98,,359.15,130,,,fee schedule,130% of fee schedule,359.15,130,,,fee schedule,130% of fee schedule,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,362.19,119,,,fee schedule,119% of fee schedule,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,100% of fee schedule,339.57,90,,,percent of total billed charges,90% of total billed charges,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,316.15,100,,,fee schedule,100% of fee schedule,179.65,362.19,
DIS-Shoulder (w/manip & w/anesth)-PRO,4856,CDM,981,RC,23655,HCPCS,outpatient,,,932.94,699.71,,518.27,130,,,fee schedule,130% of fee schedule,518.27,130,,,fee schedule,130% of fee schedule,427.13,100,,,fee schedule,Pays 100% Medicare OPPS,427.13,100,,,fee schedule,Pays 100% Medicare OPPS,504.64,119,,,fee schedule,119% of fee schedule,427.13,100,,,fee schedule,Pays 100% Medicare OPPS,427.13,100,,,fee schedule,100% of fee schedule,839.65,90,,,percent of total billed charges,90% of total billed charges,427.13,100,,,fee schedule,Pays 100% Medicare OPPS,427.13,100,,,fee schedule,Pays 100% Medicare OPPS,427.13,100,,,fee schedule,Pays 100% Medicare OPPS,427.13,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,427.13,100,,,fee schedule,100% of fee schedule,179.65,839.65,
I&D upper arm or elbow area deep abscess or hematoma-PRO,4857,CDM,981,RC,23930,HCPCS,outpatient,,,806.19,604.64,,285.12,130,,,fee schedule,130% of fee schedule,285.12,130,,,fee schedule,130% of fee schedule,220.52,100,,,fee schedule,Pays 100% Medicare OPPS,220.52,100,,,fee schedule,Pays 100% Medicare OPPS,264.13,119,,,fee schedule,119% of fee schedule,220.52,100,,,fee schedule,Pays 100% Medicare OPPS,220.52,100,,,fee schedule,100% of fee schedule,725.57,90,,,percent of total billed charges,90% of total billed charges,220.52,100,,,fee schedule,Pays 100% Medicare OPPS,220.52,100,,,fee schedule,Pays 100% Medicare OPPS,220.52,100,,,fee schedule,Pays 100% Medicare OPPS,220.52,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,220.52,100,,,fee schedule,100% of fee schedule,143.72,725.57,
Excise Oleocranon bursa-PRO,4858,CDM,975,RC,24105,HCPCS,outpatient,,,788.32,591.24,,457.64,130,,,fee schedule,130% of fee schedule,457.64,130,,,fee schedule,130% of fee schedule,377.86,100,,,fee schedule,Pays 100% Medicare OPPS,377.86,100,,,fee schedule,Pays 100% Medicare OPPS,442.25,119,,,fee schedule,119% of fee schedule,377.86,100,,,fee schedule,Pays 100% Medicare OPPS,377.86,100,,,fee schedule,100% of fee schedule,709.49,90,,,percent of total billed charges,90% of total billed charges,377.86,100,,,fee schedule,Pays 100% Medicare OPPS,377.86,100,,,fee schedule,Pays 100% Medicare OPPS,377.86,100,,,fee schedule,Pays 100% Medicare OPPS,377.86,100,,,fee schedule,Pays 100% Medicare OPPS,344.93,100,,,fee schedule,100% of fee schedule,377.86,100,,,fee schedule,100% of fee schedule,344.93,709.49,
Soft tissue FB removal - Upper Arm-PRO,4859,CDM,981,RC,24200,HCPCS,outpatient,,,487.62,365.72,,184.5,130,,,fee schedule,130% of fee schedule,184.5,130,,,fee schedule,130% of fee schedule,143.66,100,,,fee schedule,Pays 100% Medicare OPPS,143.66,100,,,fee schedule,Pays 100% Medicare OPPS,175.39,119,,,fee schedule,119% of fee schedule,143.66,100,,,fee schedule,Pays 100% Medicare OPPS,143.66,100,,,fee schedule,100% of fee schedule,438.86,90,,,percent of total billed charges,90% of total billed charges,143.66,100,,,fee schedule,Pays 100% Medicare OPPS,143.66,100,,,fee schedule,Pays 100% Medicare OPPS,143.66,100,,,fee schedule,Pays 100% Medicare OPPS,143.66,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,143.66,100,,,fee schedule,100% of fee schedule,93.42,438.86,
Soft tissue FB removal - Upper Arm -  Deep-PRO,4860,CDM,981,RC,24201,HCPCS,outpatient,,,1297.34,973.01,,481.57,130,,,fee schedule,130% of fee schedule,481.57,130,,,fee schedule,130% of fee schedule,379.11,100,,,fee schedule,Pays 100% Medicare OPPS,379.11,100,,,fee schedule,Pays 100% Medicare OPPS,451.44,119,,,fee schedule,119% of fee schedule,379.11,100,,,fee schedule,Pays 100% Medicare OPPS,379.11,100,,,fee schedule,100% of fee schedule,1167.61,90,,,percent of total billed charges,90% of total billed charges,379.11,100,,,fee schedule,Pays 100% Medicare OPPS,379.11,100,,,fee schedule,Pays 100% Medicare OPPS,379.11,100,,,fee schedule,Pays 100% Medicare OPPS,379.11,100,,,fee schedule,Pays 100% Medicare OPPS,280.25,100,,,fee schedule,100% of fee schedule,379.11,100,,,fee schedule,100% of fee schedule,280.25,1167.61,
0R PRO ARTHROTOMY ELBOW W DEBR,4861,CDM,975,RC,24358,HCPCS,outpatient,,,1973.27,1479.95,,691.81,130,,,fee schedule,130% of fee schedule,691.81,130,,,fee schedule,130% of fee schedule,549.41,100,,,fee schedule,Pays 100% Medicare OPPS,549.41,100,,,fee schedule,Pays 100% Medicare OPPS,656.68,119,,,fee schedule,119% of fee schedule,549.41,100,,,fee schedule,Pays 100% Medicare OPPS,549.41,100,,,fee schedule,100% of fee schedule,1775.94,90,,,percent of total billed charges,90% of total billed charges,549.41,100,,,fee schedule,Pays 100% Medicare OPPS,549.41,100,,,fee schedule,Pays 100% Medicare OPPS,549.41,100,,,fee schedule,Pays 100% Medicare OPPS,549.41,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,549.41,100,,,fee schedule,100% of fee schedule,549.41,1775.94,
OR PRO FASCIOTOMY LOWER ARM,4862,CDM,975,RC,24495,HCPCS,outpatient,,,1448.32,1086.24,,855.88,130,,,fee schedule,130% of fee schedule,855.88,130,,,fee schedule,130% of fee schedule,969.68,100,,,fee schedule,Pays 100% Medicare OPPS,969.68,100,,,fee schedule,Pays 100% Medicare OPPS,1017.9,119,,,fee schedule,119% of fee schedule,969.68,100,,,fee schedule,Pays 100% Medicare OPPS,969.68,100,,,fee schedule,100% of fee schedule,1303.49,90,,,percent of total billed charges,90% of total billed charges,969.68,100,,,fee schedule,Pays 100% Medicare OPPS,969.68,100,,,fee schedule,Pays 100% Medicare OPPS,969.68,100,,,fee schedule,Pays 100% Medicare OPPS,969.68,100,,,fee schedule,Pays 100% Medicare OPPS,862.32,100,,,fee schedule,100% of fee schedule,969.68,100,,,fee schedule,100% of fee schedule,855.88,1303.49,
FRX-humerus clsd (w/o manip)-PRO,4863,CDM,981,RC,24500,HCPCS,outpatient,,,883.27,662.45,,419.84,130,,,fee schedule,130% of fee schedule,419.84,130,,,fee schedule,130% of fee schedule,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,411.32,119,,,fee schedule,119% of fee schedule,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,100% of fee schedule,794.94,90,,,percent of total billed charges,90% of total billed charges,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,354.91,100,,,fee schedule,100% of fee schedule,93.42,794.94,
FRX-humerus clsd (w/o manip)-PRO,4864,CDM,981,RC,24500,HCPCS,outpatient,,,883.27,662.45,,419.84,130,,,fee schedule,130% of fee schedule,419.84,130,,,fee schedule,130% of fee schedule,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,411.32,119,,,fee schedule,119% of fee schedule,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,100% of fee schedule,794.94,90,,,percent of total billed charges,90% of total billed charges,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,354.91,100,,,fee schedule,100% of fee schedule,93.42,794.94,
Closed Humerus Fx w/ manipulation-PRO,4865,CDM,981,RC,24505,HCPCS,outpatient,,,516.75,387.56,,592.58,130,,,fee schedule,130% of fee schedule,592.58,130,,,fee schedule,130% of fee schedule,474.78,100,,,fee schedule,Pays 100% Medicare OPPS,474.78,100,,,fee schedule,Pays 100% Medicare OPPS,560.66,119,,,fee schedule,119% of fee schedule,474.78,100,,,fee schedule,Pays 100% Medicare OPPS,474.78,100,,,fee schedule,100% of fee schedule,465.08,90,,,percent of total billed charges,90% of total billed charges,474.78,100,,,fee schedule,Pays 100% Medicare OPPS,474.78,100,,,fee schedule,Pays 100% Medicare OPPS,474.78,100,,,fee schedule,Pays 100% Medicare OPPS,474.78,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,474.78,100,,,fee schedule,100% of fee schedule,359.3,592.58,
FRX/DIS Elbow/Upper Arm W/ manip,4866,CDM,521,RC,24535,HCPCS,outpatient,,,1379.16,1034.37,,1241.24,90,,,percent of total billed charges,90% of total billed charges,1282.62,93,,,percent of total billed charges,93% of total billed charges,524.08,38,,,percent of total billed charges,38% of total billed charges,524.08,38,,,percent of total billed charges,38% of total billed charges,1172.29,85,,,percent of total billed charges,85% of total billed charges,524.08,38,,,percent of total billed charges,38% of total billed charges,1122.64,81.4,,,percent of total billed charges,81.4% of total billed charges,1241.24,90,,,percent of total billed charges,90% of total billed charges,1241.24,90,,,percent of total billed charges,90% of total billed charges,524.08,38,,,percent of total billed charges,38% of total billed charges,524.08,38,,,percent of total billed charges,38% of total billed charges,524.08,38,,,percent of total billed charges,38% of total billed charges,1034.37,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,524.08,1282.62,
Closed Fracture Reduction - Supracondylar-PRO,4867,CDM,981,RC,24535,HCPCS,outpatient,,,1450.99,1088.24,,747.5,130,,,fee schedule,130% of fee schedule,747.5,130,,,fee schedule,130% of fee schedule,595.29,100,,,fee schedule,Pays 100% Medicare OPPS,595.29,100,,,fee schedule,Pays 100% Medicare OPPS,707.24,119,,,fee schedule,119% of fee schedule,595.29,100,,,fee schedule,Pays 100% Medicare OPPS,595.29,100,,,fee schedule,100% of fee schedule,1305.89,90,,,percent of total billed charges,90% of total billed charges,595.29,100,,,fee schedule,Pays 100% Medicare OPPS,595.29,100,,,fee schedule,Pays 100% Medicare OPPS,595.29,100,,,fee schedule,Pays 100% Medicare OPPS,595.29,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,595.29,100,,,fee schedule,100% of fee schedule,359.3,1305.89,
FX-HUM epicon W/O manip,4868,CDM,521,RC,24560,HCPCS,outpatient,,,640.95,480.71,,576.86,90,,,percent of total billed charges,90% of total billed charges,596.08,93,,,percent of total billed charges,93% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,544.81,85,,,percent of total billed charges,85% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,521.73,81.4,,,percent of total billed charges,81.4% of total billed charges,576.86,90,,,percent of total billed charges,90% of total billed charges,576.86,90,,,percent of total billed charges,90% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,480.71,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,243.56,596.08,
FX-HUM epicon W/O Manip-PRO,4869,CDM,981,RC,24560,HCPCS,outpatient,,,384.34,288.26,,371.19,130,,,fee schedule,130% of fee schedule,371.19,130,,,fee schedule,130% of fee schedule,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,365.73,119,,,fee schedule,119% of fee schedule,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,100% of fee schedule,345.91,90,,,percent of total billed charges,90% of total billed charges,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,314.27,100,,,fee schedule,100% of fee schedule,93.42,371.19,
FX-HUM epicon W/O Manip-PRO,4870,CDM,981,RC,24560,HCPCS,outpatient,,,384.34,288.26,,371.19,130,,,fee schedule,130% of fee schedule,371.19,130,,,fee schedule,130% of fee schedule,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,365.73,119,,,fee schedule,119% of fee schedule,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,100% of fee schedule,345.91,90,,,percent of total billed charges,90% of total billed charges,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,314.27,100,,,fee schedule,100% of fee schedule,93.42,371.19,
"Disl-Elbow,Closed W/O Manip",4871,CDM,521,RC,24600,HCPCS,outpatient,,,786.26,589.7,,707.63,90,,,percent of total billed charges,90% of total billed charges,731.22,93,,,percent of total billed charges,93% of total billed charges,298.78,38,,,percent of total billed charges,38% of total billed charges,298.78,38,,,percent of total billed charges,38% of total billed charges,668.32,85,,,percent of total billed charges,85% of total billed charges,298.78,38,,,percent of total billed charges,38% of total billed charges,640.02,81.4,,,percent of total billed charges,81.4% of total billed charges,707.63,90,,,percent of total billed charges,90% of total billed charges,707.63,90,,,percent of total billed charges,90% of total billed charges,298.78,38,,,percent of total billed charges,38% of total billed charges,298.78,38,,,percent of total billed charges,38% of total billed charges,298.78,38,,,percent of total billed charges,38% of total billed charges,589.7,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,298.78,731.22,
"Disl-Elbow,Closed W/O Manip-PRO",4872,CDM,981,RC,24600,HCPCS,outpatient,,,471.06,353.3,,426.89,130,,,fee schedule,130% of fee schedule,426.89,130,,,fee schedule,130% of fee schedule,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,419.9,119,,,fee schedule,119% of fee schedule,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,100% of fee schedule,423.95,90,,,percent of total billed charges,90% of total billed charges,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,359.66,100,,,fee schedule,100% of fee schedule,143.72,426.89,
"Disl-Elbow,Closed W/O Manip-PRO",4873,CDM,981,RC,24600,HCPCS,outpatient,,,471.06,353.3,,426.89,130,,,fee schedule,130% of fee schedule,426.89,130,,,fee schedule,130% of fee schedule,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,419.9,119,,,fee schedule,119% of fee schedule,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,100% of fee schedule,423.95,90,,,percent of total billed charges,90% of total billed charges,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,359.66,100,,,fee schedule,100% of fee schedule,143.72,426.89,
DIS-Elbow (w/anesth)-PRO,4874,CDM,981,RC,24605,HCPCS,outpatient,,,1095.25,821.44,,612.98,130,,,fee schedule,130% of fee schedule,612.98,130,,,fee schedule,130% of fee schedule,499.86,100,,,fee schedule,Pays 100% Medicare OPPS,499.86,100,,,fee schedule,Pays 100% Medicare OPPS,591.13,119,,,fee schedule,119% of fee schedule,499.86,100,,,fee schedule,Pays 100% Medicare OPPS,499.86,100,,,fee schedule,100% of fee schedule,985.73,90,,,percent of total billed charges,90% of total billed charges,499.86,100,,,fee schedule,Pays 100% Medicare OPPS,499.86,100,,,fee schedule,Pays 100% Medicare OPPS,499.86,100,,,fee schedule,Pays 100% Medicare OPPS,499.86,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,499.86,100,,,fee schedule,100% of fee schedule,179.65,985.73,
FRX/DIS-Radial Head Nursemaid W/ Manip,4875,CDM,521,RC,24640,HCPCS,outpatient,,,356.21,267.16,,320.59,90,,,percent of total billed charges,90% of total billed charges,331.28,93,,,percent of total billed charges,93% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,302.78,85,,,percent of total billed charges,85% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,289.95,81.4,,,percent of total billed charges,81.4% of total billed charges,320.59,90,,,percent of total billed charges,90% of total billed charges,320.59,90,,,percent of total billed charges,90% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,135.36,38,,,percent of total billed charges,38% of total billed charges,267.16,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,135.36,331.28,
FRX/DIS-Radial Head Nursemaid W/ Manip.-PRO,4876,CDM,981,RC,24640,HCPCS,outpatient,,,214.42,160.82,,118.24,130,,,fee schedule,130% of fee schedule,118.24,130,,,fee schedule,130% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,97.98,119,,,fee schedule,119% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,100% of fee schedule,192.98,90,,,percent of total billed charges,90% of total billed charges,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,82.27,100,,,fee schedule,100% of fee schedule,82.27,192.98,
FRX/DIS-Radial Head Nursemaid W/ Manip.-PRO,4877,CDM,981,RC,24640,HCPCS,outpatient,,,214.42,160.82,,118.24,130,,,fee schedule,130% of fee schedule,118.24,130,,,fee schedule,130% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,97.98,119,,,fee schedule,119% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,100% of fee schedule,192.98,90,,,percent of total billed charges,90% of total billed charges,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,82.27,100,,,fee schedule,100% of fee schedule,82.27,192.98,
FRX/DIS-Radial Head Nursemaid W/ Manip.-PRO,4878,CDM,981,RC,24640,HCPCS,outpatient,,,214.42,160.82,,118.24,130,,,fee schedule,130% of fee schedule,118.24,130,,,fee schedule,130% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,97.98,119,,,fee schedule,119% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,100% of fee schedule,192.98,90,,,percent of total billed charges,90% of total billed charges,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,82.27,100,,,fee schedule,100% of fee schedule,82.27,192.98,
FRX/DIS-Radial Head Nursemaid W/ Manip.-FAC,4879,CDM,450,RC,24640,HCPCS,outpatient,,,141.79,106.34,,127.61,90,,,percent of total billed charges,90% of total billed charges,131.86,93,,,percent of total billed charges,93% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,115.42,81.4,,,percent of total billed charges,81.4% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,106.34,75,,,percent of total billed charges,75% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,131.86,
FRX/DIS-Radial Head Nursemaid W/ Manip.-FAC,4880,CDM,450,RC,24640,HCPCS,outpatient,,,141.79,106.34,,127.61,90,,,percent of total billed charges,90% of total billed charges,131.86,93,,,percent of total billed charges,93% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,115.42,81.4,,,percent of total billed charges,81.4% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,106.34,75,,,percent of total billed charges,75% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,131.86,
FRX-Radial Head W/O Manip,4881,CDM,521,RC,24650,HCPCS,outpatient,,,605.81,454.36,,545.23,90,,,percent of total billed charges,90% of total billed charges,563.4,93,,,percent of total billed charges,93% of total billed charges,230.21,38,,,percent of total billed charges,38% of total billed charges,230.21,38,,,percent of total billed charges,38% of total billed charges,514.94,85,,,percent of total billed charges,85% of total billed charges,230.21,38,,,percent of total billed charges,38% of total billed charges,493.13,81.4,,,percent of total billed charges,81.4% of total billed charges,545.23,90,,,percent of total billed charges,90% of total billed charges,545.23,90,,,percent of total billed charges,90% of total billed charges,230.21,38,,,percent of total billed charges,38% of total billed charges,230.21,38,,,percent of total billed charges,38% of total billed charges,230.21,38,,,percent of total billed charges,38% of total billed charges,454.36,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,230.21,563.4,
FRX-Radial Head W/O Manip-PRO,4882,CDM,981,RC,24650,HCPCS,outpatient,,,556.46,417.35,,309.53,130,,,fee schedule,130% of fee schedule,309.53,130,,,fee schedule,130% of fee schedule,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,303.07,119,,,fee schedule,119% of fee schedule,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,100% of fee schedule,500.81,90,,,percent of total billed charges,90% of total billed charges,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,262.41,100,,,fee schedule,100% of fee schedule,143.72,500.81,
FRX-Radial Head W/O Manip-PRO,4883,CDM,981,RC,24650,HCPCS,outpatient,,,556.46,417.35,,309.53,130,,,fee schedule,130% of fee schedule,309.53,130,,,fee schedule,130% of fee schedule,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,303.07,119,,,fee schedule,119% of fee schedule,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,100% of fee schedule,500.81,90,,,percent of total billed charges,90% of total billed charges,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,262.41,100,,,fee schedule,100% of fee schedule,143.72,500.81,
Closed Fracture Reduction - Radial head-PRO,4884,CDM,981,RC,24655,HCPCS,outpatient,,,1029.32,771.99,,515.84,130,,,fee schedule,130% of fee schedule,515.84,130,,,fee schedule,130% of fee schedule,426,100,,,fee schedule,Pays 100% Medicare OPPS,426,100,,,fee schedule,Pays 100% Medicare OPPS,497.85,119,,,fee schedule,119% of fee schedule,426,100,,,fee schedule,Pays 100% Medicare OPPS,426,100,,,fee schedule,100% of fee schedule,926.39,90,,,percent of total billed charges,90% of total billed charges,426,100,,,fee schedule,Pays 100% Medicare OPPS,426,100,,,fee schedule,Pays 100% Medicare OPPS,426,100,,,fee schedule,Pays 100% Medicare OPPS,426,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,426,100,,,fee schedule,100% of fee schedule,215.58,926.39,
"FX- Ulna, W/O Manip",4885,CDM,521,RC,24670,HCPCS,outpatient,,,595.25,446.44,,535.73,90,,,percent of total billed charges,90% of total billed charges,553.58,93,,,percent of total billed charges,93% of total billed charges,226.2,38,,,percent of total billed charges,38% of total billed charges,226.2,38,,,percent of total billed charges,38% of total billed charges,505.96,85,,,percent of total billed charges,85% of total billed charges,226.2,38,,,percent of total billed charges,38% of total billed charges,484.53,81.4,,,percent of total billed charges,81.4% of total billed charges,535.73,90,,,percent of total billed charges,90% of total billed charges,535.73,90,,,percent of total billed charges,90% of total billed charges,226.2,38,,,percent of total billed charges,38% of total billed charges,226.2,38,,,percent of total billed charges,38% of total billed charges,226.2,38,,,percent of total billed charges,38% of total billed charges,446.44,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,226.2,553.58,
FRX-Ulnar (prox)-clsd (w/o manip)-PRO,4886,CDM,981,RC,24670,HCPCS,outpatient,,,772.86,579.65,,339.56,130,,,fee schedule,130% of fee schedule,339.56,130,,,fee schedule,130% of fee schedule,285.25,100,,,fee schedule,Pays 100% Medicare OPPS,285.25,100,,,fee schedule,Pays 100% Medicare OPPS,331.38,119,,,fee schedule,119% of fee schedule,285.25,100,,,fee schedule,Pays 100% Medicare OPPS,285.25,100,,,fee schedule,100% of fee schedule,695.57,90,,,percent of total billed charges,90% of total billed charges,285.25,100,,,fee schedule,Pays 100% Medicare OPPS,285.25,100,,,fee schedule,Pays 100% Medicare OPPS,285.25,100,,,fee schedule,Pays 100% Medicare OPPS,285.25,100,,,fee schedule,Pays 100% Medicare OPPS,136.53,100,,,fee schedule,100% of fee schedule,285.25,100,,,fee schedule,100% of fee schedule,136.53,695.57,
Closed Fracture Reduction - Ulnar-PRO,4887,CDM,981,RC,24675,HCPCS,outpatient,,,1069.86,802.4,,545.14,130,,,fee schedule,130% of fee schedule,545.14,130,,,fee schedule,130% of fee schedule,439.18,100,,,fee schedule,Pays 100% Medicare OPPS,439.18,100,,,fee schedule,Pays 100% Medicare OPPS,519.68,119,,,fee schedule,119% of fee schedule,439.18,100,,,fee schedule,Pays 100% Medicare OPPS,439.18,100,,,fee schedule,100% of fee schedule,962.87,90,,,percent of total billed charges,90% of total billed charges,439.18,100,,,fee schedule,Pays 100% Medicare OPPS,439.18,100,,,fee schedule,Pays 100% Medicare OPPS,439.18,100,,,fee schedule,Pays 100% Medicare OPPS,439.18,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,439.18,100,,,fee schedule,100% of fee schedule,215.58,962.87,
OR PRO Inc. Extensor Tendon Sheath,4888,CDM,975,RC,25000,HCPCS,outpatient,,,558.94,419.21,,440.17,130,,,fee schedule,130% of fee schedule,440.17,130,,,fee schedule,130% of fee schedule,363.6,100,,,fee schedule,Pays 100% Medicare OPPS,363.6,100,,,fee schedule,Pays 100% Medicare OPPS,423.6,119,,,fee schedule,119% of fee schedule,363.6,100,,,fee schedule,Pays 100% Medicare OPPS,363.6,100,,,fee schedule,100% of fee schedule,503.05,90,,,percent of total billed charges,90% of total billed charges,363.6,100,,,fee schedule,Pays 100% Medicare OPPS,363.6,100,,,fee schedule,Pays 100% Medicare OPPS,363.6,100,,,fee schedule,Pays 100% Medicare OPPS,363.6,100,,,fee schedule,Pays 100% Medicare OPPS,316.18,100,,,fee schedule,100% of fee schedule,363.6,100,,,fee schedule,100% of fee schedule,316.18,503.05,
OR PRO EXCISION GANGLION WRIST,4889,CDM,975,RC,25111,HCPCS,outpatient,,,1220.98,915.74,,418.59,130,,,fee schedule,130% of fee schedule,418.59,130,,,fee schedule,130% of fee schedule,340.86,100,,,fee schedule,Pays 100% Medicare OPPS,340.86,100,,,fee schedule,Pays 100% Medicare OPPS,401.4,119,,,fee schedule,119% of fee schedule,340.86,100,,,fee schedule,Pays 100% Medicare OPPS,340.86,100,,,fee schedule,100% of fee schedule,1098.88,90,,,percent of total billed charges,90% of total billed charges,340.86,100,,,fee schedule,Pays 100% Medicare OPPS,340.86,100,,,fee schedule,Pays 100% Medicare OPPS,340.86,100,,,fee schedule,Pays 100% Medicare OPPS,340.86,100,,,fee schedule,Pays 100% Medicare OPPS,222.77,100,,,fee schedule,100% of fee schedule,340.86,100,,,fee schedule,100% of fee schedule,222.77,1098.88,
OR Excise Wrist Tendon sheath w/o anes PRO,4890,CDM,975,RC,25118,HCPCS,outpatient,,,662.44,496.83,,502.66,130,,,fee schedule,130% of fee schedule,502.66,130,,,fee schedule,130% of fee schedule,400.26,100,,,fee schedule,Pays 100% Medicare OPPS,400.26,100,,,fee schedule,Pays 100% Medicare OPPS,475.49,119,,,fee schedule,119% of fee schedule,400.26,100,,,fee schedule,Pays 100% Medicare OPPS,400.26,100,,,fee schedule,100% of fee schedule,596.2,90,,,percent of total billed charges,90% of total billed charges,400.26,100,,,fee schedule,Pays 100% Medicare OPPS,400.26,100,,,fee schedule,Pays 100% Medicare OPPS,400.26,100,,,fee schedule,Pays 100% Medicare OPPS,400.26,100,,,fee schedule,Pays 100% Medicare OPPS,718.6,100,,,fee schedule,100% of fee schedule,400.26,100,,,fee schedule,100% of fee schedule,400.26,718.6,
FRX-Radial Shaft; W/O Manip,4891,CDM,521,RC,25500,HCPCS,outpatient,,,616.37,462.28,,554.73,90,,,percent of total billed charges,90% of total billed charges,573.22,93,,,percent of total billed charges,93% of total billed charges,234.22,38,,,percent of total billed charges,38% of total billed charges,234.22,38,,,percent of total billed charges,38% of total billed charges,523.91,85,,,percent of total billed charges,85% of total billed charges,234.22,38,,,percent of total billed charges,38% of total billed charges,501.73,81.4,,,percent of total billed charges,81.4% of total billed charges,554.73,90,,,percent of total billed charges,90% of total billed charges,554.73,90,,,percent of total billed charges,90% of total billed charges,234.22,38,,,percent of total billed charges,38% of total billed charges,234.22,38,,,percent of total billed charges,38% of total billed charges,234.22,38,,,percent of total billed charges,38% of total billed charges,462.28,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,234.22,573.22,
FRX-radial shaft-clsd-w/o manip-PRO,4892,CDM,981,RC,25500,HCPCS,outpatient,,,662.44,496.83,,321.26,130,,,fee schedule,130% of fee schedule,321.26,130,,,fee schedule,130% of fee schedule,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,315.31,119,,,fee schedule,119% of fee schedule,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,100% of fee schedule,596.2,90,,,percent of total billed charges,90% of total billed charges,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,274.35,100,,,fee schedule,100% of fee schedule,93.42,596.2,
FRX-radial shaft-clsd-w/o manip-PRO,4893,CDM,981,RC,25500,HCPCS,outpatient,,,662.44,496.83,,321.26,130,,,fee schedule,130% of fee schedule,321.26,130,,,fee schedule,130% of fee schedule,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,315.31,119,,,fee schedule,119% of fee schedule,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,100% of fee schedule,596.2,90,,,percent of total billed charges,90% of total billed charges,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,274.35,100,,,fee schedule,100% of fee schedule,93.42,596.2,
Closed Radial Fx w/ manipulation-PRO,4894,CDM,981,RC,25505,HCPCS,outpatient,,,49.22,36.92,,63.99,130,,,fee schedule,130% of fee schedule,63.99,130,,,fee schedule,130% of fee schedule,49.22,100,,,fee schedule,Pays 100% Medicare OPPS,49.22,100,,,fee schedule,Pays 100% Medicare OPPS,58.57,119,,,fee schedule,119% of fee schedule,49.22,100,,,fee schedule,Pays 100% Medicare OPPS,49.22,100,,,fee schedule,100% of fee schedule,44.3,90,,,percent of total billed charges,90% of total billed charges,49.22,100,,,fee schedule,Pays 100% Medicare OPPS,49.22,100,,,fee schedule,Pays 100% Medicare OPPS,49.22,100,,,fee schedule,Pays 100% Medicare OPPS,49.22,100,,,fee schedule,Pays 100% Medicare OPPS,301.81,100,,,fee schedule,100% of fee schedule,49.22,100,,,fee schedule,100% of fee schedule,44.3,301.81,
FRX-Ulnar Shaft W/O Manip,4895,CDM,521,RC,25530,HCPCS,outpatient,,,602.3,451.73,,542.07,90,,,percent of total billed charges,90% of total billed charges,560.14,93,,,percent of total billed charges,93% of total billed charges,228.87,38,,,percent of total billed charges,38% of total billed charges,228.87,38,,,percent of total billed charges,38% of total billed charges,511.96,85,,,percent of total billed charges,85% of total billed charges,228.87,38,,,percent of total billed charges,38% of total billed charges,490.27,81.4,,,percent of total billed charges,81.4% of total billed charges,542.07,90,,,percent of total billed charges,90% of total billed charges,542.07,90,,,percent of total billed charges,90% of total billed charges,228.87,38,,,percent of total billed charges,38% of total billed charges,228.87,38,,,percent of total billed charges,38% of total billed charges,228.87,38,,,percent of total billed charges,38% of total billed charges,451.73,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,228.87,560.14,
FRX-Ulnar Shaft closed w/o manip-PRO,4896,CDM,981,RC,25530,HCPCS,outpatient,,,662.44,496.83,,305.59,130,,,fee schedule,130% of fee schedule,305.59,130,,,fee schedule,130% of fee schedule,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,299.68,119,,,fee schedule,119% of fee schedule,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,100% of fee schedule,596.2,90,,,percent of total billed charges,90% of total billed charges,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,259.4,100,,,fee schedule,100% of fee schedule,186.84,596.2,
FRX-Ulnar Shaft closed w/o manip-PRO,4897,CDM,981,RC,25530,HCPCS,outpatient,,,662.44,496.83,,305.59,130,,,fee schedule,130% of fee schedule,305.59,130,,,fee schedule,130% of fee schedule,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,299.68,119,,,fee schedule,119% of fee schedule,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,100% of fee schedule,596.2,90,,,percent of total billed charges,90% of total billed charges,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,259.4,100,,,fee schedule,100% of fee schedule,186.84,596.2,
Closed Ulnar Shaft Fx w/ Manipulation-PRO,4898,CDM,981,RC,25535,HCPCS,outpatient,,,836.66,627.5,,592.8,130,,,fee schedule,130% of fee schedule,592.8,130,,,fee schedule,130% of fee schedule,480.86,100,,,fee schedule,Pays 100% Medicare OPPS,480.86,100,,,fee schedule,Pays 100% Medicare OPPS,565.35,119,,,fee schedule,119% of fee schedule,480.86,100,,,fee schedule,Pays 100% Medicare OPPS,480.86,100,,,fee schedule,100% of fee schedule,752.99,90,,,percent of total billed charges,90% of total billed charges,480.86,100,,,fee schedule,Pays 100% Medicare OPPS,480.86,100,,,fee schedule,Pays 100% Medicare OPPS,480.86,100,,,fee schedule,Pays 100% Medicare OPPS,480.86,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,480.86,100,,,fee schedule,100% of fee schedule,287.44,752.99,
FRX-RDL/Ulnar Shaft W/O Manip[Package],4899,CDM,521,RC,25560,HCPCS,outpatient,,,625.71,469.28,,563.14,90,,,percent of total billed charges,90% of total billed charges,581.91,93,,,percent of total billed charges,93% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,531.85,85,,,percent of total billed charges,85% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,509.33,81.4,,,percent of total billed charges,81.4% of total billed charges,563.14,90,,,percent of total billed charges,90% of total billed charges,563.14,90,,,percent of total billed charges,90% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,237.77,38,,,percent of total billed charges,38% of total billed charges,469.28,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,237.77,581.91,
FRX-Radial/Ulnar Shaft w/o manip-PRO,4900,CDM,981,RC,25560,HCPCS,outpatient,,,853.05,639.79,,321.1,130,,,fee schedule,130% of fee schedule,321.1,130,,,fee schedule,130% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,317.98,119,,,fee schedule,119% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,100% of fee schedule,767.75,90,,,percent of total billed charges,90% of total billed charges,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,276.06,100,,,fee schedule,100% of fee schedule,186.84,767.75,
FRX-Radial/Ulnar Shaft w/o manip-PRO,4901,CDM,981,RC,25560,HCPCS,outpatient,,,853.05,639.79,,321.1,130,,,fee schedule,130% of fee schedule,321.1,130,,,fee schedule,130% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,317.98,119,,,fee schedule,119% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,100% of fee schedule,767.75,90,,,percent of total billed charges,90% of total billed charges,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,276.06,100,,,fee schedule,100% of fee schedule,186.84,767.75,
FRX-Radial/Ulnar Shaft w/o manip-PRO,4902,CDM,981,RC,25560,HCPCS,outpatient,,,853.05,639.79,,321.1,130,,,fee schedule,130% of fee schedule,321.1,130,,,fee schedule,130% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,317.98,119,,,fee schedule,119% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,100% of fee schedule,767.75,90,,,percent of total billed charges,90% of total billed charges,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,276.06,100,,,fee schedule,100% of fee schedule,186.84,767.75,
Closed Radial & Ulnar Fx w/ manipulation-PRO,4903,CDM,981,RC,25565,HCPCS,outpatient,,,1025.29,768.97,,619.01,130,,,fee schedule,130% of fee schedule,619.01,130,,,fee schedule,130% of fee schedule,488.71,100,,,fee schedule,Pays 100% Medicare OPPS,488.71,100,,,fee schedule,Pays 100% Medicare OPPS,579.08,119,,,fee schedule,119% of fee schedule,488.71,100,,,fee schedule,Pays 100% Medicare OPPS,488.71,100,,,fee schedule,100% of fee schedule,922.76,90,,,percent of total billed charges,90% of total billed charges,488.71,100,,,fee schedule,Pays 100% Medicare OPPS,488.71,100,,,fee schedule,Pays 100% Medicare OPPS,488.71,100,,,fee schedule,Pays 100% Medicare OPPS,488.71,100,,,fee schedule,Pays 100% Medicare OPPS,388.04,100,,,fee schedule,100% of fee schedule,488.71,100,,,fee schedule,100% of fee schedule,388.04,922.76,
FRX-Distal Radial W/O Manip,4904,CDM,521,RC,25600,HCPCS,outpatient,,,686.66,515,,617.99,90,,,percent of total billed charges,90% of total billed charges,638.59,93,,,percent of total billed charges,93% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,583.66,85,,,percent of total billed charges,85% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,558.94,81.4,,,percent of total billed charges,81.4% of total billed charges,617.99,90,,,percent of total billed charges,90% of total billed charges,617.99,90,,,percent of total billed charges,90% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,515,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,260.93,638.59,
FRX-Distal Radial W/O Manip,4905,CDM,521,RC,25600,HCPCS,outpatient,,,686.66,515,,617.99,90,,,percent of total billed charges,90% of total billed charges,638.59,93,,,percent of total billed charges,93% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,583.66,85,,,percent of total billed charges,85% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,558.94,81.4,,,percent of total billed charges,81.4% of total billed charges,617.99,90,,,percent of total billed charges,90% of total billed charges,617.99,90,,,percent of total billed charges,90% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,260.93,38,,,percent of total billed charges,38% of total billed charges,515,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,260.93,638.59,
FRX-Distal Radial W/O Manip-PRO,4906,CDM,981,RC,25600,HCPCS,outpatient,,,713.61,535.21,,346.15,130,,,fee schedule,130% of fee schedule,346.15,130,,,fee schedule,130% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,395.13,119,,,fee schedule,119% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,100% of fee schedule,642.25,90,,,percent of total billed charges,90% of total billed charges,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,346.59,100,,,fee schedule,100% of fee schedule,215.58,642.25,
FRX-Distal Radial W/O Manip-PRO,4907,CDM,981,RC,25600,HCPCS,outpatient,,,713.61,535.21,,346.15,130,,,fee schedule,130% of fee schedule,346.15,130,,,fee schedule,130% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,395.13,119,,,fee schedule,119% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,100% of fee schedule,642.25,90,,,percent of total billed charges,90% of total billed charges,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,346.59,100,,,fee schedule,100% of fee schedule,215.58,642.25,
FRX-Distal Radial closed w/o manip-PRO,4908,CDM,981,RC,25600,HCPCS,outpatient,,,717.66,538.25,,346.15,130,,,fee schedule,130% of fee schedule,346.15,130,,,fee schedule,130% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,395.13,119,,,fee schedule,119% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,100% of fee schedule,645.89,90,,,percent of total billed charges,90% of total billed charges,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,346.59,100,,,fee schedule,100% of fee schedule,215.58,645.89,
"OR PRO Decompression fasciotomy, leg posterior compartment(s) only",4909,CDM,975,RC,25601,HCPCS,outpatient,,,717.14,537.86,,573.71,80,,,percent of total billed charges,90% of total billed charges,573.71,80,,,percent of total billed charges,93% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,645.43,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,573.71,645.43,
FRX-Distal Radial closed w/manip-PRO,4910,CDM,981,RC,25605,HCPCS,outpatient,,,1387.38,1040.54,,770,130,,,fee schedule,130% of fee schedule,770,130,,,fee schedule,130% of fee schedule,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,637.8,119,,,fee schedule,119% of fee schedule,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,100% of fee schedule,1248.64,90,,,percent of total billed charges,90% of total billed charges,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,535.89,100,,,fee schedule,100% of fee schedule,287.44,1248.64,
FRX-Distal Radial closed w/manip-PRO,4911,CDM,981,RC,25605,HCPCS,outpatient,,,1387.38,1040.54,,770,130,,,fee schedule,130% of fee schedule,770,130,,,fee schedule,130% of fee schedule,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,637.8,119,,,fee schedule,119% of fee schedule,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,100% of fee schedule,1248.64,90,,,percent of total billed charges,90% of total billed charges,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,535.89,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,535.89,100,,,fee schedule,100% of fee schedule,287.44,1248.64,
OR PRO Open reduct with int fix  radius,4912,CDM,975,RC,25607,HCPCS,outpatient,,,1269.05,951.79,,969.98,130,,,fee schedule,130% of fee schedule,969.98,130,,,fee schedule,130% of fee schedule,765.52,100,,,fee schedule,Pays 100% Medicare OPPS,765.52,100,,,fee schedule,Pays 100% Medicare OPPS,917.06,119,,,fee schedule,119% of fee schedule,765.52,100,,,fee schedule,Pays 100% Medicare OPPS,765.52,100,,,fee schedule,100% of fee schedule,1142.15,90,,,percent of total billed charges,90% of total billed charges,765.52,100,,,fee schedule,Pays 100% Medicare OPPS,765.52,100,,,fee schedule,Pays 100% Medicare OPPS,765.52,100,,,fee schedule,Pays 100% Medicare OPPS,765.52,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,765.52,100,,,fee schedule,100% of fee schedule,765.52,1142.15,
OR PRO FX RADIUS 3 FRAG FIX,4913,CDM,975,RC,25609,HCPCS,outpatient,,,2581.42,1936.07,,1387.84,130,,,fee schedule,130% of fee schedule,1387.84,130,,,fee schedule,130% of fee schedule,1081.17,100,,,fee schedule,Pays 100% Medicare OPPS,1081.17,100,,,fee schedule,Pays 100% Medicare OPPS,1307.27,119,,,fee schedule,119% of fee schedule,1081.17,100,,,fee schedule,Pays 100% Medicare OPPS,1081.17,100,,,fee schedule,100% of fee schedule,2323.28,90,,,percent of total billed charges,90% of total billed charges,1081.17,100,,,fee schedule,Pays 100% Medicare OPPS,1081.17,100,,,fee schedule,Pays 100% Medicare OPPS,1081.17,100,,,fee schedule,Pays 100% Medicare OPPS,1081.17,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,1081.17,100,,,fee schedule,100% of fee schedule,1081.17,2323.28,
FRX-Carpal Bone W/O Manip,4914,CDM,521,RC,25630,HCPCS,outpatient,,,628.07,471.05,,565.26,90,,,percent of total billed charges,90% of total billed charges,584.11,93,,,percent of total billed charges,93% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,533.86,85,,,percent of total billed charges,85% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,511.25,81.4,,,percent of total billed charges,81.4% of total billed charges,565.26,90,,,percent of total billed charges,90% of total billed charges,565.26,90,,,percent of total billed charges,90% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,471.05,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,238.67,584.11,
FRX-Carpal Bone W/O Manip-PRO,4915,CDM,981,RC,25630,HCPCS,outpatient,,,377.3,282.98,,364.27,130,,,fee schedule,130% of fee schedule,364.27,130,,,fee schedule,130% of fee schedule,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,353.3,119,,,fee schedule,119% of fee schedule,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,100% of fee schedule,339.57,90,,,percent of total billed charges,90% of total billed charges,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,251.51,100,,,fee schedule,100% of fee schedule,302.45,100,,,fee schedule,100% of fee schedule,251.51,364.27,
FRX-Carpal Bone W/O Manip-PRO,4916,CDM,981,RC,25630,HCPCS,outpatient,,,377.3,282.98,,364.27,130,,,fee schedule,130% of fee schedule,364.27,130,,,fee schedule,130% of fee schedule,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,353.3,119,,,fee schedule,119% of fee schedule,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,100% of fee schedule,339.57,90,,,percent of total billed charges,90% of total billed charges,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,251.51,100,,,fee schedule,100% of fee schedule,302.45,100,,,fee schedule,100% of fee schedule,251.51,364.27,
FRX-Ulnar Styloid,4917,CDM,521,RC,25650,HCPCS,outpatient,,,746.43,559.82,,671.79,90,,,percent of total billed charges,90% of total billed charges,694.18,93,,,percent of total billed charges,93% of total billed charges,283.64,38,,,percent of total billed charges,38% of total billed charges,283.64,38,,,percent of total billed charges,38% of total billed charges,634.47,85,,,percent of total billed charges,85% of total billed charges,283.64,38,,,percent of total billed charges,38% of total billed charges,607.59,81.4,,,percent of total billed charges,81.4% of total billed charges,671.79,90,,,percent of total billed charges,90% of total billed charges,671.79,90,,,percent of total billed charges,90% of total billed charges,283.64,38,,,percent of total billed charges,38% of total billed charges,283.64,38,,,percent of total billed charges,38% of total billed charges,283.64,38,,,percent of total billed charges,38% of total billed charges,559.82,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,283.64,694.18,
FRX-Ulnar Styloid-PRO,4918,CDM,981,RC,25650,HCPCS,outpatient,,,448.79,336.59,,390.68,130,,,fee schedule,130% of fee schedule,390.68,130,,,fee schedule,130% of fee schedule,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,378.09,119,,,fee schedule,119% of fee schedule,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,100% of fee schedule,403.91,90,,,percent of total billed charges,90% of total billed charges,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,326.18,100,,,fee schedule,100% of fee schedule,107.79,403.91,
FRX-Ulnar Styloid-PRO,4919,CDM,981,RC,25650,HCPCS,outpatient,,,448.79,336.59,,390.68,130,,,fee schedule,130% of fee schedule,390.68,130,,,fee schedule,130% of fee schedule,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,378.09,119,,,fee schedule,119% of fee schedule,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,100% of fee schedule,403.91,90,,,percent of total billed charges,90% of total billed charges,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,326.18,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,326.18,100,,,fee schedule,100% of fee schedule,107.79,403.91,
Dislocation of Intercarpel-PRO,4920,CDM,981,RC,25660,HCPCS,outpatient,,,861.26,645.95,,525.14,130,,,fee schedule,130% of fee schedule,525.14,130,,,fee schedule,130% of fee schedule,472.01,100,,,fee schedule,Pays 100% Medicare OPPS,472.01,100,,,fee schedule,Pays 100% Medicare OPPS,517.42,119,,,fee schedule,119% of fee schedule,472.01,100,,,fee schedule,Pays 100% Medicare OPPS,472.01,100,,,fee schedule,100% of fee schedule,775.13,90,,,percent of total billed charges,90% of total billed charges,472.01,100,,,fee schedule,Pays 100% Medicare OPPS,472.01,100,,,fee schedule,Pays 100% Medicare OPPS,472.01,100,,,fee schedule,Pays 100% Medicare OPPS,472.01,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,472.01,100,,,fee schedule,100% of fee schedule,215.58,775.13,
OR PRO FX PROX HUMERUS OPEN,4921,CDM,975,RC,25676,HCPCS,outpatient,,,1420.2,1065.15,,833.79,130,,,fee schedule,130% of fee schedule,833.79,130,,,fee schedule,130% of fee schedule,652.87,100,,,fee schedule,Pays 100% Medicare OPPS,652.87,100,,,fee schedule,Pays 100% Medicare OPPS,787.42,119,,,fee schedule,119% of fee schedule,652.87,100,,,fee schedule,Pays 100% Medicare OPPS,652.87,100,,,fee schedule,100% of fee schedule,1278.18,90,,,percent of total billed charges,90% of total billed charges,652.87,100,,,fee schedule,Pays 100% Medicare OPPS,652.87,100,,,fee schedule,Pays 100% Medicare OPPS,652.87,100,,,fee schedule,Pays 100% Medicare OPPS,652.87,100,,,fee schedule,Pays 100% Medicare OPPS,718.6,100,,,fee schedule,100% of fee schedule,652.87,100,,,fee schedule,100% of fee schedule,652.87,1278.18,
Closed Wrist Fx w/ dislocation w/ manipulation-PRO,4922,CDM,981,RC,25680,HCPCS,outpatient,,,1079.21,809.41,,607.62,130,,,fee schedule,130% of fee schedule,607.62,130,,,fee schedule,130% of fee schedule,554.69,100,,,fee schedule,Pays 100% Medicare OPPS,554.69,100,,,fee schedule,Pays 100% Medicare OPPS,654.63,119,,,fee schedule,119% of fee schedule,554.69,100,,,fee schedule,Pays 100% Medicare OPPS,554.69,100,,,fee schedule,100% of fee schedule,971.29,90,,,percent of total billed charges,90% of total billed charges,554.69,100,,,fee schedule,Pays 100% Medicare OPPS,554.69,100,,,fee schedule,Pays 100% Medicare OPPS,554.69,100,,,fee schedule,Pays 100% Medicare OPPS,554.69,100,,,fee schedule,Pays 100% Medicare OPPS,431.16,100,,,fee schedule,100% of fee schedule,554.69,100,,,fee schedule,100% of fee schedule,431.16,971.29,
Drainage of finger abscess simple-PRO,4923,CDM,981,RC,26010,HCPCS,outpatient,,,591.74,443.81,,179.11,130,,,fee schedule,130% of fee schedule,179.11,130,,,fee schedule,130% of fee schedule,146.48,100,,,fee schedule,Pays 100% Medicare OPPS,146.48,100,,,fee schedule,Pays 100% Medicare OPPS,172.38,119,,,fee schedule,119% of fee schedule,146.48,100,,,fee schedule,Pays 100% Medicare OPPS,146.48,100,,,fee schedule,100% of fee schedule,532.57,90,,,percent of total billed charges,90% of total billed charges,146.48,100,,,fee schedule,Pays 100% Medicare OPPS,146.48,100,,,fee schedule,Pays 100% Medicare OPPS,146.48,100,,,fee schedule,Pays 100% Medicare OPPS,146.48,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,146.48,100,,,fee schedule,100% of fee schedule,57.49,532.57,
OR PRO-TENOVAGINOTOMY FINGER,4924,CDM,975,RC,26055,HCPCS,outpatient,,,1252.07,939.05,,405.68,130,,,fee schedule,130% of fee schedule,405.68,130,,,fee schedule,130% of fee schedule,305.53,100,,,fee schedule,Pays 100% Medicare OPPS,305.53,100,,,fee schedule,Pays 100% Medicare OPPS,361.18,119,,,fee schedule,119% of fee schedule,305.53,100,,,fee schedule,Pays 100% Medicare OPPS,305.53,100,,,fee schedule,100% of fee schedule,1126.86,90,,,percent of total billed charges,90% of total billed charges,305.53,100,,,fee schedule,Pays 100% Medicare OPPS,305.53,100,,,fee schedule,Pays 100% Medicare OPPS,305.53,100,,,fee schedule,Pays 100% Medicare OPPS,305.53,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,305.53,100,,,fee schedule,100% of fee schedule,305.53,1126.86,
"OR PRO Exc. tumor, mal, soft hand <1.5cm",4925,CDM,975,RC,26115,HCPCS,outpatient,,,790.95,593.21,,438.27,130,,,fee schedule,130% of fee schedule,438.27,130,,,fee schedule,130% of fee schedule,345.65,100,,,fee schedule,Pays 100% Medicare OPPS,345.65,100,,,fee schedule,Pays 100% Medicare OPPS,412.43,119,,,fee schedule,119% of fee schedule,345.65,100,,,fee schedule,Pays 100% Medicare OPPS,345.65,100,,,fee schedule,100% of fee schedule,711.86,90,,,percent of total billed charges,90% of total billed charges,345.65,100,,,fee schedule,Pays 100% Medicare OPPS,345.65,100,,,fee schedule,Pays 100% Medicare OPPS,345.65,100,,,fee schedule,Pays 100% Medicare OPPS,345.65,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,345.65,100,,,fee schedule,100% of fee schedule,201.21,711.86,
OR Pro Exc. Lesion Tendon Sheath/joint  Hand/finger,4926,CDM,975,RC,26160,HCPCS,outpatient,,,844.63,633.47,,438.26,130,,,fee schedule,130% of fee schedule,438.26,130,,,fee schedule,130% of fee schedule,330.83,100,,,fee schedule,Pays 100% Medicare OPPS,330.83,100,,,fee schedule,Pays 100% Medicare OPPS,392.52,119,,,fee schedule,119% of fee schedule,330.83,100,,,fee schedule,Pays 100% Medicare OPPS,330.83,100,,,fee schedule,100% of fee schedule,760.17,90,,,percent of total billed charges,90% of total billed charges,330.83,100,,,fee schedule,Pays 100% Medicare OPPS,330.83,100,,,fee schedule,Pays 100% Medicare OPPS,330.83,100,,,fee schedule,Pays 100% Medicare OPPS,330.83,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,330.83,100,,,fee schedule,100% of fee schedule,172.46,760.17,
OR Removal -finger lesion-PRO,4927,CDM,975,RC,26210,HCPCS,outpatient,,,832.32,624.24,,583.21,130,,,fee schedule,130% of fee schedule,583.21,130,,,fee schedule,130% of fee schedule,468.19,100,,,fee schedule,Pays 100% Medicare OPPS,468.19,100,,,fee schedule,Pays 100% Medicare OPPS,554.31,119,,,fee schedule,119% of fee schedule,468.19,100,,,fee schedule,Pays 100% Medicare OPPS,468.19,100,,,fee schedule,100% of fee schedule,749.09,90,,,percent of total billed charges,90% of total billed charges,468.19,100,,,fee schedule,Pays 100% Medicare OPPS,468.19,100,,,fee schedule,Pays 100% Medicare OPPS,468.19,100,,,fee schedule,Pays 100% Medicare OPPS,468.19,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,468.19,100,,,fee schedule,100% of fee schedule,359.3,749.09,
OR Pro Repair Extensor Tendon-Hand,4928,CDM,975,RC,26401,HCPCS,outpatient,,,1280.75,960.56,,1024.6,80,,,percent of total billed charges,90% of total billed charges,1024.6,80,,,percent of total billed charges,93% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1152.68,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1024.6,1152.68,
Repair Extensor Tendon-Hand - PRO,4929,CDM,981,RC,26410,HCPCS,outpatient,,,1314.23,985.67,,725.91,130,,,fee schedule,130% of fee schedule,725.91,130,,,fee schedule,130% of fee schedule,638.37,100,,,fee schedule,Pays 100% Medicare OPPS,638.37,100,,,fee schedule,Pays 100% Medicare OPPS,723.17,119,,,fee schedule,119% of fee schedule,638.37,100,,,fee schedule,Pays 100% Medicare OPPS,638.37,100,,,fee schedule,100% of fee schedule,1182.81,90,,,percent of total billed charges,90% of total billed charges,638.37,100,,,fee schedule,Pays 100% Medicare OPPS,638.37,100,,,fee schedule,Pays 100% Medicare OPPS,638.37,100,,,fee schedule,Pays 100% Medicare OPPS,638.37,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,638.37,100,,,fee schedule,100% of fee schedule,215.58,1182.81,
PRO TENDON REPAIR EXT FINGER,4930,CDM,975,RC,26418,HCPCS,outpatient,,,1584.24,1188.18,,739.86,130,,,fee schedule,130% of fee schedule,739.86,130,,,fee schedule,130% of fee schedule,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,744.73,119,,,fee schedule,119% of fee schedule,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,100% of fee schedule,1425.82,90,,,percent of total billed charges,90% of total billed charges,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,663.98,100,,,fee schedule,100% of fee schedule,287.44,1425.82,
PRO TENDON REPAIR EXT FINGER,4931,CDM,975,RC,26418,HCPCS,outpatient,,,1584.24,1188.18,,739.86,130,,,fee schedule,130% of fee schedule,739.86,130,,,fee schedule,130% of fee schedule,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,744.73,119,,,fee schedule,119% of fee schedule,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,100% of fee schedule,1425.82,90,,,percent of total billed charges,90% of total billed charges,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,663.98,100,,,fee schedule,100% of fee schedule,287.44,1425.82,
"FRX-HAND Single; W/O Manip, Each Bone{package}",4932,CDM,521,RC,26600,HCPCS,outpatient,,,570.65,427.99,,513.59,90,,,percent of total billed charges,90% of total billed charges,530.7,93,,,percent of total billed charges,93% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,485.05,85,,,percent of total billed charges,85% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,464.51,81.4,,,percent of total billed charges,81.4% of total billed charges,513.59,90,,,percent of total billed charges,90% of total billed charges,513.59,90,,,percent of total billed charges,90% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,427.99,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,216.85,530.7,
"FRX-HAND Single; W/O Manip, Each Bone{package}",4933,CDM,521,RC,26600,HCPCS,outpatient,,,570.65,427.99,,513.59,90,,,percent of total billed charges,90% of total billed charges,530.7,93,,,percent of total billed charges,93% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,485.05,85,,,percent of total billed charges,85% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,464.51,81.4,,,percent of total billed charges,81.4% of total billed charges,513.59,90,,,percent of total billed charges,90% of total billed charges,513.59,90,,,percent of total billed charges,90% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,216.85,38,,,percent of total billed charges,38% of total billed charges,427.99,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,216.85,530.7,
FRX-Metacarpal closed w/o manip (each)-PRO,4934,CDM,981,RC,26600,HCPCS,outpatient,,,706.62,529.97,,357.14,130,,,fee schedule,130% of fee schedule,357.14,130,,,fee schedule,130% of fee schedule,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,351.24,119,,,fee schedule,119% of fee schedule,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,100% of fee schedule,635.96,90,,,percent of total billed charges,90% of total billed charges,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,306.37,100,,,fee schedule,100% of fee schedule,107.79,635.96,
FRX-Metacarpal closed w/o manip (each)-PRO,4935,CDM,981,RC,26600,HCPCS,outpatient,,,706.62,529.97,,357.14,130,,,fee schedule,130% of fee schedule,357.14,130,,,fee schedule,130% of fee schedule,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,351.24,119,,,fee schedule,119% of fee schedule,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,100% of fee schedule,635.96,90,,,percent of total billed charges,90% of total billed charges,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,306.37,100,,,fee schedule,100% of fee schedule,107.79,635.96,
"FRX-Single; W/ Manip ,Each Bone",4936,CDM,521,RC,26605,HCPCS,outpatient,,,918.67,689,,826.8,90,,,percent of total billed charges,90% of total billed charges,854.36,93,,,percent of total billed charges,93% of total billed charges,349.09,38,,,percent of total billed charges,38% of total billed charges,349.09,38,,,percent of total billed charges,38% of total billed charges,780.87,85,,,percent of total billed charges,85% of total billed charges,349.09,38,,,percent of total billed charges,38% of total billed charges,747.8,81.4,,,percent of total billed charges,81.4% of total billed charges,826.8,90,,,percent of total billed charges,90% of total billed charges,826.8,90,,,percent of total billed charges,90% of total billed charges,349.09,38,,,percent of total billed charges,38% of total billed charges,349.09,38,,,percent of total billed charges,38% of total billed charges,349.09,38,,,percent of total billed charges,38% of total billed charges,689,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,349.09,854.36,
"FRX-Single; W/ Manip ,Each Bone-PRO",4937,CDM,981,RC,26605,HCPCS,outpatient,,,626.89,470.17,,381.15,130,,,fee schedule,130% of fee schedule,381.15,130,,,fee schedule,130% of fee schedule,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,367.5,119,,,fee schedule,119% of fee schedule,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,100% of fee schedule,564.2,90,,,percent of total billed charges,90% of total billed charges,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,316.68,100,,,fee schedule,100% of fee schedule,172.46,564.2,
"FRX-Single; W/ Manip ,Each Bone-PRO",4938,CDM,981,RC,26605,HCPCS,outpatient,,,626.89,470.17,,381.15,130,,,fee schedule,130% of fee schedule,381.15,130,,,fee schedule,130% of fee schedule,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,367.5,119,,,fee schedule,119% of fee schedule,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,100% of fee schedule,564.2,90,,,percent of total billed charges,90% of total billed charges,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,316.68,100,,,fee schedule,100% of fee schedule,172.46,564.2,
OR PRO FX METACAR FIX,4939,CDM,975,RC,26615,HCPCS,outpatient,,,2439.65,1829.74,,761.24,130,,,fee schedule,130% of fee schedule,761.24,130,,,fee schedule,130% of fee schedule,598.08,100,,,fee schedule,Pays 100% Medicare OPPS,598.08,100,,,fee schedule,Pays 100% Medicare OPPS,717.11,119,,,fee schedule,119% of fee schedule,598.08,100,,,fee schedule,Pays 100% Medicare OPPS,598.08,100,,,fee schedule,100% of fee schedule,2195.69,90,,,percent of total billed charges,90% of total billed charges,598.08,100,,,fee schedule,Pays 100% Medicare OPPS,598.08,100,,,fee schedule,Pays 100% Medicare OPPS,598.08,100,,,fee schedule,Pays 100% Medicare OPPS,598.08,100,,,fee schedule,Pays 100% Medicare OPPS,503.02,100,,,fee schedule,100% of fee schedule,598.08,100,,,fee schedule,100% of fee schedule,503.02,2195.69,
FRX/DIS-Carpo:Thumb W/ Manip,4940,CDM,521,RC,26645,HCPCS,outpatient,,,884.7,663.53,,796.23,90,,,percent of total billed charges,90% of total billed charges,822.77,93,,,percent of total billed charges,93% of total billed charges,336.19,38,,,percent of total billed charges,38% of total billed charges,336.19,38,,,percent of total billed charges,38% of total billed charges,752,85,,,percent of total billed charges,85% of total billed charges,336.19,38,,,percent of total billed charges,38% of total billed charges,720.15,81.4,,,percent of total billed charges,81.4% of total billed charges,796.23,90,,,percent of total billed charges,90% of total billed charges,796.23,90,,,percent of total billed charges,90% of total billed charges,336.19,38,,,percent of total billed charges,38% of total billed charges,336.19,38,,,percent of total billed charges,38% of total billed charges,336.19,38,,,percent of total billed charges,38% of total billed charges,663.53,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,336.19,822.77,
FRX/DIS-Carpo:Thumb W/ Manip-PRO,4941,CDM,981,RC,26645,HCPCS,outpatient,,,529.65,397.24,,512.14,130,,,fee schedule,130% of fee schedule,512.14,130,,,fee schedule,130% of fee schedule,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,490.76,119,,,fee schedule,119% of fee schedule,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,100% of fee schedule,476.69,90,,,percent of total billed charges,90% of total billed charges,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,415.75,100,,,fee schedule,100% of fee schedule,287.44,512.14,
FRX/DIS-Carpo:Thumb W/ Manip-PRO,4942,CDM,981,RC,26645,HCPCS,outpatient,,,529.65,397.24,,512.14,130,,,fee schedule,130% of fee schedule,512.14,130,,,fee schedule,130% of fee schedule,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,490.76,119,,,fee schedule,119% of fee schedule,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,100% of fee schedule,476.69,90,,,percent of total billed charges,90% of total billed charges,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,415.75,100,,,fee schedule,100% of fee schedule,287.44,512.14,
"DISL.-METACARP. W/ Manip, W/O Anes",4943,CDM,521,RC,26700,HCPCS,outpatient,,,670.24,502.68,,603.22,90,,,percent of total billed charges,90% of total billed charges,623.32,93,,,percent of total billed charges,93% of total billed charges,254.69,38,,,percent of total billed charges,38% of total billed charges,254.69,38,,,percent of total billed charges,38% of total billed charges,569.7,85,,,percent of total billed charges,85% of total billed charges,254.69,38,,,percent of total billed charges,38% of total billed charges,545.58,81.4,,,percent of total billed charges,81.4% of total billed charges,603.22,90,,,percent of total billed charges,90% of total billed charges,603.22,90,,,percent of total billed charges,90% of total billed charges,254.69,38,,,percent of total billed charges,38% of total billed charges,254.69,38,,,percent of total billed charges,38% of total billed charges,254.69,38,,,percent of total billed charges,38% of total billed charges,502.68,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,254.69,623.32,
"DISL.-METACARP. W/ Manip, W/O Anes-PRO",4944,CDM,981,RC,26700,HCPCS,outpatient,,,401.92,301.44,,385.41,130,,,fee schedule,130% of fee schedule,385.41,130,,,fee schedule,130% of fee schedule,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,383.62,119,,,fee schedule,119% of fee schedule,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,100% of fee schedule,361.73,90,,,percent of total billed charges,90% of total billed charges,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,330.73,100,,,fee schedule,100% of fee schedule,51.74,385.41,
"DISL.-METACARP. W/ Manip, W/O Anes-PRO",4945,CDM,981,RC,26700,HCPCS,outpatient,,,401.92,301.44,,385.41,130,,,fee schedule,130% of fee schedule,385.41,130,,,fee schedule,130% of fee schedule,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,383.62,119,,,fee schedule,119% of fee schedule,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,100% of fee schedule,361.73,90,,,percent of total billed charges,90% of total billed charges,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,330.73,100,,,fee schedule,100% of fee schedule,51.74,385.41,
DIS-Metacarpophal (w/manip & anesth)-PRO,4946,CDM,981,RC,26705,HCPCS,outpatient,,,879.95,659.96,,501.83,130,,,fee schedule,130% of fee schedule,501.83,130,,,fee schedule,130% of fee schedule,418.36,100,,,fee schedule,Pays 100% Medicare OPPS,418.36,100,,,fee schedule,Pays 100% Medicare OPPS,478.33,119,,,fee schedule,119% of fee schedule,418.36,100,,,fee schedule,Pays 100% Medicare OPPS,418.36,100,,,fee schedule,100% of fee schedule,791.96,90,,,percent of total billed charges,90% of total billed charges,418.36,100,,,fee schedule,Pays 100% Medicare OPPS,418.36,100,,,fee schedule,Pays 100% Medicare OPPS,418.36,100,,,fee schedule,Pays 100% Medicare OPPS,418.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,418.36,100,,,fee schedule,100% of fee schedule,143.72,791.96,
FRX phalangeal shaft closed w/o manip-PRO,4947,CDM,981,RC,26720,HCPCS,outpatient,,,474.76,356.07,,236.47,130,,,fee schedule,130% of fee schedule,236.47,130,,,fee schedule,130% of fee schedule,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,231.75,119,,,fee schedule,119% of fee schedule,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,100% of fee schedule,427.28,90,,,percent of total billed charges,90% of total billed charges,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,201.84,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,201.84,100,,,fee schedule,100% of fee schedule,71.86,427.28,
FRX/DIS-W/ Manip; W/ or W/O Skin/Skele. Tract.,4948,CDM,521,RC,26725,HCPCS,outpatient,,,714.79,536.09,,643.31,90,,,percent of total billed charges,90% of total billed charges,664.75,93,,,percent of total billed charges,93% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,607.57,85,,,percent of total billed charges,85% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,581.84,81.4,,,percent of total billed charges,81.4% of total billed charges,643.31,90,,,percent of total billed charges,90% of total billed charges,643.31,90,,,percent of total billed charges,90% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,271.62,38,,,percent of total billed charges,38% of total billed charges,536.09,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,271.62,664.75,
ORTHO FRX/DIS-W/ Manip; W/ or W/O Skin/Skele. Tract.,4949,CDM,982,RC,26725,HCPCS,outpatient,,,714.79,536.09,,397.84,130,,,fee schedule,130% of fee schedule,397.84,130,,,fee schedule,130% of fee schedule,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,378.84,119,,,fee schedule,119% of fee schedule,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,100% of fee schedule,643.31,90,,,percent of total billed charges,90% of total billed charges,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,322.34,100,,,fee schedule,100% of fee schedule,114.98,643.31,
FRX/DIS-W/ Manip; W/ or W/O Skin/Skele. Tract.-PRO,4950,CDM,981,RC,26725,HCPCS,outpatient,,,430.06,322.55,,397.84,130,,,fee schedule,130% of fee schedule,397.84,130,,,fee schedule,130% of fee schedule,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,378.84,119,,,fee schedule,119% of fee schedule,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,100% of fee schedule,387.05,90,,,percent of total billed charges,90% of total billed charges,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,322.34,100,,,fee schedule,100% of fee schedule,114.98,397.84,
FRX/DIS-W/ Manip; W/ or W/O Skin/Skele. Tract.-PRO,4951,CDM,981,RC,26725,HCPCS,outpatient,,,430.06,322.55,,397.84,130,,,fee schedule,130% of fee schedule,397.84,130,,,fee schedule,130% of fee schedule,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,378.84,119,,,fee schedule,119% of fee schedule,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,100% of fee schedule,387.05,90,,,percent of total billed charges,90% of total billed charges,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,322.34,100,,,fee schedule,100% of fee schedule,114.98,397.84,
FRX CARE-OPEN PROXIMAL PHALANGEAL SHAFT INT FIX EA,4952,CDM,982,RC,26735,HCPCS,outpatient,,,2935.31,2201.48,,788.57,130,,,fee schedule,130% of fee schedule,788.57,130,,,fee schedule,130% of fee schedule,617.67,100,,,fee schedule,Pays 100% Medicare OPPS,617.67,100,,,fee schedule,Pays 100% Medicare OPPS,741.18,119,,,fee schedule,119% of fee schedule,617.67,100,,,fee schedule,Pays 100% Medicare OPPS,617.67,100,,,fee schedule,100% of fee schedule,2641.78,90,,,percent of total billed charges,90% of total billed charges,617.67,100,,,fee schedule,Pays 100% Medicare OPPS,617.67,100,,,fee schedule,Pays 100% Medicare OPPS,617.67,100,,,fee schedule,Pays 100% Medicare OPPS,617.67,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,617.67,100,,,fee schedule,100% of fee schedule,287.44,2641.78,
OR PRO FX PHALANGEAL CLOSED,4953,CDM,975,RC,26740,HCPCS,outpatient,,,452.3,339.23,,279.25,130,,,fee schedule,130% of fee schedule,279.25,130,,,fee schedule,130% of fee schedule,235.62,100,,,fee schedule,Pays 100% Medicare OPPS,235.62,100,,,fee schedule,Pays 100% Medicare OPPS,272.25,119,,,fee schedule,119% of fee schedule,235.62,100,,,fee schedule,Pays 100% Medicare OPPS,235.62,100,,,fee schedule,100% of fee schedule,407.07,90,,,percent of total billed charges,90% of total billed charges,235.62,100,,,fee schedule,Pays 100% Medicare OPPS,235.62,100,,,fee schedule,Pays 100% Medicare OPPS,235.62,100,,,fee schedule,Pays 100% Medicare OPPS,235.62,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,235.62,100,,,fee schedule,100% of fee schedule,179.65,407.07,
FRX-Distal phalangeal closed w/o manip-PRO,4954,CDM,981,RC,26750,HCPCS,outpatient,,,474.76,356.07,,235.04,130,,,fee schedule,130% of fee schedule,235.04,130,,,fee schedule,130% of fee schedule,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,232.92,119,,,fee schedule,119% of fee schedule,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,100% of fee schedule,427.28,90,,,percent of total billed charges,90% of total billed charges,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,202.76,100,,,fee schedule,100% of fee schedule,51.74,427.28,
FRX-Distal phalangeal closed w/o manip-PRO,4955,CDM,981,RC,26750,HCPCS,outpatient,,,474.76,356.07,,235.04,130,,,fee schedule,130% of fee schedule,235.04,130,,,fee schedule,130% of fee schedule,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,232.92,119,,,fee schedule,119% of fee schedule,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,100% of fee schedule,427.28,90,,,percent of total billed charges,90% of total billed charges,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,202.76,100,,,fee schedule,100% of fee schedule,51.74,427.28,
FRX/Dislocation-Finger/Thumb; W manip-package,4956,CDM,521,RC,26755,HCPCS,outpatient,,,1361.61,1021.21,,1225.45,90,,,percent of total billed charges,90% of total billed charges,1266.3,93,,,percent of total billed charges,93% of total billed charges,517.41,38,,,percent of total billed charges,38% of total billed charges,517.41,38,,,percent of total billed charges,38% of total billed charges,1157.37,85,,,percent of total billed charges,85% of total billed charges,517.41,38,,,percent of total billed charges,38% of total billed charges,1108.35,81.4,,,percent of total billed charges,81.4% of total billed charges,1225.45,90,,,percent of total billed charges,90% of total billed charges,1225.45,90,,,percent of total billed charges,90% of total billed charges,517.41,38,,,percent of total billed charges,38% of total billed charges,517.41,38,,,percent of total billed charges,38% of total billed charges,517.41,38,,,percent of total billed charges,38% of total billed charges,1021.21,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,517.41,1266.3,
FRX/Dislocation-Finger/Thumb; W Manip-PRO,4957,CDM,982,RC,26755,HCPCS,outpatient,,,769.86,577.4,,353.77,130,,,fee schedule,130% of fee schedule,353.77,130,,,fee schedule,130% of fee schedule,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,341.26,119,,,fee schedule,119% of fee schedule,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,100% of fee schedule,692.87,90,,,percent of total billed charges,90% of total billed charges,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,290.96,100,,,fee schedule,100% of fee schedule,57.49,692.87,
FRX/Dislocation-Finger/Thumb; W Manip-PRO,4958,CDM,982,RC,26755,HCPCS,outpatient,,,769.86,577.4,,353.77,130,,,fee schedule,130% of fee schedule,353.77,130,,,fee schedule,130% of fee schedule,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,341.26,119,,,fee schedule,119% of fee schedule,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,100% of fee schedule,692.87,90,,,percent of total billed charges,90% of total billed charges,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,290.96,100,,,fee schedule,100% of fee schedule,57.49,692.87,
Open Tuft Fracture (phalange) Splinting & sutures-PRO,4959,CDM,981,RC,26765,HCPCS,outpatient,,,1065.15,798.86,,661.93,130,,,fee schedule,130% of fee schedule,661.93,130,,,fee schedule,130% of fee schedule,525.31,100,,,fee schedule,Pays 100% Medicare OPPS,525.31,100,,,fee schedule,Pays 100% Medicare OPPS,625.64,119,,,fee schedule,119% of fee schedule,525.31,100,,,fee schedule,Pays 100% Medicare OPPS,525.31,100,,,fee schedule,100% of fee schedule,958.64,90,,,percent of total billed charges,90% of total billed charges,525.31,100,,,fee schedule,Pays 100% Medicare OPPS,525.31,100,,,fee schedule,Pays 100% Medicare OPPS,525.31,100,,,fee schedule,Pays 100% Medicare OPPS,525.31,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,525.31,100,,,fee schedule,100% of fee schedule,172.46,958.64,
DIS-treatment Inter. Joint W/ Manip;W/O Anes.,4960,CDM,521,RC,26770,HCPCS,outpatient,,,903.44,677.58,,813.1,90,,,percent of total billed charges,90% of total billed charges,840.2,93,,,percent of total billed charges,93% of total billed charges,343.31,38,,,percent of total billed charges,38% of total billed charges,343.31,38,,,percent of total billed charges,38% of total billed charges,767.92,85,,,percent of total billed charges,85% of total billed charges,343.31,38,,,percent of total billed charges,38% of total billed charges,735.4,81.4,,,percent of total billed charges,81.4% of total billed charges,813.1,90,,,percent of total billed charges,90% of total billed charges,813.1,90,,,percent of total billed charges,90% of total billed charges,343.31,38,,,percent of total billed charges,38% of total billed charges,343.31,38,,,percent of total billed charges,38% of total billed charges,343.31,38,,,percent of total billed charges,38% of total billed charges,677.58,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,343.31,840.2,
DIS-treatment Inter. Joint W/ Manip.; W/O Anes.-PRO,4961,CDM,981,RC,26770,HCPCS,outpatient,,,602.3,451.73,,324.05,130,,,fee schedule,130% of fee schedule,324.05,130,,,fee schedule,130% of fee schedule,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,320.97,119,,,fee schedule,119% of fee schedule,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,100% of fee schedule,542.07,90,,,percent of total billed charges,90% of total billed charges,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,277.19,100,,,fee schedule,100% of fee schedule,51.74,542.07,
DIS-treatment Inter. Joint W/ Manip.; W/O Anes.-PRO,4962,CDM,981,RC,26770,HCPCS,outpatient,,,602.3,451.73,,324.05,130,,,fee schedule,130% of fee schedule,324.05,130,,,fee schedule,130% of fee schedule,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,320.97,119,,,fee schedule,119% of fee schedule,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,100% of fee schedule,542.07,90,,,percent of total billed charges,90% of total billed charges,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,277.19,100,,,fee schedule,100% of fee schedule,51.74,542.07,
Dislocation-interphalangeal closed w anes[Package],4963,CDM,521,RC,26775,HCPCS,outpatient,,,1538.55,1153.91,,1384.7,90,,,percent of total billed charges,90% of total billed charges,1430.85,93,,,percent of total billed charges,93% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,1307.77,85,,,percent of total billed charges,85% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,1252.38,81.4,,,percent of total billed charges,81.4% of total billed charges,1384.7,90,,,percent of total billed charges,90% of total billed charges,1384.7,90,,,percent of total billed charges,90% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,1153.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,584.65,1430.85,
Dislocation-interphalangeal closed w anes[Package],4964,CDM,521,RC,26775,HCPCS,outpatient,,,1538.55,1153.91,,1384.7,90,,,percent of total billed charges,90% of total billed charges,1430.85,93,,,percent of total billed charges,93% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,1307.77,85,,,percent of total billed charges,85% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,1252.38,81.4,,,percent of total billed charges,81.4% of total billed charges,1384.7,90,,,percent of total billed charges,90% of total billed charges,1384.7,90,,,percent of total billed charges,90% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,584.65,38,,,percent of total billed charges,38% of total billed charges,1153.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,584.65,1430.85,
OR PRO AMPUTATION FINGER,4965,CDM,975,RC,26951,HCPCS,outpatient,,,1184.67,888.5,,842.53,130,,,fee schedule,130% of fee schedule,842.53,130,,,fee schedule,130% of fee schedule,739.97,100,,,fee schedule,Pays 100% Medicare OPPS,739.97,100,,,fee schedule,Pays 100% Medicare OPPS,834.74,119,,,fee schedule,119% of fee schedule,739.97,100,,,fee schedule,Pays 100% Medicare OPPS,739.97,100,,,fee schedule,100% of fee schedule,1066.2,90,,,percent of total billed charges,90% of total billed charges,739.97,100,,,fee schedule,Pays 100% Medicare OPPS,739.97,100,,,fee schedule,Pays 100% Medicare OPPS,739.97,100,,,fee schedule,Pays 100% Medicare OPPS,739.97,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,739.97,100,,,fee schedule,100% of fee schedule,287.44,1066.2,
FBR-pelvis or hip; subcutaneous tissue-PRO,4966,CDM,981,RC,27086,HCPCS,outpatient,,,560.12,420.09,,193.92,130,,,fee schedule,130% of fee schedule,193.92,130,,,fee schedule,130% of fee schedule,174.21,100,,,fee schedule,Pays 100% Medicare OPPS,174.21,100,,,fee schedule,Pays 100% Medicare OPPS,208.96,119,,,fee schedule,119% of fee schedule,174.21,100,,,fee schedule,Pays 100% Medicare OPPS,174.21,100,,,fee schedule,100% of fee schedule,504.11,90,,,percent of total billed charges,90% of total billed charges,174.21,100,,,fee schedule,Pays 100% Medicare OPPS,174.21,100,,,fee schedule,Pays 100% Medicare OPPS,174.21,100,,,fee schedule,Pays 100% Medicare OPPS,174.21,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,174.21,100,,,fee schedule,100% of fee schedule,86.23,504.11,
FBR Pelvis/Hip; Deep - PRO,4967,CDM,981,RC,27087,HCPCS,outpatient,,,1438.11,1078.58,,827.54,130,,,fee schedule,130% of fee schedule,827.54,130,,,fee schedule,130% of fee schedule,628.72,100,,,fee schedule,Pays 100% Medicare OPPS,628.72,100,,,fee schedule,Pays 100% Medicare OPPS,766.76,119,,,fee schedule,119% of fee schedule,628.72,100,,,fee schedule,Pays 100% Medicare OPPS,628.72,100,,,fee schedule,100% of fee schedule,1294.3,90,,,percent of total billed charges,90% of total billed charges,628.72,100,,,fee schedule,Pays 100% Medicare OPPS,628.72,100,,,fee schedule,Pays 100% Medicare OPPS,628.72,100,,,fee schedule,Pays 100% Medicare OPPS,628.72,100,,,fee schedule,Pays 100% Medicare OPPS,165.28,100,,,fee schedule,100% of fee schedule,628.72,100,,,fee schedule,100% of fee schedule,165.28,1294.3,
FRX-Treatment Coccygeal CLSD,4968,CDM,521,RC,27200,HCPCS,outpatient,,,527.3,395.48,,474.57,90,,,percent of total billed charges,90% of total billed charges,490.39,93,,,percent of total billed charges,93% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,448.21,85,,,percent of total billed charges,85% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,429.22,81.4,,,percent of total billed charges,81.4% of total billed charges,474.57,90,,,percent of total billed charges,90% of total billed charges,474.57,90,,,percent of total billed charges,90% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,395.48,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,200.37,490.39,
FRX-Treatment Coccygeal CLSD-PRO,4969,CDM,981,RC,27200,HCPCS,outpatient,,,516.75,387.56,,242.97,130,,,fee schedule,130% of fee schedule,242.97,130,,,fee schedule,130% of fee schedule,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,234.8,119,,,fee schedule,119% of fee schedule,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,100% of fee schedule,465.08,90,,,percent of total billed charges,90% of total billed charges,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,199.2,100,,,fee schedule,100% of fee schedule,114.98,465.08,
FRX-Treatment Coccygeal CLSD-PRO,4970,CDM,981,RC,27200,HCPCS,outpatient,,,516.75,387.56,,242.97,130,,,fee schedule,130% of fee schedule,242.97,130,,,fee schedule,130% of fee schedule,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,234.8,119,,,fee schedule,119% of fee schedule,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,100% of fee schedule,465.08,90,,,percent of total billed charges,90% of total billed charges,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,199.2,100,,,fee schedule,100% of fee schedule,114.98,465.08,
Closed Hip Socket Fracture-PRO,4971,CDM,981,RC,27220,HCPCS,outpatient,,,1765.88,1324.41,,692.02,130,,,fee schedule,130% of fee schedule,692.02,130,,,fee schedule,130% of fee schedule,426.86,100,,,fee schedule,Pays 100% Medicare OPPS,426.86,100,,,fee schedule,Pays 100% Medicare OPPS,528.88,119,,,fee schedule,119% of fee schedule,426.86,100,,,fee schedule,Pays 100% Medicare OPPS,426.86,100,,,fee schedule,100% of fee schedule,1589.29,90,,,percent of total billed charges,90% of total billed charges,426.86,100,,,fee schedule,Pays 100% Medicare OPPS,426.86,100,,,fee schedule,Pays 100% Medicare OPPS,426.86,100,,,fee schedule,Pays 100% Medicare OPPS,426.86,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,426.86,100,,,fee schedule,100% of fee schedule,93.42,1589.29,
Closed Femoral Fracture-PRO,4972,CDM,981,RC,27230,HCPCS,outpatient,,,1181.16,885.87,,617.47,130,,,fee schedule,130% of fee schedule,617.47,130,,,fee schedule,130% of fee schedule,497.92,100,,,fee schedule,Pays 100% Medicare OPPS,497.92,100,,,fee schedule,Pays 100% Medicare OPPS,592.44,119,,,fee schedule,119% of fee schedule,497.92,100,,,fee schedule,Pays 100% Medicare OPPS,497.92,100,,,fee schedule,100% of fee schedule,1063.04,90,,,percent of total billed charges,90% of total billed charges,497.92,100,,,fee schedule,Pays 100% Medicare OPPS,497.92,100,,,fee schedule,Pays 100% Medicare OPPS,497.92,100,,,fee schedule,Pays 100% Medicare OPPS,497.92,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,497.92,100,,,fee schedule,100% of fee schedule,93.42,1063.04,
OR PRO FX FEMUR PROX FIX,4973,CDM,975,RC,27235,HCPCS,outpatient,,,1983.82,1487.87,,1207.17,130,,,fee schedule,130% of fee schedule,1207.17,130,,,fee schedule,130% of fee schedule,926.04,100,,,fee schedule,Pays 100% Medicare OPPS,926.04,100,,,fee schedule,Pays 100% Medicare OPPS,1131.17,119,,,fee schedule,119% of fee schedule,926.04,100,,,fee schedule,Pays 100% Medicare OPPS,926.04,100,,,fee schedule,100% of fee schedule,1785.44,90,,,percent of total billed charges,90% of total billed charges,926.04,100,,,fee schedule,Pays 100% Medicare OPPS,926.04,100,,,fee schedule,Pays 100% Medicare OPPS,926.04,100,,,fee schedule,Pays 100% Medicare OPPS,926.04,100,,,fee schedule,Pays 100% Medicare OPPS,1580.92,100,,,fee schedule,100% of fee schedule,926.04,100,,,fee schedule,100% of fee schedule,926.04,1785.44,
DIS-Hip (trauma)(w/o anesth),4974,CDM,521,RC,27250,HCPCS,outpatient,,,1175.28,881.46,,1057.75,90,,,percent of total billed charges,90% of total billed charges,1093.01,93,,,percent of total billed charges,93% of total billed charges,446.61,38,,,percent of total billed charges,38% of total billed charges,446.61,38,,,percent of total billed charges,38% of total billed charges,998.99,85,,,percent of total billed charges,85% of total billed charges,446.61,38,,,percent of total billed charges,38% of total billed charges,956.68,81.4,,,percent of total billed charges,81.4% of total billed charges,1057.75,90,,,percent of total billed charges,90% of total billed charges,1057.75,90,,,percent of total billed charges,90% of total billed charges,446.61,38,,,percent of total billed charges,38% of total billed charges,446.61,38,,,percent of total billed charges,38% of total billed charges,446.61,38,,,percent of total billed charges,38% of total billed charges,881.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,446.61,1093.01,
"DIS-Hip, Traumatic; W/O Anes.-PRO",4975,CDM,981,RC,27250,HCPCS,outpatient,,,1209.27,906.95,,240.21,130,,,fee schedule,130% of fee schedule,240.21,130,,,fee schedule,130% of fee schedule,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,226.8,119,,,fee schedule,119% of fee schedule,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,100% of fee schedule,1088.34,90,,,percent of total billed charges,90% of total billed charges,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,251.51,100,,,fee schedule,100% of fee schedule,178.56,100,,,fee schedule,100% of fee schedule,178.56,1088.34,
"DIS-Hip, Traumatic; W/O Anes.-PRO",4976,CDM,981,RC,27250,HCPCS,outpatient,,,1209.27,906.95,,240.21,130,,,fee schedule,130% of fee schedule,240.21,130,,,fee schedule,130% of fee schedule,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,226.8,119,,,fee schedule,119% of fee schedule,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,100% of fee schedule,1088.34,90,,,percent of total billed charges,90% of total billed charges,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,251.51,100,,,fee schedule,100% of fee schedule,178.56,100,,,fee schedule,100% of fee schedule,178.56,1088.34,
DIS-Hip (trauma)(w/anesth)-PRO,4977,CDM,981,RC,27252,HCPCS,outpatient,,,1766.53,1324.9,,998.43,130,,,fee schedule,130% of fee schedule,998.43,130,,,fee schedule,130% of fee schedule,770.69,100,,,fee schedule,Pays 100% Medicare OPPS,770.69,100,,,fee schedule,Pays 100% Medicare OPPS,940.46,119,,,fee schedule,119% of fee schedule,770.69,100,,,fee schedule,Pays 100% Medicare OPPS,770.69,100,,,fee schedule,100% of fee schedule,1589.88,90,,,percent of total billed charges,90% of total billed charges,770.69,100,,,fee schedule,Pays 100% Medicare OPPS,770.69,100,,,fee schedule,Pays 100% Medicare OPPS,770.69,100,,,fee schedule,Pays 100% Medicare OPPS,770.69,100,,,fee schedule,Pays 100% Medicare OPPS,344.93,100,,,fee schedule,100% of fee schedule,770.69,100,,,fee schedule,100% of fee schedule,344.93,1589.88,
DIS-Hip(spontan)(w/o anes./manip.)-PRO,4978,CDM,981,RC,27256,HCPCS,outpatient,,,550.71,413.03,,300.24,130,,,fee schedule,130% of fee schedule,300.24,130,,,fee schedule,130% of fee schedule,242.65,100,,,fee schedule,Pays 100% Medicare OPPS,242.65,100,,,fee schedule,Pays 100% Medicare OPPS,295.25,119,,,fee schedule,119% of fee schedule,242.65,100,,,fee schedule,Pays 100% Medicare OPPS,242.65,100,,,fee schedule,100% of fee schedule,495.64,90,,,percent of total billed charges,90% of total billed charges,242.65,100,,,fee schedule,Pays 100% Medicare OPPS,242.65,100,,,fee schedule,Pays 100% Medicare OPPS,242.65,100,,,fee schedule,Pays 100% Medicare OPPS,242.65,100,,,fee schedule,Pays 100% Medicare OPPS,934.18,100,,,fee schedule,100% of fee schedule,242.65,100,,,fee schedule,100% of fee schedule,242.65,934.18,
DIS-Hip(spontan)(w/manip & anesth)-PRO,4979,CDM,981,RC,27257,HCPCS,outpatient,,,844.63,633.47,,439.69,130,,,fee schedule,130% of fee schedule,439.69,130,,,fee schedule,130% of fee schedule,367.52,100,,,fee schedule,Pays 100% Medicare OPPS,367.52,100,,,fee schedule,Pays 100% Medicare OPPS,449.76,119,,,fee schedule,119% of fee schedule,367.52,100,,,fee schedule,Pays 100% Medicare OPPS,367.52,100,,,fee schedule,100% of fee schedule,760.17,90,,,percent of total billed charges,90% of total billed charges,367.52,100,,,fee schedule,Pays 100% Medicare OPPS,367.52,100,,,fee schedule,Pays 100% Medicare OPPS,367.52,100,,,fee schedule,Pays 100% Medicare OPPS,367.52,100,,,fee schedule,Pays 100% Medicare OPPS,1077.9,100,,,fee schedule,100% of fee schedule,367.52,100,,,fee schedule,100% of fee schedule,367.52,1077.9,
Post Hip Arthro. Disloc.(w/o anes.) - PRO,4980,CDM,981,RC,27265,HCPCS,outpatient,,,936.96,702.72,,509.52,130,,,fee schedule,130% of fee schedule,509.52,130,,,fee schedule,130% of fee schedule,433.73,100,,,fee schedule,Pays 100% Medicare OPPS,433.73,100,,,fee schedule,Pays 100% Medicare OPPS,504.13,119,,,fee schedule,119% of fee schedule,433.73,100,,,fee schedule,Pays 100% Medicare OPPS,433.73,100,,,fee schedule,100% of fee schedule,843.26,90,,,percent of total billed charges,90% of total billed charges,433.73,100,,,fee schedule,Pays 100% Medicare OPPS,433.73,100,,,fee schedule,Pays 100% Medicare OPPS,433.73,100,,,fee schedule,Pays 100% Medicare OPPS,433.73,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,433.73,100,,,fee schedule,100% of fee schedule,433.73,843.26,
OR EXC thigh/knee les SQ<3c PRO,4981,CDM,975,RC,27327,HCPCS,outpatient,,,1040.4,780.3,,408.55,130,,,fee schedule,130% of fee schedule,408.55,130,,,fee schedule,130% of fee schedule,324.51,100,,,fee schedule,Pays 100% Medicare OPPS,324.51,100,,,fee schedule,Pays 100% Medicare OPPS,389.49,119,,,fee schedule,119% of fee schedule,324.51,100,,,fee schedule,Pays 100% Medicare OPPS,324.51,100,,,fee schedule,100% of fee schedule,936.36,90,,,percent of total billed charges,90% of total billed charges,324.51,100,,,fee schedule,Pays 100% Medicare OPPS,324.51,100,,,fee schedule,Pays 100% Medicare OPPS,324.51,100,,,fee schedule,Pays 100% Medicare OPPS,324.51,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,324.51,100,,,fee schedule,100% of fee schedule,179.65,936.36,
OR PRO Arthrotomy with exc of menis  knee,4982,CDM,975,RC,27332,HCPCS,outpatient,,,1206.92,905.19,,844.79,130,,,fee schedule,130% of fee schedule,844.79,130,,,fee schedule,130% of fee schedule,666.8,100,,,fee schedule,Pays 100% Medicare OPPS,666.8,100,,,fee schedule,Pays 100% Medicare OPPS,803.05,119,,,fee schedule,119% of fee schedule,666.8,100,,,fee schedule,Pays 100% Medicare OPPS,666.8,100,,,fee schedule,100% of fee schedule,1086.23,90,,,percent of total billed charges,90% of total billed charges,666.8,100,,,fee schedule,Pays 100% Medicare OPPS,666.8,100,,,fee schedule,Pays 100% Medicare OPPS,666.8,100,,,fee schedule,Pays 100% Medicare OPPS,666.8,100,,,fee schedule,Pays 100% Medicare OPPS,1006.04,100,,,fee schedule,100% of fee schedule,666.8,100,,,fee schedule,100% of fee schedule,666.8,1086.23,
OR PRO EXC-SYN-BAKER'S CYST,4983,CDM,975,RC,27345,HCPCS,outpatient,,,1080.37,810.28,,632.23,130,,,fee schedule,130% of fee schedule,632.23,130,,,fee schedule,130% of fee schedule,504.18,100,,,fee schedule,Pays 100% Medicare OPPS,504.18,100,,,fee schedule,Pays 100% Medicare OPPS,603.26,119,,,fee schedule,119% of fee schedule,504.18,100,,,fee schedule,Pays 100% Medicare OPPS,504.18,100,,,fee schedule,100% of fee schedule,972.33,90,,,percent of total billed charges,90% of total billed charges,504.18,100,,,fee schedule,Pays 100% Medicare OPPS,504.18,100,,,fee schedule,Pays 100% Medicare OPPS,504.18,100,,,fee schedule,Pays 100% Medicare OPPS,504.18,100,,,fee schedule,Pays 100% Medicare OPPS,574.88,100,,,fee schedule,100% of fee schedule,504.18,100,,,fee schedule,100% of fee schedule,504.18,972.33,
Total Knee Arthroplasty-PRO,4984,CDM,975,RC,27447,HCPCS,outpatient,,,4161.6,3121.2,,2047.77,130,,,fee schedule,130% of fee schedule,2047.77,130,,,fee schedule,130% of fee schedule,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1685.43,119,,,fee schedule,119% of fee schedule,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,100% of fee schedule,3745.44,90,,,percent of total billed charges,90% of total billed charges,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,2874.4,100,,,fee schedule,100% of fee schedule,1300.97,100,,,fee schedule,100% of fee schedule,1300.97,3745.44,
Total Knee Arthroplasty-PRO,4985,CDM,975,RC,27447,HCPCS,outpatient,,,4161.6,3121.2,,2047.77,130,,,fee schedule,130% of fee schedule,2047.77,130,,,fee schedule,130% of fee schedule,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1685.43,119,,,fee schedule,119% of fee schedule,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,100% of fee schedule,3745.44,90,,,percent of total billed charges,90% of total billed charges,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,2874.4,100,,,fee schedule,100% of fee schedule,1300.97,100,,,fee schedule,100% of fee schedule,1300.97,3745.44,
Total Knee Arthroplasty ASST Pro,4986,CDM,975,RC,27447,HCPCS,outpatient,,,4161.6,3121.2,,2047.77,130,,,fee schedule,130% of fee schedule,2047.77,130,,,fee schedule,130% of fee schedule,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1685.43,119,,,fee schedule,119% of fee schedule,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,100% of fee schedule,3745.44,90,,,percent of total billed charges,90% of total billed charges,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,2874.4,100,,,fee schedule,100% of fee schedule,1300.97,100,,,fee schedule,100% of fee schedule,1300.97,3745.44,
Total Knee Arthroplasty ASST Pro,4987,CDM,975,RC,27447,HCPCS,outpatient,,,4161.6,3121.2,,2047.77,130,,,fee schedule,130% of fee schedule,2047.77,130,,,fee schedule,130% of fee schedule,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1685.43,119,,,fee schedule,119% of fee schedule,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,100% of fee schedule,3745.44,90,,,percent of total billed charges,90% of total billed charges,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,1300.97,100,,,fee schedule,Pays 100% Medicare OPPS,2874.4,100,,,fee schedule,100% of fee schedule,1300.97,100,,,fee schedule,100% of fee schedule,1300.97,3745.44,
FRX Femoral Shaft closed w/o manip-PRO,4988,CDM,981,RC,27500,HCPCS,outpatient,,,1711.33,1283.5,,631.36,130,,,fee schedule,130% of fee schedule,631.36,130,,,fee schedule,130% of fee schedule,499.79,100,,,fee schedule,Pays 100% Medicare OPPS,499.79,100,,,fee schedule,Pays 100% Medicare OPPS,598.69,119,,,fee schedule,119% of fee schedule,499.79,100,,,fee schedule,Pays 100% Medicare OPPS,499.79,100,,,fee schedule,100% of fee schedule,1540.2,90,,,percent of total billed charges,90% of total billed charges,499.79,100,,,fee schedule,Pays 100% Medicare OPPS,499.79,100,,,fee schedule,Pays 100% Medicare OPPS,499.79,100,,,fee schedule,Pays 100% Medicare OPPS,499.79,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,499.79,100,,,fee schedule,100% of fee schedule,215.58,1540.2,
Closed Frx. Red. Femoral Shft. (w/manip.)-PRO,4989,CDM,981,RC,27502,HCPCS,outpatient,,,1786.08,1339.56,,1029.6,130,,,fee schedule,130% of fee schedule,1029.6,130,,,fee schedule,130% of fee schedule,772.52,100,,,fee schedule,Pays 100% Medicare OPPS,772.52,100,,,fee schedule,Pays 100% Medicare OPPS,944.98,119,,,fee schedule,119% of fee schedule,772.52,100,,,fee schedule,Pays 100% Medicare OPPS,772.52,100,,,fee schedule,100% of fee schedule,1607.47,90,,,percent of total billed charges,90% of total billed charges,772.52,100,,,fee schedule,Pays 100% Medicare OPPS,772.52,100,,,fee schedule,Pays 100% Medicare OPPS,772.52,100,,,fee schedule,Pays 100% Medicare OPPS,772.52,100,,,fee schedule,Pays 100% Medicare OPPS,503.02,100,,,fee schedule,100% of fee schedule,772.52,100,,,fee schedule,100% of fee schedule,503.02,1607.47,
Closed Frx. Red. Supracond. (w/manip) - PRO,4990,CDM,981,RC,27503,HCPCS,outpatient,,,1889.7,1417.28,,1064.35,130,,,fee schedule,130% of fee schedule,1064.35,130,,,fee schedule,130% of fee schedule,822.56,100,,,fee schedule,Pays 100% Medicare OPPS,822.56,100,,,fee schedule,Pays 100% Medicare OPPS,997.57,119,,,fee schedule,119% of fee schedule,822.56,100,,,fee schedule,Pays 100% Medicare OPPS,822.56,100,,,fee schedule,100% of fee schedule,1700.73,90,,,percent of total billed charges,90% of total billed charges,822.56,100,,,fee schedule,Pays 100% Medicare OPPS,822.56,100,,,fee schedule,Pays 100% Medicare OPPS,822.56,100,,,fee schedule,Pays 100% Medicare OPPS,822.56,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,822.56,100,,,fee schedule,100% of fee schedule,822.56,1700.73,
FRX femoral distal end closed w/o manip-PRO,4991,CDM,981,RC,27508,HCPCS,outpatient,,,1490.51,1117.88,,647.58,130,,,fee schedule,130% of fee schedule,647.58,130,,,fee schedule,130% of fee schedule,519.23,100,,,fee schedule,Pays 100% Medicare OPPS,519.23,100,,,fee schedule,Pays 100% Medicare OPPS,619.07,119,,,fee schedule,119% of fee schedule,519.23,100,,,fee schedule,Pays 100% Medicare OPPS,519.23,100,,,fee schedule,100% of fee schedule,1341.46,90,,,percent of total billed charges,90% of total billed charges,519.23,100,,,fee schedule,Pays 100% Medicare OPPS,519.23,100,,,fee schedule,Pays 100% Medicare OPPS,519.23,100,,,fee schedule,Pays 100% Medicare OPPS,519.23,100,,,fee schedule,Pays 100% Medicare OPPS,467.09,100,,,fee schedule,100% of fee schedule,519.23,100,,,fee schedule,100% of fee schedule,467.09,1341.46,
Closed Frx. Red. Femoral Distal (w/manip)-PRO,4992,CDM,981,RC,27510,HCPCS,outpatient,,,1607.03,1205.27,,909.52,130,,,fee schedule,130% of fee schedule,909.52,130,,,fee schedule,130% of fee schedule,700.43,100,,,fee schedule,Pays 100% Medicare OPPS,700.43,100,,,fee schedule,Pays 100% Medicare OPPS,846.91,119,,,fee schedule,119% of fee schedule,700.43,100,,,fee schedule,Pays 100% Medicare OPPS,700.43,100,,,fee schedule,100% of fee schedule,1446.33,90,,,percent of total billed charges,90% of total billed charges,700.43,100,,,fee schedule,Pays 100% Medicare OPPS,700.43,100,,,fee schedule,Pays 100% Medicare OPPS,700.43,100,,,fee schedule,Pays 100% Medicare OPPS,700.43,100,,,fee schedule,Pays 100% Medicare OPPS,574.88,100,,,fee schedule,100% of fee schedule,700.43,100,,,fee schedule,100% of fee schedule,574.88,1446.33,
FRX-Patellar W/O Manip,4993,CDM,521,RC,27520,HCPCS,outpatient,,,754.62,565.97,,679.16,90,,,percent of total billed charges,90% of total billed charges,701.8,93,,,percent of total billed charges,93% of total billed charges,286.76,38,,,percent of total billed charges,38% of total billed charges,286.76,38,,,percent of total billed charges,38% of total billed charges,641.43,85,,,percent of total billed charges,85% of total billed charges,286.76,38,,,percent of total billed charges,38% of total billed charges,614.26,81.4,,,percent of total billed charges,81.4% of total billed charges,679.16,90,,,percent of total billed charges,90% of total billed charges,679.16,90,,,percent of total billed charges,90% of total billed charges,286.76,38,,,percent of total billed charges,38% of total billed charges,286.76,38,,,percent of total billed charges,38% of total billed charges,286.76,38,,,percent of total billed charges,38% of total billed charges,565.97,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,286.76,701.8,
FRX-Patellar W/O Manip-PRO,4994,CDM,981,RC,27520,HCPCS,outpatient,,,850.7,638.03,,383.25,130,,,fee schedule,130% of fee schedule,383.25,130,,,fee schedule,130% of fee schedule,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,371.42,119,,,fee schedule,119% of fee schedule,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,100% of fee schedule,765.63,90,,,percent of total billed charges,90% of total billed charges,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,320.14,100,,,fee schedule,100% of fee schedule,194.02,765.63,
FRX-Patellar W/O Manip-PRO,4995,CDM,981,RC,27520,HCPCS,outpatient,,,850.7,638.03,,383.25,130,,,fee schedule,130% of fee schedule,383.25,130,,,fee schedule,130% of fee schedule,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,371.42,119,,,fee schedule,119% of fee schedule,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,100% of fee schedule,765.63,90,,,percent of total billed charges,90% of total billed charges,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,320.14,100,,,fee schedule,100% of fee schedule,194.02,765.63,
"FRX-Tibial, Proximal; W/O Mantip",4996,CDM,521,RC,27530,HCPCS,outpatient,,,945.61,709.21,,851.05,90,,,percent of total billed charges,90% of total billed charges,879.42,93,,,percent of total billed charges,93% of total billed charges,359.33,38,,,percent of total billed charges,38% of total billed charges,359.33,38,,,percent of total billed charges,38% of total billed charges,803.77,85,,,percent of total billed charges,85% of total billed charges,359.33,38,,,percent of total billed charges,38% of total billed charges,769.73,81.4,,,percent of total billed charges,81.4% of total billed charges,851.05,90,,,percent of total billed charges,90% of total billed charges,851.05,90,,,percent of total billed charges,90% of total billed charges,359.33,38,,,percent of total billed charges,38% of total billed charges,359.33,38,,,percent of total billed charges,38% of total billed charges,359.33,38,,,percent of total billed charges,38% of total billed charges,709.21,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,359.33,879.42,
"FRX-Tibial, Proximal; W/O Mantip-PRO",4997,CDM,981,RC,27530,HCPCS,outpatient,,,568.3,426.23,,484.68,130,,,fee schedule,130% of fee schedule,484.68,130,,,fee schedule,130% of fee schedule,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,355,119,,,fee schedule,119% of fee schedule,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,100% of fee schedule,511.47,90,,,percent of total billed charges,90% of total billed charges,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,308.26,100,,,fee schedule,100% of fee schedule,215.58,511.47,
"FRX-Tibial, Proximal; W/O Mantip-PRO",4998,CDM,981,RC,27530,HCPCS,outpatient,,,568.3,426.23,,484.68,130,,,fee schedule,130% of fee schedule,484.68,130,,,fee schedule,130% of fee schedule,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,355,119,,,fee schedule,119% of fee schedule,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,100% of fee schedule,511.47,90,,,percent of total billed charges,90% of total billed charges,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,308.26,100,,,fee schedule,100% of fee schedule,215.58,511.47,
DIS-Treatment of Knee W/O Anes,4999,CDM,521,RC,27550,HCPCS,outpatient,,,1086.23,814.67,,977.61,90,,,percent of total billed charges,90% of total billed charges,1010.19,93,,,percent of total billed charges,93% of total billed charges,412.77,38,,,percent of total billed charges,38% of total billed charges,412.77,38,,,percent of total billed charges,38% of total billed charges,923.3,85,,,percent of total billed charges,85% of total billed charges,412.77,38,,,percent of total billed charges,38% of total billed charges,884.19,81.4,,,percent of total billed charges,81.4% of total billed charges,977.61,90,,,percent of total billed charges,90% of total billed charges,977.61,90,,,percent of total billed charges,90% of total billed charges,412.77,38,,,percent of total billed charges,38% of total billed charges,412.77,38,,,percent of total billed charges,38% of total billed charges,412.77,38,,,percent of total billed charges,38% of total billed charges,814.67,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,412.77,1010.19,
DIS-Treatment of Knee W/O Anes.-PRO,5000,CDM,981,RC,27550,HCPCS,outpatient,,,1158.88,869.16,,602.85,130,,,fee schedule,130% of fee schedule,602.85,130,,,fee schedule,130% of fee schedule,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,604.35,119,,,fee schedule,119% of fee schedule,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,100% of fee schedule,1042.99,90,,,percent of total billed charges,90% of total billed charges,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,493.76,100,,,fee schedule,100% of fee schedule,143.72,1042.99,
DIS-Treatment of Knee W/O Anes.-PRO,5001,CDM,981,RC,27550,HCPCS,outpatient,,,1158.88,869.16,,602.85,130,,,fee schedule,130% of fee schedule,602.85,130,,,fee schedule,130% of fee schedule,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,604.35,119,,,fee schedule,119% of fee schedule,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,100% of fee schedule,1042.99,90,,,percent of total billed charges,90% of total billed charges,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,493.76,100,,,fee schedule,100% of fee schedule,143.72,1042.99,
DIS-Knee (w/anesth)-PRO,5002,CDM,981,RC,27552,HCPCS,outpatient,,,1454.07,1090.55,,826.72,130,,,fee schedule,130% of fee schedule,826.72,130,,,fee schedule,130% of fee schedule,655.37,100,,,fee schedule,Pays 100% Medicare OPPS,655.37,100,,,fee schedule,Pays 100% Medicare OPPS,784.31,119,,,fee schedule,119% of fee schedule,655.37,100,,,fee schedule,Pays 100% Medicare OPPS,655.37,100,,,fee schedule,100% of fee schedule,1308.66,90,,,percent of total billed charges,90% of total billed charges,655.37,100,,,fee schedule,Pays 100% Medicare OPPS,655.37,100,,,fee schedule,Pays 100% Medicare OPPS,655.37,100,,,fee schedule,Pays 100% Medicare OPPS,655.37,100,,,fee schedule,Pays 100% Medicare OPPS,258.7,100,,,fee schedule,100% of fee schedule,655.37,100,,,fee schedule,100% of fee schedule,258.7,1308.66,
DIS-Patellar; W/O Anes-PRO,5003,CDM,981,RC,27560,HCPCS,outpatient,,,810.84,608.13,,463.03,130,,,fee schedule,130% of fee schedule,463.03,130,,,fee schedule,130% of fee schedule,361.1,100,,,fee schedule,Pays 100% Medicare OPPS,361.1,100,,,fee schedule,Pays 100% Medicare OPPS,428.32,119,,,fee schedule,119% of fee schedule,361.1,100,,,fee schedule,Pays 100% Medicare OPPS,361.1,100,,,fee schedule,100% of fee schedule,729.76,90,,,percent of total billed charges,90% of total billed charges,361.1,100,,,fee schedule,Pays 100% Medicare OPPS,361.1,100,,,fee schedule,Pays 100% Medicare OPPS,361.1,100,,,fee schedule,Pays 100% Medicare OPPS,361.1,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,361.1,100,,,fee schedule,100% of fee schedule,143.72,729.76,
DIS-Patellar (w/anesth)-PRO,5004,CDM,981,RC,27562,HCPCS,outpatient,,,1118.44,838.83,,635.25,130,,,fee schedule,130% of fee schedule,635.25,130,,,fee schedule,130% of fee schedule,511.11,100,,,fee schedule,Pays 100% Medicare OPPS,511.11,100,,,fee schedule,Pays 100% Medicare OPPS,606.57,119,,,fee schedule,119% of fee schedule,511.11,100,,,fee schedule,Pays 100% Medicare OPPS,511.11,100,,,fee schedule,100% of fee schedule,1006.6,90,,,percent of total billed charges,90% of total billed charges,511.11,100,,,fee schedule,Pays 100% Medicare OPPS,511.11,100,,,fee schedule,Pays 100% Medicare OPPS,511.11,100,,,fee schedule,Pays 100% Medicare OPPS,511.11,100,,,fee schedule,Pays 100% Medicare OPPS,258.7,100,,,fee schedule,100% of fee schedule,511.11,100,,,fee schedule,100% of fee schedule,258.7,1006.6,
FRX(Lower Leg&Ankle)-Tibial Shaft W/O Manip,5005,CDM,521,RC,27750,HCPCS,outpatient,,,816.71,612.53,,735.04,90,,,percent of total billed charges,90% of total billed charges,759.54,93,,,percent of total billed charges,93% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,694.2,85,,,percent of total billed charges,85% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,664.8,81.4,,,percent of total billed charges,81.4% of total billed charges,735.04,90,,,percent of total billed charges,90% of total billed charges,735.04,90,,,percent of total billed charges,90% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,612.53,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,310.35,759.54,
FRX(Lower Leg&Ankle)-Tibial Shaft W/O Manip,5006,CDM,521,RC,27750,HCPCS,outpatient,,,816.71,612.53,,735.04,90,,,percent of total billed charges,90% of total billed charges,759.54,93,,,percent of total billed charges,93% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,694.2,85,,,percent of total billed charges,85% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,664.8,81.4,,,percent of total billed charges,81.4% of total billed charges,735.04,90,,,percent of total billed charges,90% of total billed charges,735.04,90,,,percent of total billed charges,90% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,310.35,38,,,percent of total billed charges,38% of total billed charges,612.53,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,310.35,759.54,
FRX-Tibial Shaft closed w/o manip-PRO,5007,CDM,981,RC,27750,HCPCS,outpatient,,,734.22,550.67,,413.06,130,,,fee schedule,130% of fee schedule,413.06,130,,,fee schedule,130% of fee schedule,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,399.02,119,,,fee schedule,119% of fee schedule,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,100% of fee schedule,660.8,90,,,percent of total billed charges,90% of total billed charges,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,258.7,100,,,fee schedule,100% of fee schedule,342.25,100,,,fee schedule,100% of fee schedule,258.7,660.8,
FRX-Tibial Shaft closed w/o manip-PRO,5008,CDM,981,RC,27750,HCPCS,outpatient,,,734.22,550.67,,413.06,130,,,fee schedule,130% of fee schedule,413.06,130,,,fee schedule,130% of fee schedule,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,399.02,119,,,fee schedule,119% of fee schedule,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,100% of fee schedule,660.8,90,,,percent of total billed charges,90% of total billed charges,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,258.7,100,,,fee schedule,100% of fee schedule,342.25,100,,,fee schedule,100% of fee schedule,258.7,660.8,
Closed Frx Red.Tibial Shaft (w/manip)-PRO,5009,CDM,981,RC,27752,HCPCS,outpatient,,,1259.05,944.29,,654.73,130,,,fee schedule,130% of fee schedule,654.73,130,,,fee schedule,130% of fee schedule,511.58,100,,,fee schedule,Pays 100% Medicare OPPS,511.58,100,,,fee schedule,Pays 100% Medicare OPPS,613.81,119,,,fee schedule,119% of fee schedule,511.58,100,,,fee schedule,Pays 100% Medicare OPPS,511.58,100,,,fee schedule,100% of fee schedule,1133.15,90,,,percent of total billed charges,90% of total billed charges,511.58,100,,,fee schedule,Pays 100% Medicare OPPS,511.58,100,,,fee schedule,Pays 100% Medicare OPPS,511.58,100,,,fee schedule,Pays 100% Medicare OPPS,511.58,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,511.58,100,,,fee schedule,100% of fee schedule,359.3,1133.15,
OR PRO FX TIBIA OPEN INT FIX,5010,CDM,975,RC,27758,HCPCS,outpatient,,,3672.33,2754.25,,1181.54,130,,,fee schedule,130% of fee schedule,1181.54,130,,,fee schedule,130% of fee schedule,918.18,100,,,fee schedule,Pays 100% Medicare OPPS,918.18,100,,,fee schedule,Pays 100% Medicare OPPS,1114.61,119,,,fee schedule,119% of fee schedule,918.18,100,,,fee schedule,Pays 100% Medicare OPPS,918.18,100,,,fee schedule,100% of fee schedule,3305.1,90,,,percent of total billed charges,90% of total billed charges,918.18,100,,,fee schedule,Pays 100% Medicare OPPS,918.18,100,,,fee schedule,Pays 100% Medicare OPPS,918.18,100,,,fee schedule,Pays 100% Medicare OPPS,918.18,100,,,fee schedule,Pays 100% Medicare OPPS,1006.04,100,,,fee schedule,100% of fee schedule,918.18,100,,,fee schedule,100% of fee schedule,918.18,3305.1,
FRX-Medial Malleolus W/O Manip,5011,CDM,521,RC,27760,HCPCS,outpatient,,,699.55,524.66,,629.6,90,,,percent of total billed charges,90% of total billed charges,650.58,93,,,percent of total billed charges,93% of total billed charges,265.83,38,,,percent of total billed charges,38% of total billed charges,265.83,38,,,percent of total billed charges,38% of total billed charges,594.62,85,,,percent of total billed charges,85% of total billed charges,265.83,38,,,percent of total billed charges,38% of total billed charges,569.43,81.4,,,percent of total billed charges,81.4% of total billed charges,629.6,90,,,percent of total billed charges,90% of total billed charges,629.6,90,,,percent of total billed charges,90% of total billed charges,265.83,38,,,percent of total billed charges,38% of total billed charges,265.83,38,,,percent of total billed charges,38% of total billed charges,265.83,38,,,percent of total billed charges,38% of total billed charges,524.66,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,265.83,650.58,
FX medial malleolus closed w/o manip PRO,5012,CDM,981,RC,27760,HCPCS,outpatient,,,702.19,526.64,,396.7,130,,,fee schedule,130% of fee schedule,396.7,130,,,fee schedule,130% of fee schedule,325.21,100,,,fee schedule,Pays 100% Medicare OPPS,325.21,100,,,fee schedule,Pays 100% Medicare OPPS,383.22,119,,,fee schedule,119% of fee schedule,325.21,100,,,fee schedule,Pays 100% Medicare OPPS,325.21,100,,,fee schedule,100% of fee schedule,631.97,90,,,percent of total billed charges,90% of total billed charges,325.21,100,,,fee schedule,Pays 100% Medicare OPPS,325.21,100,,,fee schedule,Pays 100% Medicare OPPS,325.21,100,,,fee schedule,Pays 100% Medicare OPPS,325.21,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,325.21,100,,,fee schedule,100% of fee schedule,201.21,631.97,
Closed Frx Red Medial Mall. (w/manip)-PRO,5013,CDM,981,RC,27762,HCPCS,outpatient,,,1103.64,827.73,,576.26,130,,,fee schedule,130% of fee schedule,576.26,130,,,fee schedule,130% of fee schedule,457.58,100,,,fee schedule,Pays 100% Medicare OPPS,457.58,100,,,fee schedule,Pays 100% Medicare OPPS,540.63,119,,,fee schedule,119% of fee schedule,457.58,100,,,fee schedule,Pays 100% Medicare OPPS,457.58,100,,,fee schedule,100% of fee schedule,993.28,90,,,percent of total billed charges,90% of total billed charges,457.58,100,,,fee schedule,Pays 100% Medicare OPPS,457.58,100,,,fee schedule,Pays 100% Medicare OPPS,457.58,100,,,fee schedule,Pays 100% Medicare OPPS,457.58,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,457.58,100,,,fee schedule,100% of fee schedule,215.58,993.28,
OR PROF FX MED ANKLE OPEN FIX,5014,CDM,975,RC,27766,HCPCS,outpatient,,,2234.58,1675.94,,807.63,130,,,fee schedule,130% of fee schedule,807.63,130,,,fee schedule,130% of fee schedule,627.13,100,,,fee schedule,Pays 100% Medicare OPPS,627.13,100,,,fee schedule,Pays 100% Medicare OPPS,753.27,119,,,fee schedule,119% of fee schedule,627.13,100,,,fee schedule,Pays 100% Medicare OPPS,627.13,100,,,fee schedule,100% of fee schedule,2011.12,90,,,percent of total billed charges,90% of total billed charges,627.13,100,,,fee schedule,Pays 100% Medicare OPPS,627.13,100,,,fee schedule,Pays 100% Medicare OPPS,627.13,100,,,fee schedule,Pays 100% Medicare OPPS,627.13,100,,,fee schedule,Pays 100% Medicare OPPS,646.74,100,,,fee schedule,100% of fee schedule,627.13,100,,,fee schedule,100% of fee schedule,627.13,2011.12,
FRX-Posterior Malleolus closed w/o manip-PRO,5015,CDM,981,RC,27767,HCPCS,outpatient,,,651.41,488.56,,369.28,130,,,fee schedule,130% of fee schedule,369.28,130,,,fee schedule,130% of fee schedule,309.16,100,,,fee schedule,Pays 100% Medicare OPPS,309.16,100,,,fee schedule,Pays 100% Medicare OPPS,357.39,119,,,fee schedule,119% of fee schedule,309.16,100,,,fee schedule,Pays 100% Medicare OPPS,309.16,100,,,fee schedule,100% of fee schedule,586.27,90,,,percent of total billed charges,90% of total billed charges,309.16,100,,,fee schedule,Pays 100% Medicare OPPS,309.16,100,,,fee schedule,Pays 100% Medicare OPPS,309.16,100,,,fee schedule,Pays 100% Medicare OPPS,309.16,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,309.16,100,,,fee schedule,100% of fee schedule,309.16,586.27,
Closed Frx Red Posterior Mall. (w/manip)-PRO,5016,CDM,981,RC,27768,HCPCS,outpatient,,,1038.33,778.75,,577.15,130,,,fee schedule,130% of fee schedule,577.15,130,,,fee schedule,130% of fee schedule,469.37,100,,,fee schedule,Pays 100% Medicare OPPS,469.37,100,,,fee schedule,Pays 100% Medicare OPPS,553.18,119,,,fee schedule,119% of fee schedule,469.37,100,,,fee schedule,Pays 100% Medicare OPPS,469.37,100,,,fee schedule,100% of fee schedule,934.5,90,,,percent of total billed charges,90% of total billed charges,469.37,100,,,fee schedule,Pays 100% Medicare OPPS,469.37,100,,,fee schedule,Pays 100% Medicare OPPS,469.37,100,,,fee schedule,Pays 100% Medicare OPPS,469.37,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,469.37,100,,,fee schedule,100% of fee schedule,469.37,934.5,
FRX-Proximal Fibula/Shaft; W/O Manip,5017,CDM,521,RC,27780,HCPCS,outpatient,,,573.02,429.77,,515.72,90,,,percent of total billed charges,90% of total billed charges,532.91,93,,,percent of total billed charges,93% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,487.07,85,,,percent of total billed charges,85% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,466.44,81.4,,,percent of total billed charges,81.4% of total billed charges,515.72,90,,,percent of total billed charges,90% of total billed charges,515.72,90,,,percent of total billed charges,90% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,217.75,38,,,percent of total billed charges,38% of total billed charges,429.77,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,217.75,532.91,
FRX-Proximal Fibula closed w/o manip-PRO,5018,CDM,981,RC,27780,HCPCS,outpatient,,,642.57,481.93,,360.62,130,,,fee schedule,130% of fee schedule,360.62,130,,,fee schedule,130% of fee schedule,303.1,100,,,fee schedule,Pays 100% Medicare OPPS,303.1,100,,,fee schedule,Pays 100% Medicare OPPS,351.53,119,,,fee schedule,119% of fee schedule,303.1,100,,,fee schedule,Pays 100% Medicare OPPS,303.1,100,,,fee schedule,100% of fee schedule,578.31,90,,,percent of total billed charges,90% of total billed charges,303.1,100,,,fee schedule,Pays 100% Medicare OPPS,303.1,100,,,fee schedule,Pays 100% Medicare OPPS,303.1,100,,,fee schedule,Pays 100% Medicare OPPS,303.1,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,303.1,100,,,fee schedule,100% of fee schedule,143.72,578.31,
Closed Frx Red. Prox. Fibula (w/manip)-PRO,5019,CDM,981,RC,27781,HCPCS,outpatient,,,1006.78,755.09,,516.28,130,,,fee schedule,130% of fee schedule,516.28,130,,,fee schedule,130% of fee schedule,424.63,100,,,fee schedule,Pays 100% Medicare OPPS,424.63,100,,,fee schedule,Pays 100% Medicare OPPS,497.46,119,,,fee schedule,119% of fee schedule,424.63,100,,,fee schedule,Pays 100% Medicare OPPS,424.63,100,,,fee schedule,100% of fee schedule,906.1,90,,,percent of total billed charges,90% of total billed charges,424.63,100,,,fee schedule,Pays 100% Medicare OPPS,424.63,100,,,fee schedule,Pays 100% Medicare OPPS,424.63,100,,,fee schedule,Pays 100% Medicare OPPS,424.63,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,424.63,100,,,fee schedule,100% of fee schedule,215.58,906.1,
FRX-Distal Fibular; W/O Manip,5020,CDM,521,RC,27786,HCPCS,outpatient,,,653.84,490.38,,588.46,90,,,percent of total billed charges,90% of total billed charges,608.07,93,,,percent of total billed charges,93% of total billed charges,248.46,38,,,percent of total billed charges,38% of total billed charges,248.46,38,,,percent of total billed charges,38% of total billed charges,555.76,85,,,percent of total billed charges,85% of total billed charges,248.46,38,,,percent of total billed charges,38% of total billed charges,532.23,81.4,,,percent of total billed charges,81.4% of total billed charges,588.46,90,,,percent of total billed charges,90% of total billed charges,588.46,90,,,percent of total billed charges,90% of total billed charges,248.46,38,,,percent of total billed charges,38% of total billed charges,248.46,38,,,percent of total billed charges,38% of total billed charges,248.46,38,,,percent of total billed charges,38% of total billed charges,490.38,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,248.46,608.07,
FRX-Distal Fibular closed w/o manip-PRO,5021,CDM,981,RC,27786,HCPCS,outpatient,,,809.71,607.28,,372.61,130,,,fee schedule,130% of fee schedule,372.61,130,,,fee schedule,130% of fee schedule,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,358.75,119,,,fee schedule,119% of fee schedule,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,100% of fee schedule,728.74,90,,,percent of total billed charges,90% of total billed charges,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,304.95,100,,,fee schedule,100% of fee schedule,215.58,728.74,
FRX-Distal Fibular closed w/o manip-PRO,5022,CDM,981,RC,27786,HCPCS,outpatient,,,809.71,607.28,,372.61,130,,,fee schedule,130% of fee schedule,372.61,130,,,fee schedule,130% of fee schedule,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,358.75,119,,,fee schedule,119% of fee schedule,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,100% of fee schedule,728.74,90,,,percent of total billed charges,90% of total billed charges,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,304.95,100,,,fee schedule,100% of fee schedule,215.58,728.74,
Closed Frx Red. Distal Fibular (w/manip)-PRO,5023,CDM,981,RC,27788,HCPCS,outpatient,,,988.77,741.58,,506.35,130,,,fee schedule,130% of fee schedule,506.35,130,,,fee schedule,130% of fee schedule,404.8,100,,,fee schedule,Pays 100% Medicare OPPS,404.8,100,,,fee schedule,Pays 100% Medicare OPPS,481.07,119,,,fee schedule,119% of fee schedule,404.8,100,,,fee schedule,Pays 100% Medicare OPPS,404.8,100,,,fee schedule,100% of fee schedule,889.89,90,,,percent of total billed charges,90% of total billed charges,404.8,100,,,fee schedule,Pays 100% Medicare OPPS,404.8,100,,,fee schedule,Pays 100% Medicare OPPS,404.8,100,,,fee schedule,Pays 100% Medicare OPPS,404.8,100,,,fee schedule,Pays 100% Medicare OPPS,251.51,100,,,fee schedule,100% of fee schedule,404.8,100,,,fee schedule,100% of fee schedule,251.51,889.89,
FRX bimalleolar closed w/o manip-PRO,5024,CDM,981,RC,27808,HCPCS,outpatient,,,911.63,683.72,,389.82,130,,,fee schedule,130% of fee schedule,389.82,130,,,fee schedule,130% of fee schedule,325.04,100,,,fee schedule,Pays 100% Medicare OPPS,325.04,100,,,fee schedule,Pays 100% Medicare OPPS,378.59,119,,,fee schedule,119% of fee schedule,325.04,100,,,fee schedule,Pays 100% Medicare OPPS,325.04,100,,,fee schedule,100% of fee schedule,820.47,90,,,percent of total billed charges,90% of total billed charges,325.04,100,,,fee schedule,Pays 100% Medicare OPPS,325.04,100,,,fee schedule,Pays 100% Medicare OPPS,325.04,100,,,fee schedule,Pays 100% Medicare OPPS,325.04,100,,,fee schedule,Pays 100% Medicare OPPS,136.53,100,,,fee schedule,100% of fee schedule,325.04,100,,,fee schedule,100% of fee schedule,136.53,820.47,
Closed Frx Red. Bimalleolar (w/manip)-PRO,5025,CDM,981,RC,27810,HCPCS,outpatient,,,1094.63,820.97,,560.98,130,,,fee schedule,130% of fee schedule,560.98,130,,,fee schedule,130% of fee schedule,447.85,100,,,fee schedule,Pays 100% Medicare OPPS,447.85,100,,,fee schedule,Pays 100% Medicare OPPS,528.03,119,,,fee schedule,119% of fee schedule,447.85,100,,,fee schedule,Pays 100% Medicare OPPS,447.85,100,,,fee schedule,100% of fee schedule,985.17,90,,,percent of total billed charges,90% of total billed charges,447.85,100,,,fee schedule,Pays 100% Medicare OPPS,447.85,100,,,fee schedule,Pays 100% Medicare OPPS,447.85,100,,,fee schedule,Pays 100% Medicare OPPS,447.85,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,447.85,100,,,fee schedule,100% of fee schedule,359.3,985.17,
OR PRO FX ANKLE BIMAL INT FIX,5026,CDM,975,RC,27814,HCPCS,outpatient,,,1695.55,1271.66,,1024.69,130,,,fee schedule,130% of fee schedule,1024.69,130,,,fee schedule,130% of fee schedule,785.66,100,,,fee schedule,Pays 100% Medicare OPPS,785.66,100,,,fee schedule,Pays 100% Medicare OPPS,955.83,119,,,fee schedule,119% of fee schedule,785.66,100,,,fee schedule,Pays 100% Medicare OPPS,785.66,100,,,fee schedule,100% of fee schedule,1526,90,,,percent of total billed charges,90% of total billed charges,785.66,100,,,fee schedule,Pays 100% Medicare OPPS,785.66,100,,,fee schedule,Pays 100% Medicare OPPS,785.66,100,,,fee schedule,Pays 100% Medicare OPPS,785.66,100,,,fee schedule,Pays 100% Medicare OPPS,862.32,100,,,fee schedule,100% of fee schedule,785.66,100,,,fee schedule,100% of fee schedule,785.66,1526,
FRX trimalleolar closed w/o manip-PRO,5027,CDM,981,RC,27816,HCPCS,outpatient,,,667.97,500.98,,371.63,130,,,fee schedule,130% of fee schedule,371.63,130,,,fee schedule,130% of fee schedule,311.29,100,,,fee schedule,Pays 100% Medicare OPPS,311.29,100,,,fee schedule,Pays 100% Medicare OPPS,363.45,119,,,fee schedule,119% of fee schedule,311.29,100,,,fee schedule,Pays 100% Medicare OPPS,311.29,100,,,fee schedule,100% of fee schedule,601.17,90,,,percent of total billed charges,90% of total billed charges,311.29,100,,,fee schedule,Pays 100% Medicare OPPS,311.29,100,,,fee schedule,Pays 100% Medicare OPPS,311.29,100,,,fee schedule,Pays 100% Medicare OPPS,311.29,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,311.29,100,,,fee schedule,100% of fee schedule,215.58,601.17,
Closed Frx Red. Trimalleolar (w/manip)-PRO,5028,CDM,981,RC,27818,HCPCS,outpatient,,,1136.3,852.23,,567.05,130,,,fee schedule,130% of fee schedule,567.05,130,,,fee schedule,130% of fee schedule,459.49,100,,,fee schedule,Pays 100% Medicare OPPS,459.49,100,,,fee schedule,Pays 100% Medicare OPPS,542.26,119,,,fee schedule,119% of fee schedule,459.49,100,,,fee schedule,Pays 100% Medicare OPPS,459.49,100,,,fee schedule,100% of fee schedule,1022.67,90,,,percent of total billed charges,90% of total billed charges,459.49,100,,,fee schedule,Pays 100% Medicare OPPS,459.49,100,,,fee schedule,Pays 100% Medicare OPPS,459.49,100,,,fee schedule,Pays 100% Medicare OPPS,459.49,100,,,fee schedule,Pays 100% Medicare OPPS,431.16,100,,,fee schedule,100% of fee schedule,459.49,100,,,fee schedule,100% of fee schedule,431.16,1022.67,
Closed Frx Red. Wt. Bear. Art. DT-PRO,5029,CDM,981,RC,27825,HCPCS,outpatient,,,1286.08,964.56,,654.63,130,,,fee schedule,130% of fee schedule,654.63,130,,,fee schedule,130% of fee schedule,511.3,100,,,fee schedule,Pays 100% Medicare OPPS,511.3,100,,,fee schedule,Pays 100% Medicare OPPS,615.72,119,,,fee schedule,119% of fee schedule,511.3,100,,,fee schedule,Pays 100% Medicare OPPS,511.3,100,,,fee schedule,100% of fee schedule,1157.47,90,,,percent of total billed charges,90% of total billed charges,511.3,100,,,fee schedule,Pays 100% Medicare OPPS,511.3,100,,,fee schedule,Pays 100% Medicare OPPS,511.3,100,,,fee schedule,Pays 100% Medicare OPPS,511.3,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,511.3,100,,,fee schedule,100% of fee schedule,511.3,1157.47,
OR PRO FX TIB/FIB OPEN DISTAL,5030,CDM,975,RC,27829,HCPCS,outpatient,,,1527.99,1145.99,,905.2,130,,,fee schedule,130% of fee schedule,905.2,130,,,fee schedule,130% of fee schedule,732.17,100,,,fee schedule,Pays 100% Medicare OPPS,732.17,100,,,fee schedule,Pays 100% Medicare OPPS,874.82,119,,,fee schedule,119% of fee schedule,732.17,100,,,fee schedule,Pays 100% Medicare OPPS,732.17,100,,,fee schedule,100% of fee schedule,1375.19,90,,,percent of total billed charges,90% of total billed charges,732.17,100,,,fee schedule,Pays 100% Medicare OPPS,732.17,100,,,fee schedule,Pays 100% Medicare OPPS,732.17,100,,,fee schedule,Pays 100% Medicare OPPS,732.17,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,732.17,100,,,fee schedule,100% of fee schedule,732.17,1375.19,
DIS-Ankle (w/o anesth.)-PRO,5031,CDM,981,RC,27840,HCPCS,outpatient,,,869.4,652.05,,469.26,130,,,fee schedule,130% of fee schedule,469.26,130,,,fee schedule,130% of fee schedule,405.15,100,,,fee schedule,Pays 100% Medicare OPPS,405.15,100,,,fee schedule,Pays 100% Medicare OPPS,469.13,119,,,fee schedule,119% of fee schedule,405.15,100,,,fee schedule,Pays 100% Medicare OPPS,405.15,100,,,fee schedule,100% of fee schedule,782.46,90,,,percent of total billed charges,90% of total billed charges,405.15,100,,,fee schedule,Pays 100% Medicare OPPS,405.15,100,,,fee schedule,Pays 100% Medicare OPPS,405.15,100,,,fee schedule,Pays 100% Medicare OPPS,405.15,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,405.15,100,,,fee schedule,100% of fee schedule,143.72,782.46,
DIS-Ankle (w/anesth)-PRO,5032,CDM,981,RC,27842,HCPCS,outpatient,,,1132.79,849.59,,654.91,130,,,fee schedule,130% of fee schedule,654.91,130,,,fee schedule,130% of fee schedule,509.67,100,,,fee schedule,Pays 100% Medicare OPPS,509.67,100,,,fee schedule,Pays 100% Medicare OPPS,614.16,119,,,fee schedule,119% of fee schedule,509.67,100,,,fee schedule,Pays 100% Medicare OPPS,509.67,100,,,fee schedule,100% of fee schedule,1019.51,90,,,percent of total billed charges,90% of total billed charges,509.67,100,,,fee schedule,Pays 100% Medicare OPPS,509.67,100,,,fee schedule,Pays 100% Medicare OPPS,509.67,100,,,fee schedule,Pays 100% Medicare OPPS,509.67,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,509.67,100,,,fee schedule,100% of fee schedule,179.65,1019.51,
OR PRO DIS ANKLE OPEN FIX,5033,CDM,975,RC,27846,HCPCS,outpatient,,,1680.33,1260.25,,971.39,130,,,fee schedule,130% of fee schedule,971.39,130,,,fee schedule,130% of fee schedule,738.07,100,,,fee schedule,Pays 100% Medicare OPPS,738.07,100,,,fee schedule,Pays 100% Medicare OPPS,889.87,119,,,fee schedule,119% of fee schedule,738.07,100,,,fee schedule,Pays 100% Medicare OPPS,738.07,100,,,fee schedule,100% of fee schedule,1512.3,90,,,percent of total billed charges,90% of total billed charges,738.07,100,,,fee schedule,Pays 100% Medicare OPPS,738.07,100,,,fee schedule,Pays 100% Medicare OPPS,738.07,100,,,fee schedule,Pays 100% Medicare OPPS,738.07,100,,,fee schedule,Pays 100% Medicare OPPS,646.74,100,,,fee schedule,100% of fee schedule,738.07,100,,,fee schedule,100% of fee schedule,646.74,1512.3,
OR PRO Plantar Fascia Faxciectomy,5034,CDM,975,RC,28060,HCPCS,outpatient,,,1387.38,1040.54,,469.07,130,,,fee schedule,130% of fee schedule,469.07,130,,,fee schedule,130% of fee schedule,368.04,100,,,fee schedule,Pays 100% Medicare OPPS,368.04,100,,,fee schedule,Pays 100% Medicare OPPS,448.82,119,,,fee schedule,119% of fee schedule,368.04,100,,,fee schedule,Pays 100% Medicare OPPS,368.04,100,,,fee schedule,100% of fee schedule,1248.64,90,,,percent of total billed charges,90% of total billed charges,368.04,100,,,fee schedule,Pays 100% Medicare OPPS,368.04,100,,,fee schedule,Pays 100% Medicare OPPS,368.04,100,,,fee schedule,Pays 100% Medicare OPPS,368.04,100,,,fee schedule,Pays 100% Medicare OPPS,431.16,100,,,fee schedule,100% of fee schedule,368.04,100,,,fee schedule,100% of fee schedule,368.04,1248.64,
OR PRO EXCISE MORTON NEUROMA,5035,CDM,975,RC,28080,HCPCS,outpatient,,,958.5,718.88,,479.31,130,,,fee schedule,130% of fee schedule,479.31,130,,,fee schedule,130% of fee schedule,389.57,100,,,fee schedule,Pays 100% Medicare OPPS,389.57,100,,,fee schedule,Pays 100% Medicare OPPS,461.55,119,,,fee schedule,119% of fee schedule,389.57,100,,,fee schedule,Pays 100% Medicare OPPS,389.57,100,,,fee schedule,100% of fee schedule,862.65,90,,,percent of total billed charges,90% of total billed charges,389.57,100,,,fee schedule,Pays 100% Medicare OPPS,389.57,100,,,fee schedule,Pays 100% Medicare OPPS,389.57,100,,,fee schedule,Pays 100% Medicare OPPS,389.57,100,,,fee schedule,Pays 100% Medicare OPPS,258.7,100,,,fee schedule,100% of fee schedule,389.57,100,,,fee schedule,100% of fee schedule,258.7,862.65,
OR PRO OSTEOTOMY CALCANEOUS,5036,CDM,975,RC,28118,HCPCS,outpatient,,,889.39,667.04,,543.92,130,,,fee schedule,130% of fee schedule,543.92,130,,,fee schedule,130% of fee schedule,431.13,100,,,fee schedule,Pays 100% Medicare OPPS,431.13,100,,,fee schedule,Pays 100% Medicare OPPS,521.1,119,,,fee schedule,119% of fee schedule,431.13,100,,,fee schedule,Pays 100% Medicare OPPS,431.13,100,,,fee schedule,100% of fee schedule,800.45,90,,,percent of total billed charges,90% of total billed charges,431.13,100,,,fee schedule,Pays 100% Medicare OPPS,431.13,100,,,fee schedule,Pays 100% Medicare OPPS,431.13,100,,,fee schedule,Pays 100% Medicare OPPS,431.13,100,,,fee schedule,Pays 100% Medicare OPPS,503.02,100,,,fee schedule,100% of fee schedule,431.13,100,,,fee schedule,100% of fee schedule,431.13,800.45,
OR PRO HEMIPHALANECTOMY,5037,CDM,975,RC,28160,HCPCS,outpatient,,,652.68,489.51,,357.66,130,,,fee schedule,130% of fee schedule,357.66,130,,,fee schedule,130% of fee schedule,273.15,100,,,fee schedule,Pays 100% Medicare OPPS,273.15,100,,,fee schedule,Pays 100% Medicare OPPS,333.62,119,,,fee schedule,119% of fee schedule,273.15,100,,,fee schedule,Pays 100% Medicare OPPS,273.15,100,,,fee schedule,100% of fee schedule,587.41,90,,,percent of total billed charges,90% of total billed charges,273.15,100,,,fee schedule,Pays 100% Medicare OPPS,273.15,100,,,fee schedule,Pays 100% Medicare OPPS,273.15,100,,,fee schedule,Pays 100% Medicare OPPS,273.15,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,273.15,100,,,fee schedule,100% of fee schedule,143.72,587.41,
FB Removal: Foot;Subcutaneous,5038,CDM,521,RC,28190,HCPCS,outpatient,,,617.53,463.15,,555.78,90,,,percent of total billed charges,90% of total billed charges,574.3,93,,,percent of total billed charges,93% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,524.9,85,,,percent of total billed charges,85% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,502.67,81.4,,,percent of total billed charges,81.4% of total billed charges,555.78,90,,,percent of total billed charges,90% of total billed charges,555.78,90,,,percent of total billed charges,90% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,463.15,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,234.66,574.3,
FB Removal:Foot;Subcutaneous-PRO,5039,CDM,981,RC,28190,HCPCS,outpatient,,,312.87,234.65,,176.62,130,,,fee schedule,130% of fee schedule,176.62,130,,,fee schedule,130% of fee schedule,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,166.79,119,,,fee schedule,119% of fee schedule,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,100% of fee schedule,281.58,90,,,percent of total billed charges,90% of total billed charges,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,135.14,100,,,fee schedule,100% of fee schedule,93.42,281.58,
FB Removal:Foot;Subcutaneous-PRO,5040,CDM,981,RC,28190,HCPCS,outpatient,,,312.87,234.65,,176.62,130,,,fee schedule,130% of fee schedule,176.62,130,,,fee schedule,130% of fee schedule,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,166.79,119,,,fee schedule,119% of fee schedule,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,100% of fee schedule,281.58,90,,,percent of total billed charges,90% of total billed charges,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,135.14,100,,,fee schedule,100% of fee schedule,93.42,281.58,
FB Removal: Foot; Deep,5041,CDM,521,RC,28192,HCPCS,outpatient,,,833.14,624.86,,749.83,90,,,percent of total billed charges,90% of total billed charges,774.82,93,,,percent of total billed charges,93% of total billed charges,316.59,38,,,percent of total billed charges,38% of total billed charges,316.59,38,,,percent of total billed charges,38% of total billed charges,708.17,85,,,percent of total billed charges,85% of total billed charges,316.59,38,,,percent of total billed charges,38% of total billed charges,678.18,81.4,,,percent of total billed charges,81.4% of total billed charges,749.83,90,,,percent of total billed charges,90% of total billed charges,749.83,90,,,percent of total billed charges,90% of total billed charges,316.59,38,,,percent of total billed charges,38% of total billed charges,316.59,38,,,percent of total billed charges,38% of total billed charges,316.59,38,,,percent of total billed charges,38% of total billed charges,624.86,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,316.59,774.82,
FB Removal: Foot; Deep -PRO,5042,CDM,981,RC,28192,HCPCS,outpatient,,,872.96,654.72,,416.87,130,,,fee schedule,130% of fee schedule,416.87,130,,,fee schedule,130% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,390.3,119,,,fee schedule,119% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,100% of fee schedule,785.66,90,,,percent of total billed charges,90% of total billed charges,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,317.35,100,,,fee schedule,100% of fee schedule,179.65,785.66,
FB Removal: Foot; Deep -PRO,5043,CDM,981,RC,28192,HCPCS,outpatient,,,872.96,654.72,,416.87,130,,,fee schedule,130% of fee schedule,416.87,130,,,fee schedule,130% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,390.3,119,,,fee schedule,119% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,100% of fee schedule,785.66,90,,,percent of total billed charges,90% of total billed charges,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,317.35,100,,,fee schedule,100% of fee schedule,179.65,785.66,
FB Removal: Foot; Deep -PRO,5044,CDM,981,RC,28192,HCPCS,outpatient,,,872.96,654.72,,416.87,130,,,fee schedule,130% of fee schedule,416.87,130,,,fee schedule,130% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,390.3,119,,,fee schedule,119% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,100% of fee schedule,785.66,90,,,percent of total billed charges,90% of total billed charges,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,317.35,100,,,fee schedule,100% of fee schedule,179.65,785.66,
FB Removal: Foot; Complicated,5045,CDM,521,RC,28193,HCPCS,outpatient,,,1264.33,948.25,,1137.9,90,,,percent of total billed charges,90% of total billed charges,1175.83,93,,,percent of total billed charges,93% of total billed charges,480.45,38,,,percent of total billed charges,38% of total billed charges,480.45,38,,,percent of total billed charges,38% of total billed charges,1074.68,85,,,percent of total billed charges,85% of total billed charges,480.45,38,,,percent of total billed charges,38% of total billed charges,1029.16,81.4,,,percent of total billed charges,81.4% of total billed charges,1137.9,90,,,percent of total billed charges,90% of total billed charges,1137.9,90,,,percent of total billed charges,90% of total billed charges,480.45,38,,,percent of total billed charges,38% of total billed charges,480.45,38,,,percent of total billed charges,38% of total billed charges,480.45,38,,,percent of total billed charges,38% of total billed charges,948.25,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,480.45,1175.83,
FBR Foot Complicated - PRO,5046,CDM,981,RC,28193,HCPCS,outpatient,,,1257.93,943.45,,489.67,130,,,fee schedule,130% of fee schedule,489.67,130,,,fee schedule,130% of fee schedule,374.11,100,,,fee schedule,Pays 100% Medicare OPPS,374.11,100,,,fee schedule,Pays 100% Medicare OPPS,460.26,119,,,fee schedule,119% of fee schedule,374.11,100,,,fee schedule,Pays 100% Medicare OPPS,374.11,100,,,fee schedule,100% of fee schedule,1132.14,90,,,percent of total billed charges,90% of total billed charges,374.11,100,,,fee schedule,Pays 100% Medicare OPPS,374.11,100,,,fee schedule,Pays 100% Medicare OPPS,374.11,100,,,fee schedule,Pays 100% Medicare OPPS,374.11,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,374.11,100,,,fee schedule,100% of fee schedule,287.44,1132.14,
OR PRO CAPSULOTOMY TOE,5047,CDM,975,RC,28270,HCPCS,outpatient,,,1274.9,956.18,,442.6,130,,,fee schedule,130% of fee schedule,442.6,130,,,fee schedule,130% of fee schedule,342.67,100,,,fee schedule,Pays 100% Medicare OPPS,342.67,100,,,fee schedule,Pays 100% Medicare OPPS,417.87,119,,,fee schedule,119% of fee schedule,342.67,100,,,fee schedule,Pays 100% Medicare OPPS,342.67,100,,,fee schedule,100% of fee schedule,1147.41,90,,,percent of total billed charges,90% of total billed charges,342.67,100,,,fee schedule,Pays 100% Medicare OPPS,342.67,100,,,fee schedule,Pays 100% Medicare OPPS,342.67,100,,,fee schedule,Pays 100% Medicare OPPS,342.67,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,342.67,100,,,fee schedule,100% of fee schedule,143.72,1147.41,
OR PRO SYNDACTYLIZATION TOE,5048,CDM,975,RC,28280,HCPCS,outpatient,,,1816.25,1362.19,,464.72,130,,,fee schedule,130% of fee schedule,464.72,130,,,fee schedule,130% of fee schedule,356.13,100,,,fee schedule,Pays 100% Medicare OPPS,356.13,100,,,fee schedule,Pays 100% Medicare OPPS,434.33,119,,,fee schedule,119% of fee schedule,356.13,100,,,fee schedule,Pays 100% Medicare OPPS,356.13,100,,,fee schedule,100% of fee schedule,1634.63,90,,,percent of total billed charges,90% of total billed charges,356.13,100,,,fee schedule,Pays 100% Medicare OPPS,356.13,100,,,fee schedule,Pays 100% Medicare OPPS,356.13,100,,,fee schedule,Pays 100% Medicare OPPS,356.13,100,,,fee schedule,Pays 100% Medicare OPPS,258.7,100,,,fee schedule,100% of fee schedule,356.13,100,,,fee schedule,100% of fee schedule,258.7,1634.63,
FRX/DIS: Foot/Toe; FRX W/O Manip,5049,CDM,521,RC,28400,HCPCS,outpatient,,,597.61,448.21,,537.85,90,,,percent of total billed charges,90% of total billed charges,555.78,93,,,percent of total billed charges,93% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,507.97,85,,,percent of total billed charges,85% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,486.45,81.4,,,percent of total billed charges,81.4% of total billed charges,537.85,90,,,percent of total billed charges,90% of total billed charges,537.85,90,,,percent of total billed charges,90% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,448.21,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,227.09,555.78,
FRX/DIS:Foot/Toe; FRX W/O Manip-PRO,5050,CDM,981,RC,28400,HCPCS,outpatient,,,510.89,383.17,,296.58,130,,,fee schedule,130% of fee schedule,296.58,130,,,fee schedule,130% of fee schedule,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,285.27,119,,,fee schedule,119% of fee schedule,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,100% of fee schedule,459.8,90,,,percent of total billed charges,90% of total billed charges,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,242.81,100,,,fee schedule,100% of fee schedule,194.02,459.8,
FRX/DIS:Foot/Toe; FRX W/O Manip-PRO,5051,CDM,981,RC,28400,HCPCS,outpatient,,,510.89,383.17,,296.58,130,,,fee schedule,130% of fee schedule,296.58,130,,,fee schedule,130% of fee schedule,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,285.27,119,,,fee schedule,119% of fee schedule,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,100% of fee schedule,459.8,90,,,percent of total billed charges,90% of total billed charges,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,242.81,100,,,fee schedule,100% of fee schedule,194.02,459.8,
FRX/DIS: Foot/Toe;FRX Talus; W/O,5052,CDM,521,RC,28430,HCPCS,outpatient,,,561.29,420.97,,505.16,90,,,percent of total billed charges,90% of total billed charges,522,93,,,percent of total billed charges,93% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,477.1,85,,,percent of total billed charges,85% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,456.89,81.4,,,percent of total billed charges,81.4% of total billed charges,505.16,90,,,percent of total billed charges,90% of total billed charges,505.16,90,,,percent of total billed charges,90% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,213.29,38,,,percent of total billed charges,38% of total billed charges,420.97,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,213.29,522,
"FRX/DIS, FT/Toe; Tarsal FRX W/O Manip",5053,CDM,521,RC,28450,HCPCS,outpatient,,,515.59,386.69,,464.03,90,,,percent of total billed charges,90% of total billed charges,479.5,93,,,percent of total billed charges,93% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,438.25,85,,,percent of total billed charges,85% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,419.69,81.4,,,percent of total billed charges,81.4% of total billed charges,464.03,90,,,percent of total billed charges,90% of total billed charges,464.03,90,,,percent of total billed charges,90% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,386.69,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,195.92,479.5,
"FRX/DIS, FT/Toe;Metatarsal FRX; W/O Manip",5054,CDM,521,RC,28470,HCPCS,outpatient,,,513.23,384.92,,461.91,90,,,percent of total billed charges,90% of total billed charges,477.3,93,,,percent of total billed charges,93% of total billed charges,195.03,38,,,percent of total billed charges,38% of total billed charges,195.03,38,,,percent of total billed charges,38% of total billed charges,436.25,85,,,percent of total billed charges,85% of total billed charges,195.03,38,,,percent of total billed charges,38% of total billed charges,417.77,81.4,,,percent of total billed charges,81.4% of total billed charges,461.91,90,,,percent of total billed charges,90% of total billed charges,461.91,90,,,percent of total billed charges,90% of total billed charges,195.03,38,,,percent of total billed charges,38% of total billed charges,195.03,38,,,percent of total billed charges,38% of total billed charges,195.03,38,,,percent of total billed charges,38% of total billed charges,384.92,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,195.03,477.3,
FRX - Metatarsal Closed w/o manip-PRO,5055,CDM,981,RC,28470,HCPCS,outpatient,,,470.33,352.75,,249.77,130,,,fee schedule,130% of fee schedule,249.77,130,,,fee schedule,130% of fee schedule,216.26,100,,,fee schedule,Pays 100% Medicare OPPS,216.26,100,,,fee schedule,Pays 100% Medicare OPPS,254.99,119,,,fee schedule,119% of fee schedule,216.26,100,,,fee schedule,Pays 100% Medicare OPPS,216.26,100,,,fee schedule,100% of fee schedule,423.3,90,,,percent of total billed charges,90% of total billed charges,216.26,100,,,fee schedule,Pays 100% Medicare OPPS,216.26,100,,,fee schedule,Pays 100% Medicare OPPS,216.26,100,,,fee schedule,Pays 100% Medicare OPPS,216.26,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,216.26,100,,,fee schedule,100% of fee schedule,158.09,423.3,
"FRX/DIS, FT/Toe;Metatarsal FRX; W/ Manip",5056,CDM,521,RC,28475,HCPCS,outpatient,,,640.95,480.71,,576.86,90,,,percent of total billed charges,90% of total billed charges,596.08,93,,,percent of total billed charges,93% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,544.81,85,,,percent of total billed charges,85% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,521.73,81.4,,,percent of total billed charges,81.4% of total billed charges,576.86,90,,,percent of total billed charges,90% of total billed charges,576.86,90,,,percent of total billed charges,90% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,243.56,38,,,percent of total billed charges,38% of total billed charges,480.71,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,243.56,596.08,
Closed Frx Red-Metatarsal - PRO,5057,CDM,981,RC,28475,HCPCS,outpatient,,,599.68,449.76,,299.16,130,,,fee schedule,130% of fee schedule,299.16,130,,,fee schedule,130% of fee schedule,237.21,100,,,fee schedule,Pays 100% Medicare OPPS,237.21,100,,,fee schedule,Pays 100% Medicare OPPS,282.95,119,,,fee schedule,119% of fee schedule,237.21,100,,,fee schedule,Pays 100% Medicare OPPS,237.21,100,,,fee schedule,100% of fee schedule,539.71,90,,,percent of total billed charges,90% of total billed charges,237.21,100,,,fee schedule,Pays 100% Medicare OPPS,237.21,100,,,fee schedule,Pays 100% Medicare OPPS,237.21,100,,,fee schedule,Pays 100% Medicare OPPS,237.21,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,237.21,100,,,fee schedule,100% of fee schedule,172.46,539.71,
"FRX/DIS, FT/Toe;Great Toe/Phalanx/Phalanges FRX W/O Manip",5058,CDM,521,RC,28490,HCPCS,outpatient,,,329.27,246.95,,296.34,90,,,percent of total billed charges,90% of total billed charges,306.22,93,,,percent of total billed charges,93% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,279.88,85,,,percent of total billed charges,85% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,268.03,81.4,,,percent of total billed charges,81.4% of total billed charges,296.34,90,,,percent of total billed charges,90% of total billed charges,296.34,90,,,percent of total billed charges,90% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,125.12,38,,,percent of total billed charges,38% of total billed charges,246.95,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,125.12,306.22,
FRX/DIS Great Toe Closed w/o manip-PRO,5059,CDM,981,RC,28490,HCPCS,outpatient,,,345.68,259.26,,161.19,130,,,fee schedule,130% of fee schedule,161.19,130,,,fee schedule,130% of fee schedule,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,154.95,119,,,fee schedule,119% of fee schedule,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,100% of fee schedule,311.11,90,,,percent of total billed charges,90% of total billed charges,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,64.67,100,,,fee schedule,100% of fee schedule,131.96,100,,,fee schedule,100% of fee schedule,64.67,311.11,
FRX/DIS Great Toe Closed w/o manip-PRO,5060,CDM,981,RC,28490,HCPCS,outpatient,,,345.68,259.26,,161.19,130,,,fee schedule,130% of fee schedule,161.19,130,,,fee schedule,130% of fee schedule,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,154.95,119,,,fee schedule,119% of fee schedule,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,100% of fee schedule,311.11,90,,,percent of total billed charges,90% of total billed charges,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,64.67,100,,,fee schedule,100% of fee schedule,131.96,100,,,fee schedule,100% of fee schedule,64.67,311.11,
Closed Frx Red-Great Toe - PRO,5061,CDM,981,RC,28495,HCPCS,outpatient,,,420.07,315.05,,196.72,130,,,fee schedule,130% of fee schedule,196.72,130,,,fee schedule,130% of fee schedule,155.92,100,,,fee schedule,Pays 100% Medicare OPPS,155.92,100,,,fee schedule,Pays 100% Medicare OPPS,185.12,119,,,fee schedule,119% of fee schedule,155.92,100,,,fee schedule,Pays 100% Medicare OPPS,155.92,100,,,fee schedule,100% of fee schedule,378.06,90,,,percent of total billed charges,90% of total billed charges,155.92,100,,,fee schedule,Pays 100% Medicare OPPS,155.92,100,,,fee schedule,Pays 100% Medicare OPPS,155.92,100,,,fee schedule,Pays 100% Medicare OPPS,155.92,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,155.92,100,,,fee schedule,100% of fee schedule,86.23,378.06,
"FRX/DIS, FT/Toe; FRX Of Phalanx or Phalanges W/O Manip",5062,CDM,521,RC,28510,HCPCS,outpatient,,,282.41,211.81,,254.17,90,,,percent of total billed charges,90% of total billed charges,262.64,93,,,percent of total billed charges,93% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,240.05,85,,,percent of total billed charges,85% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,229.88,81.4,,,percent of total billed charges,81.4% of total billed charges,254.17,90,,,percent of total billed charges,90% of total billed charges,254.17,90,,,percent of total billed charges,90% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,107.32,38,,,percent of total billed charges,38% of total billed charges,211.81,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,107.32,262.64,
FRX/DIS FT/Toe Phalanx Closed w/o Manip-PRO,5063,CDM,981,RC,28510,HCPCS,outpatient,,,331.61,248.71,,155.36,130,,,fee schedule,130% of fee schedule,155.36,130,,,fee schedule,130% of fee schedule,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,148.9,119,,,fee schedule,119% of fee schedule,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,100% of fee schedule,298.45,90,,,percent of total billed charges,90% of total billed charges,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,50.3,100,,,fee schedule,100% of fee schedule,126.88,100,,,fee schedule,100% of fee schedule,50.3,298.45,
FRX/DIS FT/Toe Phalanx Closed w/o Manip-PRO,5064,CDM,981,RC,28510,HCPCS,outpatient,,,331.61,248.71,,155.36,130,,,fee schedule,130% of fee schedule,155.36,130,,,fee schedule,130% of fee schedule,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,148.9,119,,,fee schedule,119% of fee schedule,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,100% of fee schedule,298.45,90,,,percent of total billed charges,90% of total billed charges,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,50.3,100,,,fee schedule,100% of fee schedule,126.88,100,,,fee schedule,100% of fee schedule,50.3,298.45,
"FRX/DIS, FT/Toe; FRX Of Phalanx or Phalanges W/ Manip",5065,CDM,521,RC,28515,HCPCS,outpatient,,,346.85,260.14,,312.17,90,,,percent of total billed charges,90% of total billed charges,322.57,93,,,percent of total billed charges,93% of total billed charges,131.8,38,,,percent of total billed charges,38% of total billed charges,131.8,38,,,percent of total billed charges,38% of total billed charges,294.82,85,,,percent of total billed charges,85% of total billed charges,131.8,38,,,percent of total billed charges,38% of total billed charges,282.34,81.4,,,percent of total billed charges,81.4% of total billed charges,312.17,90,,,percent of total billed charges,90% of total billed charges,312.17,90,,,percent of total billed charges,90% of total billed charges,131.8,38,,,percent of total billed charges,38% of total billed charges,131.8,38,,,percent of total billed charges,38% of total billed charges,131.8,38,,,percent of total billed charges,38% of total billed charges,260.14,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,131.8,322.57,
Closed Frx Red - Phalanx - PRO,5066,CDM,981,RC,28515,HCPCS,outpatient,,,382.34,286.76,,185.15,130,,,fee schedule,130% of fee schedule,185.15,130,,,fee schedule,130% of fee schedule,150.5,100,,,fee schedule,Pays 100% Medicare OPPS,150.5,100,,,fee schedule,Pays 100% Medicare OPPS,177.8,119,,,fee schedule,119% of fee schedule,150.5,100,,,fee schedule,Pays 100% Medicare OPPS,150.5,100,,,fee schedule,100% of fee schedule,344.11,90,,,percent of total billed charges,90% of total billed charges,150.5,100,,,fee schedule,Pays 100% Medicare OPPS,150.5,100,,,fee schedule,Pays 100% Medicare OPPS,150.5,100,,,fee schedule,Pays 100% Medicare OPPS,150.5,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,150.5,100,,,fee schedule,100% of fee schedule,71.86,344.11,
"FRX/DIS, FT/Toe; Tarsal Bone DIS W/O Anes.",5067,CDM,521,RC,28540,HCPCS,outpatient,,,482.78,362.09,,434.5,90,,,percent of total billed charges,90% of total billed charges,448.99,93,,,percent of total billed charges,93% of total billed charges,183.46,38,,,percent of total billed charges,38% of total billed charges,183.46,38,,,percent of total billed charges,38% of total billed charges,410.36,85,,,percent of total billed charges,85% of total billed charges,183.46,38,,,percent of total billed charges,38% of total billed charges,392.98,81.4,,,percent of total billed charges,81.4% of total billed charges,434.5,90,,,percent of total billed charges,90% of total billed charges,434.5,90,,,percent of total billed charges,90% of total billed charges,183.46,38,,,percent of total billed charges,38% of total billed charges,183.46,38,,,percent of total billed charges,38% of total billed charges,183.46,38,,,percent of total billed charges,38% of total billed charges,362.09,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,183.46,448.99,
OR Pro Open Tx talotarsal joint,5068,CDM,975,RC,28585,HCPCS,outpatient,,,2067.02,1550.27,,955.88,130,,,fee schedule,130% of fee schedule,955.88,130,,,fee schedule,130% of fee schedule,713.94,100,,,fee schedule,Pays 100% Medicare OPPS,713.94,100,,,fee schedule,Pays 100% Medicare OPPS,847.98,119,,,fee schedule,119% of fee schedule,713.94,100,,,fee schedule,Pays 100% Medicare OPPS,713.94,100,,,fee schedule,100% of fee schedule,1860.32,90,,,percent of total billed charges,90% of total billed charges,713.94,100,,,fee schedule,Pays 100% Medicare OPPS,713.94,100,,,fee schedule,Pays 100% Medicare OPPS,713.94,100,,,fee schedule,Pays 100% Medicare OPPS,713.94,100,,,fee schedule,Pays 100% Medicare OPPS,718.6,100,,,fee schedule,100% of fee schedule,713.94,100,,,fee schedule,100% of fee schedule,713.94,1860.32,
"FRX/DIS, FT/Toe;MTP Joint DIS W/O Anes.",5069,CDM,521,RC,28630,HCPCS,outpatient,,,352.71,264.53,,317.44,90,,,percent of total billed charges,90% of total billed charges,328.02,93,,,percent of total billed charges,93% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,299.8,85,,,percent of total billed charges,85% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,287.11,81.4,,,percent of total billed charges,81.4% of total billed charges,317.44,90,,,percent of total billed charges,90% of total billed charges,317.44,90,,,percent of total billed charges,90% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,264.53,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,134.03,328.02,
DIS Toe - Metatarsophalangeal - PRO,5070,CDM,981,RC,28630,HCPCS,outpatient,,,370.5,277.88,,143.98,130,,,fee schedule,130% of fee schedule,143.98,130,,,fee schedule,130% of fee schedule,113.23,100,,,fee schedule,Pays 100% Medicare OPPS,113.23,100,,,fee schedule,Pays 100% Medicare OPPS,137.99,119,,,fee schedule,119% of fee schedule,113.23,100,,,fee schedule,Pays 100% Medicare OPPS,113.23,100,,,fee schedule,100% of fee schedule,333.45,90,,,percent of total billed charges,90% of total billed charges,113.23,100,,,fee schedule,Pays 100% Medicare OPPS,113.23,100,,,fee schedule,Pays 100% Medicare OPPS,113.23,100,,,fee schedule,Pays 100% Medicare OPPS,113.23,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,113.23,100,,,fee schedule,100% of fee schedule,51.74,333.45,
DIS-TOE Metatarsophal (w/anesth)-PRO,5071,CDM,981,RC,28635,HCPCS,outpatient,,,306.93,230.2,,178.4,130,,,fee schedule,130% of fee schedule,178.4,130,,,fee schedule,130% of fee schedule,138.07,100,,,fee schedule,Pays 100% Medicare OPPS,138.07,100,,,fee schedule,Pays 100% Medicare OPPS,164.98,119,,,fee schedule,119% of fee schedule,138.07,100,,,fee schedule,Pays 100% Medicare OPPS,138.07,100,,,fee schedule,100% of fee schedule,276.24,90,,,percent of total billed charges,90% of total billed charges,138.07,100,,,fee schedule,Pays 100% Medicare OPPS,138.07,100,,,fee schedule,Pays 100% Medicare OPPS,138.07,100,,,fee schedule,Pays 100% Medicare OPPS,138.07,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,138.07,100,,,fee schedule,100% of fee schedule,129.35,276.24,
DIS-Toe Interphal. Jnt. (w/out anesth.)-PRO,5072,CDM,981,RC,28660,HCPCS,outpatient,,,273.67,205.25,,115.17,130,,,fee schedule,130% of fee schedule,115.17,130,,,fee schedule,130% of fee schedule,95.79,100,,,fee schedule,Pays 100% Medicare OPPS,95.79,100,,,fee schedule,Pays 100% Medicare OPPS,113.15,119,,,fee schedule,119% of fee schedule,95.79,100,,,fee schedule,Pays 100% Medicare OPPS,95.79,100,,,fee schedule,100% of fee schedule,246.3,90,,,percent of total billed charges,90% of total billed charges,95.79,100,,,fee schedule,Pays 100% Medicare OPPS,95.79,100,,,fee schedule,Pays 100% Medicare OPPS,95.79,100,,,fee schedule,Pays 100% Medicare OPPS,95.79,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,95.79,100,,,fee schedule,100% of fee schedule,51.74,246.3,
DIS-TOE Interphalang (w/anesth)-PRO,5073,CDM,981,RC,28665,HCPCS,outpatient,,,302.52,226.89,,175.54,130,,,fee schedule,130% of fee schedule,175.54,130,,,fee schedule,130% of fee schedule,127.81,100,,,fee schedule,Pays 100% Medicare OPPS,127.81,100,,,fee schedule,Pays 100% Medicare OPPS,161.08,119,,,fee schedule,119% of fee schedule,127.81,100,,,fee schedule,Pays 100% Medicare OPPS,127.81,100,,,fee schedule,100% of fee schedule,272.27,90,,,percent of total billed charges,90% of total billed charges,127.81,100,,,fee schedule,Pays 100% Medicare OPPS,127.81,100,,,fee schedule,Pays 100% Medicare OPPS,127.81,100,,,fee schedule,Pays 100% Medicare OPPS,127.81,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,127.81,100,,,fee schedule,100% of fee schedule,86.23,272.27,
OR PRO ORIF DIP JOINT GRT TOE,5074,CDM,975,RC,28675,HCPCS,outpatient,,,1293.63,970.22,,541.48,130,,,fee schedule,130% of fee schedule,541.48,130,,,fee schedule,130% of fee schedule,425.13,100,,,fee schedule,Pays 100% Medicare OPPS,425.13,100,,,fee schedule,Pays 100% Medicare OPPS,503.97,119,,,fee schedule,119% of fee schedule,425.13,100,,,fee schedule,Pays 100% Medicare OPPS,425.13,100,,,fee schedule,100% of fee schedule,1164.27,90,,,percent of total billed charges,90% of total billed charges,425.13,100,,,fee schedule,Pays 100% Medicare OPPS,425.13,100,,,fee schedule,Pays 100% Medicare OPPS,425.13,100,,,fee schedule,Pays 100% Medicare OPPS,425.13,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,425.13,100,,,fee schedule,100% of fee schedule,172.46,1164.27,
APPLY CAST LONG ARM-PRO,5075,CDM,983,RC,29065,HCPCS,outpatient,,,217.95,163.46,,89.99,130,,,fee schedule,130% of fee schedule,89.99,130,,,fee schedule,130% of fee schedule,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,84.39,119,,,fee schedule,119% of fee schedule,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,100% of fee schedule,196.16,90,,,percent of total billed charges,90% of total billed charges,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,69.71,100,,,fee schedule,100% of fee schedule,57.49,196.16,
APPLY CAST LONG ARM-PRO,5076,CDM,983,RC,29065,HCPCS,outpatient,,,217.95,163.46,,89.99,130,,,fee schedule,130% of fee schedule,89.99,130,,,fee schedule,130% of fee schedule,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,84.39,119,,,fee schedule,119% of fee schedule,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,100% of fee schedule,196.16,90,,,percent of total billed charges,90% of total billed charges,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,69.71,100,,,fee schedule,100% of fee schedule,57.49,196.16,
Casting:Arm/Shldr/ Torso;Elbow to Finger,5077,CDM,521,RC,29075,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,65.9,161.27,
Casting:Arm/Shldr/ Torso;Elbow to Finger,5078,CDM,521,RC,29075,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,65.9,161.27,
Casting:Arm/Shldr/ Torso;Elbow to Finger,5079,CDM,521,RC,29075,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,65.9,161.27,
Casting:Arm/Shldr/Torso'Elbow to Finger-PRO,5080,CDM,982,RC,29075,HCPCS,outpatient,,,183.98,137.99,,82.03,130,,,fee schedule,130% of fee schedule,82.03,130,,,fee schedule,130% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,76.27,119,,,fee schedule,119% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,100% of fee schedule,165.58,90,,,percent of total billed charges,90% of total billed charges,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,64.26,100,,,fee schedule,100% of fee schedule,43.12,165.58,
Casting:Arm/Shldr/Torso'Elbow to Finger-PRO,5081,CDM,982,RC,29075,HCPCS,outpatient,,,183.98,137.99,,82.03,130,,,fee schedule,130% of fee schedule,82.03,130,,,fee schedule,130% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,76.27,119,,,fee schedule,119% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,100% of fee schedule,165.58,90,,,percent of total billed charges,90% of total billed charges,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,64.26,100,,,fee schedule,100% of fee schedule,43.12,165.58,
Casting:Arm/Shldr/Torso'Elbow to Finger-PRO,5082,CDM,982,RC,29075,HCPCS,outpatient,,,183.98,137.99,,82.03,130,,,fee schedule,130% of fee schedule,82.03,130,,,fee schedule,130% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,76.27,119,,,fee schedule,119% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,100% of fee schedule,165.58,90,,,percent of total billed charges,90% of total billed charges,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,64.26,100,,,fee schedule,100% of fee schedule,43.12,165.58,
APPLY CAST GAUNTLET,5083,CDM,983,RC,29085,HCPCS,outpatient,,,213.26,159.95,,88.73,130,,,fee schedule,130% of fee schedule,88.73,130,,,fee schedule,130% of fee schedule,68.73,100,,,fee schedule,Pays 100% Medicare OPPS,68.73,100,,,fee schedule,Pays 100% Medicare OPPS,83.11,119,,,fee schedule,119% of fee schedule,68.73,100,,,fee schedule,Pays 100% Medicare OPPS,68.73,100,,,fee schedule,100% of fee schedule,191.93,90,,,percent of total billed charges,90% of total billed charges,68.73,100,,,fee schedule,Pays 100% Medicare OPPS,68.73,100,,,fee schedule,Pays 100% Medicare OPPS,68.73,100,,,fee schedule,Pays 100% Medicare OPPS,68.73,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,68.73,100,,,fee schedule,100% of fee schedule,43.12,191.93,
Splint/Strap:Torso/Upper;Shldr. to Hand(long),5084,CDM,521,RC,29105,HCPCS,outpatient,,,210.93,158.2,,189.84,90,,,percent of total billed charges,90% of total billed charges,196.16,93,,,percent of total billed charges,93% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,179.29,85,,,percent of total billed charges,85% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,171.7,81.4,,,percent of total billed charges,81.4% of total billed charges,189.84,90,,,percent of total billed charges,90% of total billed charges,189.84,90,,,percent of total billed charges,90% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,158.2,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,80.15,196.16,
Splint/Strap:Torso/Upper;Shldr. to Hand(long)-PRO,5085,CDM,981,RC,29105,HCPCS,outpatient,,,118.35,88.76,,78.23,130,,,fee schedule,130% of fee schedule,78.23,130,,,fee schedule,130% of fee schedule,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,51.82,119,,,fee schedule,119% of fee schedule,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,100% of fee schedule,106.52,90,,,percent of total billed charges,90% of total billed charges,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,42.15,100,,,fee schedule,100% of fee schedule,42.15,106.52,
Splint/Strap:Torso/Upper;Shldr. to Hand(long)-PRO,5086,CDM,981,RC,29105,HCPCS,outpatient,,,118.35,88.76,,78.23,130,,,fee schedule,130% of fee schedule,78.23,130,,,fee schedule,130% of fee schedule,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,51.82,119,,,fee schedule,119% of fee schedule,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,100% of fee schedule,106.52,90,,,percent of total billed charges,90% of total billed charges,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,42.15,100,,,fee schedule,100% of fee schedule,42.15,106.52,
Splint/Strap:Torso/Upper;Forearm to Splint(short),5087,CDM,521,RC,29125,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,61.45,150.39,
Splint/Strap:Torso/Upper;Forearm to Splint(short),5088,CDM,521,RC,29125,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,61.45,150.39,
Splint/Strap:Torso/Upper;Forearm to Splint(short),5089,CDM,521,RC,29125,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,61.45,150.39,
Splint/Strap:Torso/Upper;Forearm to Splint(short)-PRO,5090,CDM,981,RC,29125,HCPCS,outpatient,,,158.18,118.64,,57.42,130,,,fee schedule,130% of fee schedule,57.42,130,,,fee schedule,130% of fee schedule,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,48.92,119,,,fee schedule,119% of fee schedule,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,100% of fee schedule,142.36,90,,,percent of total billed charges,90% of total billed charges,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,41.43,100,,,fee schedule,100% of fee schedule,35.93,142.36,
Splint/Strap:Torso/Upper;Forearm to Splint(short)-PRO,5091,CDM,981,RC,29125,HCPCS,outpatient,,,158.18,118.64,,57.42,130,,,fee schedule,130% of fee schedule,57.42,130,,,fee schedule,130% of fee schedule,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,48.92,119,,,fee schedule,119% of fee schedule,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,100% of fee schedule,142.36,90,,,percent of total billed charges,90% of total billed charges,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,41.43,100,,,fee schedule,100% of fee schedule,35.93,142.36,
Application of finger splint-PRO,5092,CDM,981,RC,29130,HCPCS,outpatient,,,87.88,65.91,,37.65,130,,,fee schedule,130% of fee schedule,37.65,130,,,fee schedule,130% of fee schedule,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,36.5,119,,,fee schedule,119% of fee schedule,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,100% of fee schedule,79.09,90,,,percent of total billed charges,90% of total billed charges,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,29.69,100,,,fee schedule,100% of fee schedule,29.69,79.09,
Application of finger splint-PRO,5093,CDM,981,RC,29130,HCPCS,outpatient,,,87.88,65.91,,37.65,130,,,fee schedule,130% of fee schedule,37.65,130,,,fee schedule,130% of fee schedule,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,36.5,119,,,fee schedule,119% of fee schedule,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,100% of fee schedule,79.09,90,,,percent of total billed charges,90% of total billed charges,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,29.69,100,,,fee schedule,100% of fee schedule,29.69,79.09,
Application of finger splint-PRO,5094,CDM,981,RC,29130,HCPCS,outpatient,,,87.88,65.91,,37.65,130,,,fee schedule,130% of fee schedule,37.65,130,,,fee schedule,130% of fee schedule,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,36.5,119,,,fee schedule,119% of fee schedule,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,100% of fee schedule,79.09,90,,,percent of total billed charges,90% of total billed charges,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,29.69,100,,,fee schedule,100% of fee schedule,29.69,79.09,
Strapping - Thorax - PRO,5095,CDM,981,RC,29200,HCPCS,outpatient,,,73.21,54.91,,53.05,130,,,fee schedule,130% of fee schedule,53.05,130,,,fee schedule,130% of fee schedule,18.8,100,,,fee schedule,Pays 100% Medicare OPPS,18.8,100,,,fee schedule,Pays 100% Medicare OPPS,23.29,119,,,fee schedule,119% of fee schedule,18.8,100,,,fee schedule,Pays 100% Medicare OPPS,18.8,100,,,fee schedule,100% of fee schedule,65.89,90,,,percent of total billed charges,90% of total billed charges,18.8,100,,,fee schedule,Pays 100% Medicare OPPS,18.8,100,,,fee schedule,Pays 100% Medicare OPPS,18.8,100,,,fee schedule,Pays 100% Medicare OPPS,18.8,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,18.8,100,,,fee schedule,100% of fee schedule,18.8,65.89,
Strapping - Shoulder - PRO,5096,CDM,981,RC,29240,HCPCS,outpatient,,,70.39,52.79,,56.63,130,,,fee schedule,130% of fee schedule,56.63,130,,,fee schedule,130% of fee schedule,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,23.29,119,,,fee schedule,119% of fee schedule,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,100% of fee schedule,63.35,90,,,percent of total billed charges,90% of total billed charges,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,18.44,100,,,fee schedule,100% of fee schedule,18.44,63.35,
Strapping - Elbow or wrist - PRO,5097,CDM,981,RC,29260,HCPCS,outpatient,,,69.82,52.37,,49.56,130,,,fee schedule,130% of fee schedule,49.56,130,,,fee schedule,130% of fee schedule,19.34,100,,,fee schedule,Pays 100% Medicare OPPS,19.34,100,,,fee schedule,Pays 100% Medicare OPPS,24.12,119,,,fee schedule,119% of fee schedule,19.34,100,,,fee schedule,Pays 100% Medicare OPPS,19.34,100,,,fee schedule,100% of fee schedule,62.84,90,,,percent of total billed charges,90% of total billed charges,19.34,100,,,fee schedule,Pays 100% Medicare OPPS,19.34,100,,,fee schedule,Pays 100% Medicare OPPS,19.34,100,,,fee schedule,Pays 100% Medicare OPPS,19.34,100,,,fee schedule,Pays 100% Medicare OPPS,17.25,100,,,fee schedule,100% of fee schedule,19.34,100,,,fee schedule,100% of fee schedule,17.25,62.84,
Strapping - Hand or finger - PRO,5098,CDM,981,RC,29280,HCPCS,outpatient,,,70.39,52.79,,47.84,130,,,fee schedule,130% of fee schedule,47.84,130,,,fee schedule,130% of fee schedule,20.05,100,,,fee schedule,Pays 100% Medicare OPPS,20.05,100,,,fee schedule,Pays 100% Medicare OPPS,25.79,119,,,fee schedule,119% of fee schedule,20.05,100,,,fee schedule,Pays 100% Medicare OPPS,20.05,100,,,fee schedule,100% of fee schedule,63.35,90,,,percent of total billed charges,90% of total billed charges,20.05,100,,,fee schedule,Pays 100% Medicare OPPS,20.05,100,,,fee schedule,Pays 100% Medicare OPPS,20.05,100,,,fee schedule,Pays 100% Medicare OPPS,20.05,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,20.05,100,,,fee schedule,100% of fee schedule,20.05,63.35,
Cast - Long Leg (Thigh to Toes)-PRO,5099,CDM,981,RC,29345,HCPCS,outpatient,,,319.83,239.87,,133.76,130,,,fee schedule,130% of fee schedule,133.76,130,,,fee schedule,130% of fee schedule,101.22,100,,,fee schedule,Pays 100% Medicare OPPS,101.22,100,,,fee schedule,Pays 100% Medicare OPPS,123.86,119,,,fee schedule,119% of fee schedule,101.22,100,,,fee schedule,Pays 100% Medicare OPPS,101.22,100,,,fee schedule,100% of fee schedule,287.85,90,,,percent of total billed charges,90% of total billed charges,101.22,100,,,fee schedule,Pays 100% Medicare OPPS,101.22,100,,,fee schedule,Pays 100% Medicare OPPS,101.22,100,,,fee schedule,Pays 100% Medicare OPPS,101.22,100,,,fee schedule,Pays 100% Medicare OPPS,79.05,100,,,fee schedule,100% of fee schedule,101.22,100,,,fee schedule,100% of fee schedule,79.05,287.85,
Casting:Legs;Below Knee  to Toes(short),5100,CDM,521,RC,29405,HCPCS,outpatient,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,82.38,201.61,
Casting:Legs;Below Knee  to Toes(short),5101,CDM,521,RC,29405,HCPCS,outpatient,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,82.38,201.61,
Casting:Legs;Below Knee to Toes(short)-PRO,5102,CDM,983,RC,29405,HCPCS,outpatient,,,226.16,169.62,,83.38,130,,,fee schedule,130% of fee schedule,83.38,130,,,fee schedule,130% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,73.17,119,,,fee schedule,119% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,100% of fee schedule,203.54,90,,,percent of total billed charges,90% of total billed charges,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,59.66,100,,,fee schedule,100% of fee schedule,57.49,203.54,
Casting:Legs;Below Knee to Toes(short)-PRO,5103,CDM,983,RC,29405,HCPCS,outpatient,,,226.16,169.62,,83.38,130,,,fee schedule,130% of fee schedule,83.38,130,,,fee schedule,130% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,73.17,119,,,fee schedule,119% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,100% of fee schedule,203.54,90,,,percent of total billed charges,90% of total billed charges,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,59.66,100,,,fee schedule,100% of fee schedule,57.49,203.54,
Casting:Legs;Below Knee to Toes(short)-PRO,5104,CDM,983,RC,29405,HCPCS,outpatient,,,226.16,169.62,,83.38,130,,,fee schedule,130% of fee schedule,83.38,130,,,fee schedule,130% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,73.17,119,,,fee schedule,119% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,100% of fee schedule,203.54,90,,,percent of total billed charges,90% of total billed charges,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,59.66,100,,,fee schedule,100% of fee schedule,57.49,203.54,
Apply rigid leg (TCC) PRO,5105,CDM,982,RC,29445,HCPCS,outpatient,,,247.31,185.48,,142.51,130,,,fee schedule,130% of fee schedule,142.51,130,,,fee schedule,130% of fee schedule,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,126.69,119,,,fee schedule,119% of fee schedule,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,100% of fee schedule,222.58,90,,,percent of total billed charges,90% of total billed charges,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,99.19,100,,,fee schedule,100% of fee schedule,99.19,222.58,
WND Apply rigid leg cast (TCC)-G,5106,CDM,982,RC,29445,HCPCS,outpatient,,,698.22,523.67,,142.51,130,,,fee schedule,130% of fee schedule,142.51,130,,,fee schedule,130% of fee schedule,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,126.69,119,,,fee schedule,119% of fee schedule,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,100% of fee schedule,628.4,90,,,percent of total billed charges,90% of total billed charges,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,99.19,100,,,fee schedule,100% of fee schedule,99.19,628.4,
"Application, long leg splint-PRO",5107,CDM,981,RC,29505,HCPCS,outpatient,,,167.58,125.69,,63.61,130,,,fee schedule,130% of fee schedule,63.61,130,,,fee schedule,130% of fee schedule,53.07,100,,,fee schedule,Pays 100% Medicare OPPS,53.07,100,,,fee schedule,Pays 100% Medicare OPPS,62.74,119,,,fee schedule,119% of fee schedule,53.07,100,,,fee schedule,Pays 100% Medicare OPPS,53.07,100,,,fee schedule,100% of fee schedule,150.82,90,,,percent of total billed charges,90% of total billed charges,53.07,100,,,fee schedule,Pays 100% Medicare OPPS,53.07,100,,,fee schedule,Pays 100% Medicare OPPS,53.07,100,,,fee schedule,Pays 100% Medicare OPPS,53.07,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,53.07,100,,,fee schedule,100% of fee schedule,51.74,150.82,
Splint/Strap:Ankle/FT/Leg/Toes;Calf to FT(Short),5108,CDM,521,RC,29515,HCPCS,outpatient,,,167.58,125.69,,150.82,90,,,percent of total billed charges,90% of total billed charges,155.85,93,,,percent of total billed charges,93% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,142.44,85,,,percent of total billed charges,85% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,136.41,81.4,,,percent of total billed charges,81.4% of total billed charges,150.82,90,,,percent of total billed charges,90% of total billed charges,150.82,90,,,percent of total billed charges,90% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,125.69,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,63.68,155.85,
Split/Strap:Ankle/Ft to Calf(Short)-PRO,5109,CDM,981,RC,29515,HCPCS,outpatient,,,164.04,123.03,,64.97,130,,,fee schedule,130% of fee schedule,64.97,130,,,fee schedule,130% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,61.36,119,,,fee schedule,119% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,100% of fee schedule,147.64,90,,,percent of total billed charges,90% of total billed charges,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,50.24,100,,,fee schedule,100% of fee schedule,43.12,147.64,
Split/Strap:Ankle/Ft to Calf(Short)-PRO,5110,CDM,981,RC,29515,HCPCS,outpatient,,,164.04,123.03,,64.97,130,,,fee schedule,130% of fee schedule,64.97,130,,,fee schedule,130% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,61.36,119,,,fee schedule,119% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,100% of fee schedule,147.64,90,,,percent of total billed charges,90% of total billed charges,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,50.24,100,,,fee schedule,100% of fee schedule,43.12,147.64,
Split/Strap:Ankle/Ft to Calf(Short)-PRO,5111,CDM,981,RC,29515,HCPCS,outpatient,,,164.04,123.03,,64.97,130,,,fee schedule,130% of fee schedule,64.97,130,,,fee schedule,130% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,61.36,119,,,fee schedule,119% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,100% of fee schedule,147.64,90,,,percent of total billed charges,90% of total billed charges,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,50.24,100,,,fee schedule,100% of fee schedule,43.12,147.64,
Split/Strap:Ankle/Ft to Calf(Short)-PRO,5112,CDM,981,RC,29515,HCPCS,outpatient,,,164.04,123.03,,64.97,130,,,fee schedule,130% of fee schedule,64.97,130,,,fee schedule,130% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,61.36,119,,,fee schedule,119% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,100% of fee schedule,147.64,90,,,percent of total billed charges,90% of total billed charges,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,50.24,100,,,fee schedule,100% of fee schedule,43.12,147.64,
Strapping - Knee - PRO,5113,CDM,981,RC,29530,HCPCS,outpatient,,,69.82,52.37,,49.99,130,,,fee schedule,130% of fee schedule,49.99,130,,,fee schedule,130% of fee schedule,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,23.29,119,,,fee schedule,119% of fee schedule,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,100% of fee schedule,62.84,90,,,percent of total billed charges,90% of total billed charges,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,18.44,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,18.44,100,,,fee schedule,100% of fee schedule,18.44,62.84,
Splint/Strap:Ankle/FT/Leg/Toes; Ankle and or FT,5114,CDM,521,RC,29540,HCPCS,outpatient,,,117.18,87.89,,105.46,90,,,percent of total billed charges,90% of total billed charges,108.98,93,,,percent of total billed charges,93% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,99.6,85,,,percent of total billed charges,85% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,95.38,81.4,,,percent of total billed charges,81.4% of total billed charges,105.46,90,,,percent of total billed charges,90% of total billed charges,105.46,90,,,percent of total billed charges,90% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,87.89,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,44.53,108.98,
Strapping - Ankle and or/foot - PRO,5115,CDM,981,RC,29540,HCPCS,outpatient,,,61.37,46.03,,29.93,130,,,fee schedule,130% of fee schedule,29.93,130,,,fee schedule,130% of fee schedule,17.56,100,,,fee schedule,Pays 100% Medicare OPPS,17.56,100,,,fee schedule,Pays 100% Medicare OPPS,21.91,119,,,fee schedule,119% of fee schedule,17.56,100,,,fee schedule,Pays 100% Medicare OPPS,17.56,100,,,fee schedule,100% of fee schedule,55.23,90,,,percent of total billed charges,90% of total billed charges,17.56,100,,,fee schedule,Pays 100% Medicare OPPS,17.56,100,,,fee schedule,Pays 100% Medicare OPPS,17.56,100,,,fee schedule,Pays 100% Medicare OPPS,17.56,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,17.56,100,,,fee schedule,100% of fee schedule,17.56,55.23,
Strapping Toes - PRO,5116,CDM,981,RC,29550,HCPCS,outpatient,,,45.05,33.79,,19.34,130,,,fee schedule,130% of fee schedule,19.34,130,,,fee schedule,130% of fee schedule,11.18,100,,,fee schedule,Pays 100% Medicare OPPS,11.18,100,,,fee schedule,Pays 100% Medicare OPPS,14.17,119,,,fee schedule,119% of fee schedule,11.18,100,,,fee schedule,Pays 100% Medicare OPPS,11.18,100,,,fee schedule,100% of fee schedule,40.55,90,,,percent of total billed charges,90% of total billed charges,11.18,100,,,fee schedule,Pays 100% Medicare OPPS,11.18,100,,,fee schedule,Pays 100% Medicare OPPS,11.18,100,,,fee schedule,Pays 100% Medicare OPPS,11.18,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,11.18,100,,,fee schedule,100% of fee schedule,11.18,40.55,
WND Strapping - Unna Boot - PRO,5117,CDM,982,RC,29580,HCPCS,outpatient,,,84.46,63.35,,47.16,130,,,fee schedule,130% of fee schedule,47.16,130,,,fee schedule,130% of fee schedule,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,33.82,119,,,fee schedule,119% of fee schedule,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,100% of fee schedule,76.01,90,,,percent of total billed charges,90% of total billed charges,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,26.31,100,,,fee schedule,100% of fee schedule,26.31,76.01,
Strapping - Unna Boot - PRO,5118,CDM,981,RC,29580,HCPCS,outpatient,,,144.15,108.11,,47.16,130,,,fee schedule,130% of fee schedule,47.16,130,,,fee schedule,130% of fee schedule,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,33.82,119,,,fee schedule,119% of fee schedule,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,100% of fee schedule,129.74,90,,,percent of total billed charges,90% of total billed charges,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,26.31,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,26.31,100,,,fee schedule,100% of fee schedule,26.31,129.74,
WND Strapping low extremity -G,5119,CDM,982,RC,29581,HCPCS,outpatient,,,250.73,188.05,,41.61,130,,,fee schedule,130% of fee schedule,41.61,130,,,fee schedule,130% of fee schedule,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,34.52,119,,,fee schedule,119% of fee schedule,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,100% of fee schedule,225.66,90,,,percent of total billed charges,90% of total billed charges,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,27.1,100,,,fee schedule,100% of fee schedule,27.1,225.66,
"WND Strapping, low extremity -PRO",5120,CDM,982,RC,29581,HCPCS,outpatient,,,78.85,59.14,,41.61,130,,,fee schedule,130% of fee schedule,41.61,130,,,fee schedule,130% of fee schedule,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,34.52,119,,,fee schedule,119% of fee schedule,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,100% of fee schedule,70.97,90,,,percent of total billed charges,90% of total billed charges,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,27.1,100,,,fee schedule,100% of fee schedule,27.1,70.97,
"Apply Strapping lower ex, multi-layer cast PRO",5121,CDM,983,RC,29581,HCPCS,outpatient,,,78.71,59.03,,41.61,130,,,fee schedule,130% of fee schedule,41.61,130,,,fee schedule,130% of fee schedule,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,34.52,119,,,fee schedule,119% of fee schedule,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,100% of fee schedule,70.84,90,,,percent of total billed charges,90% of total billed charges,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,27.1,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,27.1,100,,,fee schedule,100% of fee schedule,27.1,70.84,
Removal/Revision of Cast,5122,CDM,521,RC,29705,HCPCS,outpatient,,,117.18,87.89,,105.46,90,,,percent of total billed charges,90% of total billed charges,108.98,93,,,percent of total billed charges,93% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,99.6,85,,,percent of total billed charges,85% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,95.38,81.4,,,percent of total billed charges,81.4% of total billed charges,105.46,90,,,percent of total billed charges,90% of total billed charges,105.46,90,,,percent of total billed charges,90% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,87.89,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,44.53,108.98,
OR ARTHRO Diagnostic PRO,5123,CDM,975,RC,29870,HCPCS,outpatient,,,884.34,663.26,,544.67,130,,,fee schedule,130% of fee schedule,544.67,130,,,fee schedule,130% of fee schedule,420.79,100,,,fee schedule,Pays 100% Medicare OPPS,420.79,100,,,fee schedule,Pays 100% Medicare OPPS,511.25,119,,,fee schedule,119% of fee schedule,420.79,100,,,fee schedule,Pays 100% Medicare OPPS,420.79,100,,,fee schedule,100% of fee schedule,795.91,90,,,percent of total billed charges,90% of total billed charges,420.79,100,,,fee schedule,Pays 100% Medicare OPPS,420.79,100,,,fee schedule,Pays 100% Medicare OPPS,420.79,100,,,fee schedule,Pays 100% Medicare OPPS,420.79,100,,,fee schedule,Pays 100% Medicare OPPS,373.67,100,,,fee schedule,100% of fee schedule,420.79,100,,,fee schedule,100% of fee schedule,373.67,795.91,
OR PRO ARTHROS KNEE SYNV LIMIT,5124,CDM,975,RC,29875,HCPCS,outpatient,,,1080.37,810.28,,655.5,130,,,fee schedule,130% of fee schedule,655.5,130,,,fee schedule,130% of fee schedule,512.72,100,,,fee schedule,Pays 100% Medicare OPPS,512.72,100,,,fee schedule,Pays 100% Medicare OPPS,618.82,119,,,fee schedule,119% of fee schedule,512.72,100,,,fee schedule,Pays 100% Medicare OPPS,512.72,100,,,fee schedule,100% of fee schedule,972.33,90,,,percent of total billed charges,90% of total billed charges,512.72,100,,,fee schedule,Pays 100% Medicare OPPS,512.72,100,,,fee schedule,Pays 100% Medicare OPPS,512.72,100,,,fee schedule,Pays 100% Medicare OPPS,512.72,100,,,fee schedule,Pays 100% Medicare OPPS,862.32,100,,,fee schedule,100% of fee schedule,512.72,100,,,fee schedule,100% of fee schedule,512.72,972.33,
OR PRO ARTHROS KNEE SYNV MAJOR,5125,CDM,975,RC,29876,HCPCS,outpatient,,,3445.01,2583.76,,870.6,130,,,fee schedule,130% of fee schedule,870.6,130,,,fee schedule,130% of fee schedule,670.81,100,,,fee schedule,Pays 100% Medicare OPPS,670.81,100,,,fee schedule,Pays 100% Medicare OPPS,814.34,119,,,fee schedule,119% of fee schedule,670.81,100,,,fee schedule,Pays 100% Medicare OPPS,670.81,100,,,fee schedule,100% of fee schedule,3100.51,90,,,percent of total billed charges,90% of total billed charges,670.81,100,,,fee schedule,Pays 100% Medicare OPPS,670.81,100,,,fee schedule,Pays 100% Medicare OPPS,670.81,100,,,fee schedule,Pays 100% Medicare OPPS,670.81,100,,,fee schedule,Pays 100% Medicare OPPS,1006.04,100,,,fee schedule,100% of fee schedule,670.81,100,,,fee schedule,100% of fee schedule,670.81,3100.51,
OR Chondroplasty Pro,5126,CDM,975,RC,29877,HCPCS,outpatient,,,1511.67,1133.75,,825.11,130,,,fee schedule,130% of fee schedule,825.11,130,,,fee schedule,130% of fee schedule,639.45,100,,,fee schedule,Pays 100% Medicare OPPS,639.45,100,,,fee schedule,Pays 100% Medicare OPPS,773.94,119,,,fee schedule,119% of fee schedule,639.45,100,,,fee schedule,Pays 100% Medicare OPPS,639.45,100,,,fee schedule,100% of fee schedule,1360.5,90,,,percent of total billed charges,90% of total billed charges,639.45,100,,,fee schedule,Pays 100% Medicare OPPS,639.45,100,,,fee schedule,Pays 100% Medicare OPPS,639.45,100,,,fee schedule,Pays 100% Medicare OPPS,639.45,100,,,fee schedule,Pays 100% Medicare OPPS,934.18,100,,,fee schedule,100% of fee schedule,639.45,100,,,fee schedule,100% of fee schedule,639.45,1360.5,
Arthroscopy- lat-med meniscctomy PRO,5127,CDM,975,RC,29880,HCPCS,outpatient,,,1378.43,1033.82,,916.14,130,,,fee schedule,130% of fee schedule,916.14,130,,,fee schedule,130% of fee schedule,579.76,100,,,fee schedule,Pays 100% Medicare OPPS,579.76,100,,,fee schedule,Pays 100% Medicare OPPS,699.97,119,,,fee schedule,119% of fee schedule,579.76,100,,,fee schedule,Pays 100% Medicare OPPS,579.76,100,,,fee schedule,100% of fee schedule,1240.59,90,,,percent of total billed charges,90% of total billed charges,579.76,100,,,fee schedule,Pays 100% Medicare OPPS,579.76,100,,,fee schedule,Pays 100% Medicare OPPS,579.76,100,,,fee schedule,Pays 100% Medicare OPPS,579.76,100,,,fee schedule,Pays 100% Medicare OPPS,1106.64,100,,,fee schedule,100% of fee schedule,579.76,100,,,fee schedule,100% of fee schedule,579.76,1240.59,
OR Arthro w meniscectomy-PRO,5128,CDM,975,RC,29881,HCPCS,outpatient,,,1320.99,990.74,,857.38,130,,,fee schedule,130% of fee schedule,857.38,130,,,fee schedule,130% of fee schedule,558.66,100,,,fee schedule,Pays 100% Medicare OPPS,558.66,100,,,fee schedule,Pays 100% Medicare OPPS,674.63,119,,,fee schedule,119% of fee schedule,558.66,100,,,fee schedule,Pays 100% Medicare OPPS,558.66,100,,,fee schedule,100% of fee schedule,1188.89,90,,,percent of total billed charges,90% of total billed charges,558.66,100,,,fee schedule,Pays 100% Medicare OPPS,558.66,100,,,fee schedule,Pays 100% Medicare OPPS,558.66,100,,,fee schedule,Pays 100% Medicare OPPS,558.66,100,,,fee schedule,Pays 100% Medicare OPPS,1006.04,100,,,fee schedule,100% of fee schedule,558.66,100,,,fee schedule,100% of fee schedule,558.66,1188.89,
Turb. Inj. FB:Nose;Intranasal,5129,CDM,521,RC,30300,HCPCS,outpatient,,,301.16,225.87,,271.04,90,,,percent of total billed charges,90% of total billed charges,280.08,93,,,percent of total billed charges,93% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,255.99,85,,,percent of total billed charges,85% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,245.14,81.4,,,percent of total billed charges,81.4% of total billed charges,271.04,90,,,percent of total billed charges,90% of total billed charges,271.04,90,,,percent of total billed charges,90% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,114.44,38,,,percent of total billed charges,38% of total billed charges,225.87,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,114.44,280.08,
"Turb.Inj,FB:Nose;Intranasal-PRO",5130,CDM,981,RC,30300,HCPCS,outpatient,,,180.45,135.34,,168.71,130,,,fee schedule,130% of fee schedule,168.71,130,,,fee schedule,130% of fee schedule,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,141.03,119,,,fee schedule,119% of fee schedule,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,100% of fee schedule,162.41,90,,,percent of total billed charges,90% of total billed charges,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,130.31,100,,,fee schedule,100% of fee schedule,71.86,168.71,
"Turb.Inj,FB:Nose;Intranasal-PRO",5131,CDM,981,RC,30300,HCPCS,outpatient,,,180.45,135.34,,168.71,130,,,fee schedule,130% of fee schedule,168.71,130,,,fee schedule,130% of fee schedule,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,141.03,119,,,fee schedule,119% of fee schedule,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,100% of fee schedule,162.41,90,,,percent of total billed charges,90% of total billed charges,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,130.31,100,,,fee schedule,100% of fee schedule,71.86,168.71,
"Control Nose Bleed,ante., simple pkg",5132,CDM,521,RC,30901,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
"Control Nose Bleed,ante., simple pkg",5133,CDM,521,RC,30901,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
"Control Nose Bleed,ante., simple pkg",5134,CDM,521,RC,30901,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
"Control Nose Bleed,ante., simple pkg",5135,CDM,521,RC,30901,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
"Control Nose Bleed,ante., simple-PRO",5136,CDM,981,RC,30901,HCPCS,outpatient,,,253.12,189.84,,75.96,130,,,fee schedule,130% of fee schedule,75.96,130,,,fee schedule,130% of fee schedule,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,70.2,119,,,fee schedule,119% of fee schedule,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,100% of fee schedule,227.81,90,,,percent of total billed charges,90% of total billed charges,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,56.82,100,,,fee schedule,100% of fee schedule,56.82,227.81,
"Control Nose Bleed,ante., simple-PRO",5137,CDM,981,RC,30901,HCPCS,outpatient,,,253.12,189.84,,75.96,130,,,fee schedule,130% of fee schedule,75.96,130,,,fee schedule,130% of fee schedule,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,70.2,119,,,fee schedule,119% of fee schedule,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,100% of fee schedule,227.81,90,,,percent of total billed charges,90% of total billed charges,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,56.82,100,,,fee schedule,100% of fee schedule,56.82,227.81,
"Control Nose Bleed:Nasal hemo.,ante.,Complex",5138,CDM,521,RC,30903,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,75.7,185.27,
"Control Nose Bleed:Nasal hemo.,hemo.,ante.,Complex-PRO",5139,CDM,981,RC,30903,HCPCS,outpatient,,,417.16,312.87,,109.15,130,,,fee schedule,130% of fee schedule,109.15,130,,,fee schedule,130% of fee schedule,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,97.47,119,,,fee schedule,119% of fee schedule,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,100% of fee schedule,375.44,90,,,percent of total billed charges,90% of total billed charges,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,77.61,100,,,fee schedule,100% of fee schedule,77.61,375.44,
"Control Nose Bleed:Nasal hemo.,hemo.,ante.,Complex-PRO",5140,CDM,981,RC,30903,HCPCS,outpatient,,,417.16,312.87,,109.15,130,,,fee schedule,130% of fee schedule,109.15,130,,,fee schedule,130% of fee schedule,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,97.47,119,,,fee schedule,119% of fee schedule,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,100% of fee schedule,375.44,90,,,percent of total billed charges,90% of total billed charges,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,77.61,100,,,fee schedule,100% of fee schedule,77.61,375.44,
Intubation-PRO,5141,CDM,981,RC,31500,HCPCS,outpatient,,,445.28,333.96,,144.5,130,,,fee schedule,130% of fee schedule,144.5,130,,,fee schedule,130% of fee schedule,140.11,100,,,fee schedule,Pays 100% Medicare OPPS,140.11,100,,,fee schedule,Pays 100% Medicare OPPS,177.05,119,,,fee schedule,119% of fee schedule,140.11,100,,,fee schedule,Pays 100% Medicare OPPS,140.11,100,,,fee schedule,100% of fee schedule,400.75,90,,,percent of total billed charges,90% of total billed charges,140.11,100,,,fee schedule,Pays 100% Medicare OPPS,140.11,100,,,fee schedule,Pays 100% Medicare OPPS,140.11,100,,,fee schedule,Pays 100% Medicare OPPS,140.11,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,140.11,100,,,fee schedule,100% of fee schedule,100.6,400.75,
Incision of trachea - PRO,5142,CDM,981,RC,31605,HCPCS,outpatient,,,993.67,745.25,,244,130,,,fee schedule,130% of fee schedule,244,130,,,fee schedule,130% of fee schedule,329.66,100,,,fee schedule,Pays 100% Medicare OPPS,329.66,100,,,fee schedule,Pays 100% Medicare OPPS,414.37,119,,,fee schedule,119% of fee schedule,329.66,100,,,fee schedule,Pays 100% Medicare OPPS,329.66,100,,,fee schedule,100% of fee schedule,894.3,90,,,percent of total billed charges,90% of total billed charges,329.66,100,,,fee schedule,Pays 100% Medicare OPPS,329.66,100,,,fee schedule,Pays 100% Medicare OPPS,329.66,100,,,fee schedule,Pays 100% Medicare OPPS,329.66,100,,,fee schedule,Pays 100% Medicare OPPS,388.04,100,,,fee schedule,100% of fee schedule,329.66,100,,,fee schedule,100% of fee schedule,244,894.3,
Chest tube thoracostomy with draining-PRO,5143,CDM,981,RC,32551,HCPCS,outpatient,,,564.79,423.59,,224.95,130,,,fee schedule,130% of fee schedule,224.95,130,,,fee schedule,130% of fee schedule,153.78,100,,,fee schedule,Pays 100% Medicare OPPS,153.78,100,,,fee schedule,Pays 100% Medicare OPPS,195.08,119,,,fee schedule,119% of fee schedule,153.78,100,,,fee schedule,Pays 100% Medicare OPPS,153.78,100,,,fee schedule,100% of fee schedule,508.31,90,,,percent of total billed charges,90% of total billed charges,153.78,100,,,fee schedule,Pays 100% Medicare OPPS,153.78,100,,,fee schedule,Pays 100% Medicare OPPS,153.78,100,,,fee schedule,Pays 100% Medicare OPPS,153.78,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,153.78,100,,,fee schedule,100% of fee schedule,153.78,508.31,
Thorocentesis w/o imaging w/o tube -PRO,5144,CDM,981,RC,32554,HCPCS,outpatient,,,553.07,414.8,,442.46,80,,,percent of total billed charges,90% of total billed charges,442.46,80,,,percent of total billed charges,93% of total billed charges,88.02,100,,,fee schedule,Pays 100% Medicare OPPS,88.02,100,,,fee schedule,Pays 100% Medicare OPPS,111.28,119,,,fee schedule,119% of fee schedule,88.02,100,,,fee schedule,Pays 100% Medicare OPPS,88.02,100,,,fee schedule,100% of fee schedule,497.76,90,,,percent of total billed charges,90% of total billed charges,88.02,100,,,fee schedule,Pays 100% Medicare OPPS,88.02,100,,,fee schedule,Pays 100% Medicare OPPS,88.02,100,,,fee schedule,Pays 100% Medicare OPPS,88.02,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,88.02,100,,,fee schedule,100% of fee schedule,88.02,497.76,
Thorocentesis w imaging w/o tube -PRO,5145,CDM,981,RC,32555,HCPCS,outpatient,,,457,342.75,,365.6,80,,,percent of total billed charges,90% of total billed charges,365.6,80,,,percent of total billed charges,93% of total billed charges,109.04,100,,,fee schedule,Pays 100% Medicare OPPS,109.04,100,,,fee schedule,Pays 100% Medicare OPPS,138.59,119,,,fee schedule,119% of fee schedule,109.04,100,,,fee schedule,Pays 100% Medicare OPPS,109.04,100,,,fee schedule,100% of fee schedule,411.3,90,,,percent of total billed charges,90% of total billed charges,109.04,100,,,fee schedule,Pays 100% Medicare OPPS,109.04,100,,,fee schedule,Pays 100% Medicare OPPS,109.04,100,,,fee schedule,Pays 100% Medicare OPPS,109.04,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,109.04,100,,,fee schedule,100% of fee schedule,109.04,411.3,
* Venipuncture - < 3 years-PRO,5146,CDM,981,RC,36400,HCPCS,outpatient,,,45.05,33.79,,22.43,130,,,fee schedule,130% of fee schedule,22.43,130,,,fee schedule,130% of fee schedule,19,100,,,fee schedule,Pays 100% Medicare OPPS,19,100,,,fee schedule,Pays 100% Medicare OPPS,23.25,119,,,fee schedule,119% of fee schedule,19,100,,,fee schedule,Pays 100% Medicare OPPS,19,100,,,fee schedule,100% of fee schedule,40.55,90,,,percent of total billed charges,90% of total billed charges,19,100,,,fee schedule,Pays 100% Medicare OPPS,19,100,,,fee schedule,Pays 100% Medicare OPPS,19,100,,,fee schedule,Pays 100% Medicare OPPS,19,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,19,100,,,fee schedule,100% of fee schedule,19,40.55,
* Venipuncture - > 3 years-PRO,5147,CDM,981,RC,36410,HCPCS,outpatient,,,45.05,33.79,,12.79,130,,,fee schedule,130% of fee schedule,12.79,130,,,fee schedule,130% of fee schedule,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,11.6,119,,,fee schedule,119% of fee schedule,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,100% of fee schedule,40.55,90,,,percent of total billed charges,90% of total billed charges,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,9.16,100,,,fee schedule,Pays 100% Medicare OPPS,14.37,100,,,fee schedule,100% of fee schedule,9.16,100,,,fee schedule,100% of fee schedule,9.16,40.55,
Central Line insertion-PRO,5148,CDM,981,RC,36556,HCPCS,outpatient,,,732.36,549.27,,161.14,130,,,fee schedule,130% of fee schedule,161.14,130,,,fee schedule,130% of fee schedule,83.68,100,,,fee schedule,Pays 100% Medicare OPPS,83.68,100,,,fee schedule,Pays 100% Medicare OPPS,105.43,119,,,fee schedule,119% of fee schedule,83.68,100,,,fee schedule,Pays 100% Medicare OPPS,83.68,100,,,fee schedule,100% of fee schedule,659.12,90,,,percent of total billed charges,90% of total billed charges,83.68,100,,,fee schedule,Pays 100% Medicare OPPS,83.68,100,,,fee schedule,Pays 100% Medicare OPPS,83.68,100,,,fee schedule,Pays 100% Medicare OPPS,83.68,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,83.68,100,,,fee schedule,100% of fee schedule,83.68,659.12,
IO Insertion-PRO,5149,CDM,981,RC,36680,HCPCS,outpatient,,,241.38,181.04,,77.3,130,,,fee schedule,130% of fee schedule,77.3,130,,,fee schedule,130% of fee schedule,58.9,100,,,fee schedule,Pays 100% Medicare OPPS,58.9,100,,,fee schedule,Pays 100% Medicare OPPS,74.22,119,,,fee schedule,119% of fee schedule,58.9,100,,,fee schedule,Pays 100% Medicare OPPS,58.9,100,,,fee schedule,100% of fee schedule,217.24,90,,,percent of total billed charges,90% of total billed charges,58.9,100,,,fee schedule,Pays 100% Medicare OPPS,58.9,100,,,fee schedule,Pays 100% Medicare OPPS,58.9,100,,,fee schedule,Pays 100% Medicare OPPS,58.9,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,58.9,100,,,fee schedule,100% of fee schedule,58.9,217.24,
DERM BIOPSY OF LIP - PRO,5150,CDM,982,RC,40490,HCPCS,outpatient,,,265.3,198.98,,101.69,130,,,fee schedule,130% of fee schedule,101.69,130,,,fee schedule,130% of fee schedule,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,87.71,119,,,fee schedule,119% of fee schedule,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,100% of fee schedule,238.77,90,,,percent of total billed charges,90% of total billed charges,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,70.05,100,,,fee schedule,100% of fee schedule,57.49,238.77,
DERM Biopsy of Lip - G,5151,CDM,982,RC,40490,HCPCS,outpatient,,,636.72,477.54,,101.69,130,,,fee schedule,130% of fee schedule,101.69,130,,,fee schedule,130% of fee schedule,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,87.71,119,,,fee schedule,119% of fee schedule,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,100% of fee schedule,573.05,90,,,percent of total billed charges,90% of total billed charges,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,70.05,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,70.05,100,,,fee schedule,100% of fee schedule,57.49,573.05,
FBR-Mouth -PRO,5152,CDM,981,RC,40804,HCPCS,outpatient,,,449.95,337.46,,177.88,130,,,fee schedule,130% of fee schedule,177.88,130,,,fee schedule,130% of fee schedule,116.82,100,,,fee schedule,Pays 100% Medicare OPPS,116.82,100,,,fee schedule,Pays 100% Medicare OPPS,147.56,119,,,fee schedule,119% of fee schedule,116.82,100,,,fee schedule,Pays 100% Medicare OPPS,116.82,100,,,fee schedule,100% of fee schedule,404.96,90,,,percent of total billed charges,90% of total billed charges,116.82,100,,,fee schedule,Pays 100% Medicare OPPS,116.82,100,,,fee schedule,Pays 100% Medicare OPPS,116.82,100,,,fee schedule,Pays 100% Medicare OPPS,116.82,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,116.82,100,,,fee schedule,100% of fee schedule,57.49,404.96,
Soft tissue FBR - Vestibule - Complicated-PRO,5153,CDM,981,RC,40805,HCPCS,outpatient,,,754.52,565.89,,306.49,130,,,fee schedule,130% of fee schedule,306.49,130,,,fee schedule,130% of fee schedule,202.73,100,,,fee schedule,Pays 100% Medicare OPPS,202.73,100,,,fee schedule,Pays 100% Medicare OPPS,260.85,119,,,fee schedule,119% of fee schedule,202.73,100,,,fee schedule,Pays 100% Medicare OPPS,202.73,100,,,fee schedule,100% of fee schedule,679.07,90,,,percent of total billed charges,90% of total billed charges,202.73,100,,,fee schedule,Pays 100% Medicare OPPS,202.73,100,,,fee schedule,Pays 100% Medicare OPPS,202.73,100,,,fee schedule,Pays 100% Medicare OPPS,202.73,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,202.73,100,,,fee schedule,100% of fee schedule,107.79,679.07,
DERM UNDER EXCISION AND DESTRUCTION PROCEDURES ON THE VESTIBULE OF MOUTH - PRO,5154,CDM,982,RC,40808,HCPCS,outpatient,,,348.55,261.41,,146.59,130,,,fee schedule,130% of fee schedule,146.59,130,,,fee schedule,130% of fee schedule,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,107.48,119,,,fee schedule,119% of fee schedule,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,100% of fee schedule,313.7,90,,,percent of total billed charges,90% of total billed charges,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,91.66,100,,,fee schedule,100% of fee schedule,57.49,313.7,
DERM UNDER EXCISION AND DESTRUCTION PROCEDURES ON THE VESTIBULE OF MOUTH - G,5155,CDM,982,RC,40808,HCPCS,outpatient,,,593.56,445.17,,146.59,130,,,fee schedule,130% of fee schedule,146.59,130,,,fee schedule,130% of fee schedule,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,107.48,119,,,fee schedule,119% of fee schedule,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,100% of fee schedule,534.2,90,,,percent of total billed charges,90% of total billed charges,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,91.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,91.66,100,,,fee schedule,100% of fee schedule,57.49,534.2,
"Wound Repair - Mouth, Tongue <2.5 cm-PRO",5156,CDM,981,RC,41250,HCPCS,outpatient,,,635.16,476.37,,202.42,130,,,fee schedule,130% of fee schedule,202.42,130,,,fee schedule,130% of fee schedule,157.86,100,,,fee schedule,Pays 100% Medicare OPPS,157.86,100,,,fee schedule,Pays 100% Medicare OPPS,191.83,119,,,fee schedule,119% of fee schedule,157.86,100,,,fee schedule,Pays 100% Medicare OPPS,157.86,100,,,fee schedule,100% of fee schedule,571.64,90,,,percent of total billed charges,90% of total billed charges,157.86,100,,,fee schedule,Pays 100% Medicare OPPS,157.86,100,,,fee schedule,Pays 100% Medicare OPPS,157.86,100,,,fee schedule,Pays 100% Medicare OPPS,157.86,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,157.86,100,,,fee schedule,100% of fee schedule,86.23,571.64,
Wound Repair - Posterior Tongue - PRO,5157,CDM,981,RC,41251,HCPCS,outpatient,,,702.72,527.04,,229.44,130,,,fee schedule,130% of fee schedule,229.44,130,,,fee schedule,130% of fee schedule,188.31,100,,,fee schedule,Pays 100% Medicare OPPS,188.31,100,,,fee schedule,Pays 100% Medicare OPPS,227.86,119,,,fee schedule,119% of fee schedule,188.31,100,,,fee schedule,Pays 100% Medicare OPPS,188.31,100,,,fee schedule,100% of fee schedule,632.45,90,,,percent of total billed charges,90% of total billed charges,188.31,100,,,fee schedule,Pays 100% Medicare OPPS,188.31,100,,,fee schedule,Pays 100% Medicare OPPS,188.31,100,,,fee schedule,Pays 100% Medicare OPPS,188.31,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,188.31,100,,,fee schedule,100% of fee schedule,114.98,632.45,
Drainage of gum lesion Pro,5158,CDM,981,RC,41800,HCPCS,outpatient,,,287.17,215.38,,192.18,130,,,fee schedule,130% of fee schedule,192.18,130,,,fee schedule,130% of fee schedule,160.56,100,,,fee schedule,Pays 100% Medicare OPPS,160.56,100,,,fee schedule,Pays 100% Medicare OPPS,190.85,119,,,fee schedule,119% of fee schedule,160.56,100,,,fee schedule,Pays 100% Medicare OPPS,160.56,100,,,fee schedule,100% of fee schedule,258.45,90,,,percent of total billed charges,90% of total billed charges,160.56,100,,,fee schedule,Pays 100% Medicare OPPS,160.56,100,,,fee schedule,Pays 100% Medicare OPPS,160.56,100,,,fee schedule,Pays 100% Medicare OPPS,160.56,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,160.56,100,,,fee schedule,100% of fee schedule,28.74,258.45,
FBR-embedded dentoalveolar- soft tissues-PRO,5159,CDM,981,RC,41805,HCPCS,outpatient,,,574.33,430.75,,228.81,130,,,fee schedule,130% of fee schedule,228.81,130,,,fee schedule,130% of fee schedule,207.39,100,,,fee schedule,Pays 100% Medicare OPPS,207.39,100,,,fee schedule,Pays 100% Medicare OPPS,237.89,119,,,fee schedule,119% of fee schedule,207.39,100,,,fee schedule,Pays 100% Medicare OPPS,207.39,100,,,fee schedule,100% of fee schedule,516.9,90,,,percent of total billed charges,90% of total billed charges,207.39,100,,,fee schedule,Pays 100% Medicare OPPS,207.39,100,,,fee schedule,Pays 100% Medicare OPPS,207.39,100,,,fee schedule,Pays 100% Medicare OPPS,207.39,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,207.39,100,,,fee schedule,100% of fee schedule,57.49,516.9,
I&D Peritonsillar-PRO,5160,CDM,981,RC,42700,HCPCS,outpatient,,,303.49,227.62,,186.52,130,,,fee schedule,130% of fee schedule,186.52,130,,,fee schedule,130% of fee schedule,140.83,100,,,fee schedule,Pays 100% Medicare OPPS,140.83,100,,,fee schedule,Pays 100% Medicare OPPS,167.49,119,,,fee schedule,119% of fee schedule,140.83,100,,,fee schedule,Pays 100% Medicare OPPS,140.83,100,,,fee schedule,100% of fee schedule,273.14,90,,,percent of total billed charges,90% of total billed charges,140.83,100,,,fee schedule,Pays 100% Medicare OPPS,140.83,100,,,fee schedule,Pays 100% Medicare OPPS,140.83,100,,,fee schedule,Pays 100% Medicare OPPS,140.83,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,140.83,100,,,fee schedule,100% of fee schedule,71.86,273.14,
FBR-pharynx-PRO,5161,CDM,981,RC,42809,HCPCS,outpatient,,,376.14,282.11,,179.63,130,,,fee schedule,130% of fee schedule,179.63,130,,,fee schedule,130% of fee schedule,129.53,100,,,fee schedule,Pays 100% Medicare OPPS,129.53,100,,,fee schedule,Pays 100% Medicare OPPS,153.76,119,,,fee schedule,119% of fee schedule,129.53,100,,,fee schedule,Pays 100% Medicare OPPS,129.53,100,,,fee schedule,100% of fee schedule,338.53,90,,,percent of total billed charges,90% of total billed charges,129.53,100,,,fee schedule,Pays 100% Medicare OPPS,129.53,100,,,fee schedule,Pays 100% Medicare OPPS,129.53,100,,,fee schedule,Pays 100% Medicare OPPS,129.53,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,129.53,100,,,fee schedule,100% of fee schedule,71.86,338.53,
OR EGD- Diagnostic PRO,5162,CDM,975,RC,43235,HCPCS,outpatient,,,451.44,338.58,,193.8,130,,,fee schedule,130% of fee schedule,193.8,130,,,fee schedule,130% of fee schedule,122.67,100,,,fee schedule,Pays 100% Medicare OPPS,122.67,100,,,fee schedule,Pays 100% Medicare OPPS,152.65,119,,,fee schedule,119% of fee schedule,122.67,100,,,fee schedule,Pays 100% Medicare OPPS,122.67,100,,,fee schedule,100% of fee schedule,406.3,90,,,percent of total billed charges,90% of total billed charges,122.67,100,,,fee schedule,Pays 100% Medicare OPPS,122.67,100,,,fee schedule,Pays 100% Medicare OPPS,122.67,100,,,fee schedule,Pays 100% Medicare OPPS,122.67,100,,,fee schedule,Pays 100% Medicare OPPS,301.81,100,,,fee schedule,100% of fee schedule,122.67,100,,,fee schedule,100% of fee schedule,122.67,406.3,
OR EGD- w biopsy PRO,5163,CDM,975,RC,43239,HCPCS,outpatient,,,344.6,258.45,,228.87,130,,,fee schedule,130% of fee schedule,228.87,130,,,fee schedule,130% of fee schedule,138.33,100,,,fee schedule,Pays 100% Medicare OPPS,138.33,100,,,fee schedule,Pays 100% Medicare OPPS,172.07,119,,,fee schedule,119% of fee schedule,138.33,100,,,fee schedule,Pays 100% Medicare OPPS,138.33,100,,,fee schedule,100% of fee schedule,310.14,90,,,percent of total billed charges,90% of total billed charges,138.33,100,,,fee schedule,Pays 100% Medicare OPPS,138.33,100,,,fee schedule,Pays 100% Medicare OPPS,138.33,100,,,fee schedule,Pays 100% Medicare OPPS,138.33,100,,,fee schedule,Pays 100% Medicare OPPS,344.93,100,,,fee schedule,100% of fee schedule,138.33,100,,,fee schedule,100% of fee schedule,138.33,344.93,
OR PRO EGD  w band ligation,5164,CDM,975,RC,43244,HCPCS,outpatient,,,574.33,430.75,,393.69,130,,,fee schedule,130% of fee schedule,393.69,130,,,fee schedule,130% of fee schedule,244.47,100,,,fee schedule,Pays 100% Medicare OPPS,244.47,100,,,fee schedule,Pays 100% Medicare OPPS,305.27,119,,,fee schedule,119% of fee schedule,244.47,100,,,fee schedule,Pays 100% Medicare OPPS,244.47,100,,,fee schedule,100% of fee schedule,516.9,90,,,percent of total billed charges,90% of total billed charges,244.47,100,,,fee schedule,Pays 100% Medicare OPPS,244.47,100,,,fee schedule,Pays 100% Medicare OPPS,244.47,100,,,fee schedule,Pays 100% Medicare OPPS,244.47,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,244.47,100,,,fee schedule,100% of fee schedule,244.47,516.9,
OR EGD-PRO w snare,5166,CDM,975,RC,43251,HCPCS,outpatient,,,477.87,358.4,,291.21,130,,,fee schedule,130% of fee schedule,291.21,130,,,fee schedule,130% of fee schedule,195.7,100,,,fee schedule,Pays 100% Medicare OPPS,195.7,100,,,fee schedule,Pays 100% Medicare OPPS,243.97,119,,,fee schedule,119% of fee schedule,195.7,100,,,fee schedule,Pays 100% Medicare OPPS,195.7,100,,,fee schedule,100% of fee schedule,430.08,90,,,percent of total billed charges,90% of total billed charges,195.7,100,,,fee schedule,Pays 100% Medicare OPPS,195.7,100,,,fee schedule,Pays 100% Medicare OPPS,195.7,100,,,fee schedule,Pays 100% Medicare OPPS,195.7,100,,,fee schedule,Pays 100% Medicare OPPS,392.36,100,,,fee schedule,100% of fee schedule,195.7,100,,,fee schedule,100% of fee schedule,195.7,430.08,
Gastric Intubations-PRO,5167,CDM,981,RC,43752,HCPCS,outpatient,,,186.31,139.73,,53.57,130,,,fee schedule,130% of fee schedule,53.57,130,,,fee schedule,130% of fee schedule,40.24,100,,,fee schedule,Pays 100% Medicare OPPS,40.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.71,119,,,fee schedule,119% of fee schedule,40.24,100,,,fee schedule,Pays 100% Medicare OPPS,40.24,100,,,fee schedule,100% of fee schedule,167.68,90,,,percent of total billed charges,90% of total billed charges,40.24,100,,,fee schedule,Pays 100% Medicare OPPS,40.24,100,,,fee schedule,Pays 100% Medicare OPPS,40.24,100,,,fee schedule,Pays 100% Medicare OPPS,40.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,40.24,100,,,fee schedule,100% of fee schedule,40.24,167.68,
Gastric Lavage-PRO,5168,CDM,981,RC,43753,HCPCS,outpatient,,,424.18,318.14,,27,130,,,fee schedule,130% of fee schedule,27,130,,,fee schedule,130% of fee schedule,21.4,100,,,fee schedule,Pays 100% Medicare OPPS,21.4,100,,,fee schedule,Pays 100% Medicare OPPS,27.7,119,,,fee schedule,119% of fee schedule,21.4,100,,,fee schedule,Pays 100% Medicare OPPS,21.4,100,,,fee schedule,100% of fee schedule,381.76,90,,,percent of total billed charges,90% of total billed charges,21.4,100,,,fee schedule,Pays 100% Medicare OPPS,21.4,100,,,fee schedule,Pays 100% Medicare OPPS,21.4,100,,,fee schedule,Pays 100% Medicare OPPS,21.4,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,21.4,100,,,fee schedule,100% of fee schedule,21.4,381.76,
Change gastrostomy tube-PRO,5169,CDM,981,RC,43762,HCPCS,outpatient,,,1162.19,871.64,,929.75,80,,,percent of total billed charges,90% of total billed charges,929.75,80,,,percent of total billed charges,93% of total billed charges,36.61,100,,,fee schedule,Pays 100% Medicare OPPS,36.61,100,,,fee schedule,Pays 100% Medicare OPPS,47.08,119,,,fee schedule,119% of fee schedule,36.61,100,,,fee schedule,Pays 100% Medicare OPPS,36.61,100,,,fee schedule,100% of fee schedule,1045.97,90,,,percent of total billed charges,90% of total billed charges,36.61,100,,,fee schedule,Pays 100% Medicare OPPS,36.61,100,,,fee schedule,Pays 100% Medicare OPPS,36.61,100,,,fee schedule,Pays 100% Medicare OPPS,36.61,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,36.61,100,,,fee schedule,100% of fee schedule,36.61,1045.97,
OR Sigmoidoscopy w biopsy PRO,5170,CDM,975,RC,45331,HCPCS,outpatient,,,165.61,124.21,,100.87,130,,,fee schedule,130% of fee schedule,100.87,130,,,fee schedule,130% of fee schedule,72.49,100,,,fee schedule,Pays 100% Medicare OPPS,72.49,100,,,fee schedule,Pays 100% Medicare OPPS,89.05,119,,,fee schedule,119% of fee schedule,72.49,100,,,fee schedule,Pays 100% Medicare OPPS,72.49,100,,,fee schedule,100% of fee schedule,149.05,90,,,percent of total billed charges,90% of total billed charges,72.49,100,,,fee schedule,Pays 100% Medicare OPPS,72.49,100,,,fee schedule,Pays 100% Medicare OPPS,72.49,100,,,fee schedule,Pays 100% Medicare OPPS,72.49,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,72.49,100,,,fee schedule,100% of fee schedule,72.49,149.05,
OR PRO Colonoscopy-Diagnostic,5171,CDM,975,RC,45378,HCPCS,outpatient,,,355.05,266.29,,289.68,130,,,fee schedule,130% of fee schedule,289.68,130,,,fee schedule,130% of fee schedule,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,230.47,119,,,fee schedule,119% of fee schedule,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,100% of fee schedule,319.55,90,,,percent of total billed charges,90% of total billed charges,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,467.09,100,,,fee schedule,100% of fee schedule,184.27,100,,,fee schedule,100% of fee schedule,184.27,467.09,
OR PRO Colonoscopy w biopsy,5172,CDM,975,RC,45380,HCPCS,outpatient,,,1183.5,887.63,,346.55,130,,,fee schedule,130% of fee schedule,346.55,130,,,fee schedule,130% of fee schedule,200.37,100,,,fee schedule,Pays 100% Medicare OPPS,200.37,100,,,fee schedule,Pays 100% Medicare OPPS,249.57,119,,,fee schedule,119% of fee schedule,200.37,100,,,fee schedule,Pays 100% Medicare OPPS,200.37,100,,,fee schedule,100% of fee schedule,1065.15,90,,,percent of total billed charges,90% of total billed charges,200.37,100,,,fee schedule,Pays 100% Medicare OPPS,200.37,100,,,fee schedule,Pays 100% Medicare OPPS,200.37,100,,,fee schedule,Pays 100% Medicare OPPS,200.37,100,,,fee schedule,Pays 100% Medicare OPPS,488.65,100,,,fee schedule,100% of fee schedule,200.37,100,,,fee schedule,100% of fee schedule,200.37,1065.15,
OR PRO Colonoscopy biopsy hot for/cautery,5173,CDM,975,RC,45384,HCPCS,outpatient,,,710.08,532.56,,362.26,130,,,fee schedule,130% of fee schedule,362.26,130,,,fee schedule,130% of fee schedule,226.77,100,,,fee schedule,Pays 100% Medicare OPPS,226.77,100,,,fee schedule,Pays 100% Medicare OPPS,283.95,119,,,fee schedule,119% of fee schedule,226.77,100,,,fee schedule,Pays 100% Medicare OPPS,226.77,100,,,fee schedule,100% of fee schedule,639.07,90,,,percent of total billed charges,90% of total billed charges,226.77,100,,,fee schedule,Pays 100% Medicare OPPS,226.77,100,,,fee schedule,Pays 100% Medicare OPPS,226.77,100,,,fee schedule,Pays 100% Medicare OPPS,226.77,100,,,fee schedule,Pays 100% Medicare OPPS,531.76,100,,,fee schedule,100% of fee schedule,226.77,100,,,fee schedule,100% of fee schedule,226.77,639.07,
OR PRO Colonoscopy biopsy snare,5174,CDM,975,RC,45385,HCPCS,outpatient,,,781.58,586.19,,411.16,130,,,fee schedule,130% of fee schedule,411.16,130,,,fee schedule,130% of fee schedule,253.39,100,,,fee schedule,Pays 100% Medicare OPPS,253.39,100,,,fee schedule,Pays 100% Medicare OPPS,316.73,119,,,fee schedule,119% of fee schedule,253.39,100,,,fee schedule,Pays 100% Medicare OPPS,253.39,100,,,fee schedule,100% of fee schedule,703.42,90,,,percent of total billed charges,90% of total billed charges,253.39,100,,,fee schedule,Pays 100% Medicare OPPS,253.39,100,,,fee schedule,Pays 100% Medicare OPPS,253.39,100,,,fee schedule,Pays 100% Medicare OPPS,253.39,100,,,fee schedule,Pays 100% Medicare OPPS,531.76,100,,,fee schedule,100% of fee schedule,253.39,100,,,fee schedule,100% of fee schedule,253.39,703.42,
I&D - Perirectal - PRO,5175,CDM,981,RC,46040,HCPCS,outpatient,,,1268.06,951.05,,539.68,130,,,fee schedule,130% of fee schedule,539.68,130,,,fee schedule,130% of fee schedule,436.85,100,,,fee schedule,Pays 100% Medicare OPPS,436.85,100,,,fee schedule,Pays 100% Medicare OPPS,525.63,119,,,fee schedule,119% of fee schedule,436.85,100,,,fee schedule,Pays 100% Medicare OPPS,436.85,100,,,fee schedule,100% of fee schedule,1141.25,90,,,percent of total billed charges,90% of total billed charges,436.85,100,,,fee schedule,Pays 100% Medicare OPPS,436.85,100,,,fee schedule,Pays 100% Medicare OPPS,436.85,100,,,fee schedule,Pays 100% Medicare OPPS,436.85,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,436.85,100,,,fee schedule,100% of fee schedule,172.46,1141.25,
I&D perianal abscess superficial-PRO,5176,CDM,981,RC,46050,HCPCS,outpatient,,,378.48,283.86,,127.78,130,,,fee schedule,130% of fee schedule,127.78,130,,,fee schedule,130% of fee schedule,104.13,100,,,fee schedule,Pays 100% Medicare OPPS,104.13,100,,,fee schedule,Pays 100% Medicare OPPS,123.3,119,,,fee schedule,119% of fee schedule,104.13,100,,,fee schedule,Pays 100% Medicare OPPS,104.13,100,,,fee schedule,100% of fee schedule,340.63,90,,,percent of total billed charges,90% of total billed charges,104.13,100,,,fee schedule,Pays 100% Medicare OPPS,104.13,100,,,fee schedule,Pays 100% Medicare OPPS,104.13,100,,,fee schedule,Pays 100% Medicare OPPS,104.13,100,,,fee schedule,Pays 100% Medicare OPPS,34.49,100,,,fee schedule,100% of fee schedule,104.13,100,,,fee schedule,100% of fee schedule,34.49,340.63,
Surg Incision:Anus;Thrombosed Hem. Ext.,5177,CDM,521,RC,46083,HCPCS,outpatient,,,376.14,282.11,,338.53,90,,,percent of total billed charges,90% of total billed charges,349.81,93,,,percent of total billed charges,93% of total billed charges,142.93,38,,,percent of total billed charges,38% of total billed charges,142.93,38,,,percent of total billed charges,38% of total billed charges,319.72,85,,,percent of total billed charges,85% of total billed charges,142.93,38,,,percent of total billed charges,38% of total billed charges,306.18,81.4,,,percent of total billed charges,81.4% of total billed charges,338.53,90,,,percent of total billed charges,90% of total billed charges,338.53,90,,,percent of total billed charges,90% of total billed charges,142.93,38,,,percent of total billed charges,38% of total billed charges,142.93,38,,,percent of total billed charges,38% of total billed charges,142.93,38,,,percent of total billed charges,38% of total billed charges,282.11,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,142.93,349.81,
Anoscopy - PRO,5178,CDM,981,RC,46600,HCPCS,outpatient,,,209.47,157.1,,53.5,130,,,fee schedule,130% of fee schedule,53.5,130,,,fee schedule,130% of fee schedule,42.06,100,,,fee schedule,Pays 100% Medicare OPPS,42.06,100,,,fee schedule,Pays 100% Medicare OPPS,50.62,119,,,fee schedule,119% of fee schedule,42.06,100,,,fee schedule,Pays 100% Medicare OPPS,42.06,100,,,fee schedule,100% of fee schedule,188.52,90,,,percent of total billed charges,90% of total billed charges,42.06,100,,,fee schedule,Pays 100% Medicare OPPS,42.06,100,,,fee schedule,Pays 100% Medicare OPPS,42.06,100,,,fee schedule,Pays 100% Medicare OPPS,42.06,100,,,fee schedule,Pays 100% Medicare OPPS,23,100,,,fee schedule,100% of fee schedule,42.06,100,,,fee schedule,100% of fee schedule,23,188.52,
Anoscopy - w/FBR - PRO,5179,CDM,981,RC,46608,HCPCS,outpatient,,,564.2,423.15,,106.25,130,,,fee schedule,130% of fee schedule,106.25,130,,,fee schedule,130% of fee schedule,84.76,100,,,fee schedule,Pays 100% Medicare OPPS,84.76,100,,,fee schedule,Pays 100% Medicare OPPS,104.64,119,,,fee schedule,119% of fee schedule,84.76,100,,,fee schedule,Pays 100% Medicare OPPS,84.76,100,,,fee schedule,100% of fee schedule,507.78,90,,,percent of total billed charges,90% of total billed charges,84.76,100,,,fee schedule,Pays 100% Medicare OPPS,84.76,100,,,fee schedule,Pays 100% Medicare OPPS,84.76,100,,,fee schedule,Pays 100% Medicare OPPS,84.76,100,,,fee schedule,Pays 100% Medicare OPPS,73.3,100,,,fee schedule,100% of fee schedule,84.76,100,,,fee schedule,100% of fee schedule,73.3,507.78,
AND Physical (DSS),5180,CDM,521,RC,46651,HCPCS,outpatient,,,42.17,31.63,,37.95,90,,,percent of total billed charges,90% of total billed charges,39.22,93,,,percent of total billed charges,93% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,35.84,85,,,percent of total billed charges,85% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,34.33,81.4,,,percent of total billed charges,81.4% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,31.63,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,16.02,39.22,
AND Physical (DSS),5181,CDM,521,RC,46651,HCPCS,outpatient,,,42.17,31.63,,37.95,90,,,percent of total billed charges,90% of total billed charges,39.22,93,,,percent of total billed charges,93% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,35.84,85,,,percent of total billed charges,85% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,34.33,81.4,,,percent of total billed charges,81.4% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,31.63,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,16.02,39.22,
Abd Paracentesis PRO w/o image guidance,5182,CDM,981,RC,49082,HCPCS,outpatient,,,178.11,133.58,,142.49,80,,,percent of total billed charges,90% of total billed charges,142.49,80,,,percent of total billed charges,93% of total billed charges,73.33,100,,,fee schedule,Pays 100% Medicare OPPS,73.33,100,,,fee schedule,Pays 100% Medicare OPPS,92.19,119,,,fee schedule,119% of fee schedule,73.33,100,,,fee schedule,Pays 100% Medicare OPPS,73.33,100,,,fee schedule,100% of fee schedule,160.3,90,,,percent of total billed charges,90% of total billed charges,73.33,100,,,fee schedule,Pays 100% Medicare OPPS,73.33,100,,,fee schedule,Pays 100% Medicare OPPS,73.33,100,,,fee schedule,Pays 100% Medicare OPPS,73.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,73.33,100,,,fee schedule,100% of fee schedule,73.33,160.3,
Peritoneal lavage - PRO,5183,CDM,981,RC,49084,HCPCS,outpatient,,,256.76,192.57,,205.41,80,,,percent of total billed charges,90% of total billed charges,205.41,80,,,percent of total billed charges,93% of total billed charges,106.32,100,,,fee schedule,Pays 100% Medicare OPPS,106.32,100,,,fee schedule,Pays 100% Medicare OPPS,134.98,119,,,fee schedule,119% of fee schedule,106.32,100,,,fee schedule,Pays 100% Medicare OPPS,106.32,100,,,fee schedule,100% of fee schedule,231.08,90,,,percent of total billed charges,90% of total billed charges,106.32,100,,,fee schedule,Pays 100% Medicare OPPS,106.32,100,,,fee schedule,Pays 100% Medicare OPPS,106.32,100,,,fee schedule,Pays 100% Medicare OPPS,106.32,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,106.32,100,,,fee schedule,100% of fee schedule,106.32,231.08,
aspiration of bladder by needle-pro,5184,CDM,981,RC,51100,HCPCS,outpatient,,,137.85,103.39,,51.79,130,,,fee schedule,130% of fee schedule,51.79,130,,,fee schedule,130% of fee schedule,38.87,100,,,fee schedule,Pays 100% Medicare OPPS,38.87,100,,,fee schedule,Pays 100% Medicare OPPS,48.08,119,,,fee schedule,119% of fee schedule,38.87,100,,,fee schedule,Pays 100% Medicare OPPS,38.87,100,,,fee schedule,100% of fee schedule,124.07,90,,,percent of total billed charges,90% of total billed charges,38.87,100,,,fee schedule,Pays 100% Medicare OPPS,38.87,100,,,fee schedule,Pays 100% Medicare OPPS,38.87,100,,,fee schedule,Pays 100% Medicare OPPS,38.87,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.87,100,,,fee schedule,100% of fee schedule,38.87,124.07,
Clinic Bladder scan for residual,5185,CDM,521,RC,51798,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,62.93,154.02,
Urethral Dilation:Female;Suppository/Instillaion;initial,5186,CDM,521,RC,53660,HCPCS,outpatient,,,194.51,145.88,,175.06,90,,,percent of total billed charges,90% of total billed charges,180.89,93,,,percent of total billed charges,93% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,165.33,85,,,percent of total billed charges,85% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,158.33,81.4,,,percent of total billed charges,81.4% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,145.88,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,73.91,180.89,
Lysis fo Preputial Adhesions pro,5187,CDM,981,RC,54450,HCPCS,outpatient,,,492.12,369.09,,74.91,130,,,fee schedule,130% of fee schedule,74.91,130,,,fee schedule,130% of fee schedule,56.86,100,,,fee schedule,Pays 100% Medicare OPPS,56.86,100,,,fee schedule,Pays 100% Medicare OPPS,71.34,119,,,fee schedule,119% of fee schedule,56.86,100,,,fee schedule,Pays 100% Medicare OPPS,56.86,100,,,fee schedule,100% of fee schedule,442.91,90,,,percent of total billed charges,90% of total billed charges,56.86,100,,,fee schedule,Pays 100% Medicare OPPS,56.86,100,,,fee schedule,Pays 100% Medicare OPPS,56.86,100,,,fee schedule,Pays 100% Medicare OPPS,56.86,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,56.86,100,,,fee schedule,100% of fee schedule,35.93,442.91,
"I&D epididymis, testis and/or scrotal space (abscess/hematoma)-PRO",5188,CDM,981,RC,54700,HCPCS,outpatient,,,502.69,377.02,,277.9,130,,,fee schedule,130% of fee schedule,277.9,130,,,fee schedule,130% of fee schedule,215.1,100,,,fee schedule,Pays 100% Medicare OPPS,215.1,100,,,fee schedule,Pays 100% Medicare OPPS,266.67,119,,,fee schedule,119% of fee schedule,215.1,100,,,fee schedule,Pays 100% Medicare OPPS,215.1,100,,,fee schedule,100% of fee schedule,452.42,90,,,percent of total billed charges,90% of total billed charges,215.1,100,,,fee schedule,Pays 100% Medicare OPPS,215.1,100,,,fee schedule,Pays 100% Medicare OPPS,215.1,100,,,fee schedule,Pays 100% Medicare OPPS,215.1,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,215.1,100,,,fee schedule,100% of fee schedule,100.6,452.42,
I&D - Scrotal Wall Abcess - PRO,5189,CDM,981,RC,55100,HCPCS,outpatient,,,510.15,382.61,,216.48,130,,,fee schedule,130% of fee schedule,216.48,130,,,fee schedule,130% of fee schedule,170.45,100,,,fee schedule,Pays 100% Medicare OPPS,170.45,100,,,fee schedule,Pays 100% Medicare OPPS,207.55,119,,,fee schedule,119% of fee schedule,170.45,100,,,fee schedule,Pays 100% Medicare OPPS,170.45,100,,,fee schedule,100% of fee schedule,459.14,90,,,percent of total billed charges,90% of total billed charges,170.45,100,,,fee schedule,Pays 100% Medicare OPPS,170.45,100,,,fee schedule,Pays 100% Medicare OPPS,170.45,100,,,fee schedule,Pays 100% Medicare OPPS,170.45,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,170.45,100,,,fee schedule,100% of fee schedule,28.74,459.14,
I&D Vulva/Perineal Abscess-PRO,5190,CDM,981,RC,56405,HCPCS,outpatient,,,248.42,186.32,,143.27,130,,,fee schedule,130% of fee schedule,143.27,130,,,fee schedule,130% of fee schedule,131.86,100,,,fee schedule,Pays 100% Medicare OPPS,131.86,100,,,fee schedule,Pays 100% Medicare OPPS,148.62,119,,,fee schedule,119% of fee schedule,131.86,100,,,fee schedule,Pays 100% Medicare OPPS,131.86,100,,,fee schedule,100% of fee schedule,223.58,90,,,percent of total billed charges,90% of total billed charges,131.86,100,,,fee schedule,Pays 100% Medicare OPPS,131.86,100,,,fee schedule,Pays 100% Medicare OPPS,131.86,100,,,fee schedule,Pays 100% Medicare OPPS,131.86,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,131.86,100,,,fee schedule,100% of fee schedule,131.86,223.58,
I&D Bartholin gland abcess-PRO,5191,CDM,981,RC,56420,HCPCS,outpatient,,,322.23,241.67,,121.1,130,,,fee schedule,130% of fee schedule,121.1,130,,,fee schedule,130% of fee schedule,114.85,100,,,fee schedule,Pays 100% Medicare OPPS,114.85,100,,,fee schedule,Pays 100% Medicare OPPS,128.34,119,,,fee schedule,119% of fee schedule,114.85,100,,,fee schedule,Pays 100% Medicare OPPS,114.85,100,,,fee schedule,100% of fee schedule,290.01,90,,,percent of total billed charges,90% of total billed charges,114.85,100,,,fee schedule,Pays 100% Medicare OPPS,114.85,100,,,fee schedule,Pays 100% Medicare OPPS,114.85,100,,,fee schedule,Pays 100% Medicare OPPS,114.85,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,114.85,100,,,fee schedule,100% of fee schedule,57.49,290.01,
Vulvar/Perineal; Biopsy: 1 lesion,5192,CDM,521,RC,56605,HCPCS,outpatient,,,141.79,106.34,,127.61,90,,,percent of total billed charges,90% of total billed charges,131.86,93,,,percent of total billed charges,93% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,115.42,81.4,,,percent of total billed charges,81.4% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,106.34,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,53.88,131.86,
Excis Procedure: Vagina; Mucosa;Simple,5193,CDM,521,RC,57100,HCPCS,outpatient,,,153.5,115.13,,138.15,90,,,percent of total billed charges,90% of total billed charges,142.76,93,,,percent of total billed charges,93% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,130.48,85,,,percent of total billed charges,85% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,124.95,81.4,,,percent of total billed charges,81.4% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,138.15,90,,,percent of total billed charges,90% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,58.33,38,,,percent of total billed charges,38% of total billed charges,115.13,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,58.33,142.76,
Irrag./Ins./Intro.:Vag Med./Supply:Insert Pessary,5194,CDM,521,RC,57160,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.34,162.37,
Irrag./Ins./Intro:Vag Med./Supply:Insert Pessary-PRO,5195,CDM,981,RC,57160,HCPCS,outpatient,,,106.63,79.97,,63.61,130,,,fee schedule,130% of fee schedule,63.61,130,,,fee schedule,130% of fee schedule,46.18,100,,,fee schedule,Pays 100% Medicare OPPS,46.18,100,,,fee schedule,Pays 100% Medicare OPPS,57.91,119,,,fee schedule,119% of fee schedule,46.18,100,,,fee schedule,Pays 100% Medicare OPPS,46.18,100,,,fee schedule,100% of fee schedule,95.97,90,,,percent of total billed charges,90% of total billed charges,46.18,100,,,fee schedule,Pays 100% Medicare OPPS,46.18,100,,,fee schedule,Pays 100% Medicare OPPS,46.18,100,,,fee schedule,Pays 100% Medicare OPPS,46.18,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,46.18,100,,,fee schedule,100% of fee schedule,21.56,95.97,
Diaphragm Fitting,5196,CDM,521,RC,57170,HCPCS,outpatient,,,178.11,133.58,,160.3,90,,,percent of total billed charges,90% of total billed charges,165.64,93,,,percent of total billed charges,93% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,144.98,81.4,,,percent of total billed charges,81.4% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,133.58,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,67.68,165.64,
"Endo. Vag Procedures:Colposcopy,Entire;W/ Cervix",5197,CDM,521,RC,57420,HCPCS,outpatient,,,212.1,159.08,,190.89,90,,,percent of total billed charges,90% of total billed charges,197.25,93,,,percent of total billed charges,93% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,172.65,81.4,,,percent of total billed charges,81.4% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,159.08,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,80.6,197.25,
Endo. Cervical Procedures:Cervix&Upper/Adj. Vagina,5198,CDM,521,RC,57452,HCPCS,outpatient,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,82.38,201.61,
Endo. Cervical Procedures:Cervix&Upper/Adj. Vagina W/ Biopsy,5199,CDM,521,RC,57454,HCPCS,outpatient,,,322.23,241.67,,290.01,90,,,percent of total billed charges,90% of total billed charges,299.67,93,,,percent of total billed charges,93% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,273.9,85,,,percent of total billed charges,85% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,262.3,81.4,,,percent of total billed charges,81.4% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,241.67,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,122.45,299.67,
Endo. Cervical Procedures:Cervix&Upper/Adj. Vagina W/ cervix Biopsy,5200,CDM,521,RC,57455,HCPCS,outpatient,,,261.29,195.97,,235.16,90,,,percent of total billed charges,90% of total billed charges,243,93,,,percent of total billed charges,93% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,222.1,85,,,percent of total billed charges,85% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,212.69,81.4,,,percent of total billed charges,81.4% of total billed charges,235.16,90,,,percent of total billed charges,90% of total billed charges,235.16,90,,,percent of total billed charges,90% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,99.29,38,,,percent of total billed charges,38% of total billed charges,195.97,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,99.29,243,
Endo. Cervical Procedures:W/ endocervical Curettage,5201,CDM,521,RC,57456,HCPCS,outpatient,,,244.91,183.68,,220.42,90,,,percent of total billed charges,90% of total billed charges,227.77,93,,,percent of total billed charges,93% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,208.17,85,,,percent of total billed charges,85% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,199.36,81.4,,,percent of total billed charges,81.4% of total billed charges,220.42,90,,,percent of total billed charges,90% of total billed charges,220.42,90,,,percent of total billed charges,90% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,93.07,38,,,percent of total billed charges,38% of total billed charges,183.68,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,93.07,227.77,
Irrag./Ins./Intro.:Vag Med./Supply:Insert Pessary-PRO,5202,CDM,981,RC,57610,HCPCS,outpatient,,,106.63,79.97,,85.3,80,,,percent of total billed charges,90% of total billed charges,85.3,80,,,percent of total billed charges,93% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,95.97,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,85.3,95.97,
Irrag./Ins./Intro.:Vag Med./Supply:Insert Pessary-PRO,5203,CDM,981,RC,57610,HCPCS,outpatient,,,106.63,79.97,,85.3,80,,,percent of total billed charges,90% of total billed charges,85.3,80,,,percent of total billed charges,93% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,95.97,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,85.3,95.97,
Procuder of Endo; Samp.W/or W/O Endo. Samp. W/O Dilation,5204,CDM,521,RC,58100,HCPCS,outpatient,,,318.73,239.05,,286.86,90,,,percent of total billed charges,90% of total billed charges,296.42,93,,,percent of total billed charges,93% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,270.92,85,,,percent of total billed charges,85% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,259.45,81.4,,,percent of total billed charges,81.4% of total billed charges,286.86,90,,,percent of total billed charges,90% of total billed charges,286.86,90,,,percent of total billed charges,90% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,239.05,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,121.12,296.42,
Contraceptions/Reproduction:Insertion of IUD,5205,CDM,521,RC,58300,HCPCS,outpatient,,,263.65,197.74,,237.29,90,,,percent of total billed charges,90% of total billed charges,245.19,93,,,percent of total billed charges,93% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,214.61,81.4,,,percent of total billed charges,81.4% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,197.74,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,100.19,245.19,
IUD Removal,5206,CDM,521,RC,58301,HCPCS,outpatient,,,133.59,100.19,,120.23,90,,,percent of total billed charges,90% of total billed charges,124.24,93,,,percent of total billed charges,93% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,113.55,85,,,percent of total billed charges,85% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,108.74,81.4,,,percent of total billed charges,81.4% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,100.19,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,50.76,124.24,
Vaginal delivery only-PRO,5207,CDM,981,RC,59409,HCPCS,outpatient,,,2076.39,1557.29,,981.92,130,,,fee schedule,130% of fee schedule,981.92,130,,,fee schedule,130% of fee schedule,797.78,100,,,fee schedule,Pays 100% Medicare OPPS,797.78,100,,,fee schedule,Pays 100% Medicare OPPS,1003.78,119,,,fee schedule,119% of fee schedule,797.78,100,,,fee schedule,Pays 100% Medicare OPPS,797.78,100,,,fee schedule,100% of fee schedule,1868.75,90,,,percent of total billed charges,90% of total billed charges,797.78,100,,,fee schedule,Pays 100% Medicare OPPS,797.78,100,,,fee schedule,Pays 100% Medicare OPPS,797.78,100,,,fee schedule,Pays 100% Medicare OPPS,797.78,100,,,fee schedule,Pays 100% Medicare OPPS,718.6,100,,,fee schedule,100% of fee schedule,797.78,100,,,fee schedule,100% of fee schedule,718.6,1868.75,
Delivery Placenta-PRO,5208,CDM,981,RC,59414,HCPCS,outpatient,,,617.53,463.15,,110.55,130,,,fee schedule,130% of fee schedule,110.55,130,,,fee schedule,130% of fee schedule,89.94,100,,,fee schedule,Pays 100% Medicare OPPS,89.94,100,,,fee schedule,Pays 100% Medicare OPPS,113.3,119,,,fee schedule,119% of fee schedule,89.94,100,,,fee schedule,Pays 100% Medicare OPPS,89.94,100,,,fee schedule,100% of fee schedule,555.78,90,,,percent of total billed charges,90% of total billed charges,89.94,100,,,fee schedule,Pays 100% Medicare OPPS,89.94,100,,,fee schedule,Pays 100% Medicare OPPS,89.94,100,,,fee schedule,Pays 100% Medicare OPPS,89.94,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,89.94,100,,,fee schedule,100% of fee schedule,89.94,555.78,
Prenatal/Postpartum:Antepartum Care;4-6 visits,5209,CDM,521,RC,59425,HCPCS,outpatient,,,617.53,463.15,,555.78,90,,,percent of total billed charges,90% of total billed charges,574.3,93,,,percent of total billed charges,93% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,524.9,85,,,percent of total billed charges,85% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,502.67,81.4,,,percent of total billed charges,81.4% of total billed charges,555.78,90,,,percent of total billed charges,90% of total billed charges,555.78,90,,,percent of total billed charges,90% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,234.66,38,,,percent of total billed charges,38% of total billed charges,463.15,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,234.66,574.3,
Prenatal/Postpartum:Antepartum Care; 7> visits,5210,CDM,521,RC,59426,HCPCS,outpatient,,,1838.51,1378.88,,1654.66,90,,,percent of total billed charges,90% of total billed charges,1709.81,93,,,percent of total billed charges,93% of total billed charges,698.63,38,,,percent of total billed charges,38% of total billed charges,698.63,38,,,percent of total billed charges,38% of total billed charges,1562.73,85,,,percent of total billed charges,85% of total billed charges,698.63,38,,,percent of total billed charges,38% of total billed charges,1496.55,81.4,,,percent of total billed charges,81.4% of total billed charges,1654.66,90,,,percent of total billed charges,90% of total billed charges,1654.66,90,,,percent of total billed charges,90% of total billed charges,698.63,38,,,percent of total billed charges,38% of total billed charges,698.63,38,,,percent of total billed charges,38% of total billed charges,698.63,38,,,percent of total billed charges,38% of total billed charges,1378.88,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,698.63,1709.81,
Incomplete Abortion-PRO,5211,CDM,981,RC,59812,HCPCS,outpatient,,,908.14,681.11,,393.9,130,,,fee schedule,130% of fee schedule,393.9,130,,,fee schedule,130% of fee schedule,311.92,100,,,fee schedule,Pays 100% Medicare OPPS,311.92,100,,,fee schedule,Pays 100% Medicare OPPS,376.96,119,,,fee schedule,119% of fee schedule,311.92,100,,,fee schedule,Pays 100% Medicare OPPS,311.92,100,,,fee schedule,100% of fee schedule,817.33,90,,,percent of total billed charges,90% of total billed charges,311.92,100,,,fee schedule,Pays 100% Medicare OPPS,311.92,100,,,fee schedule,Pays 100% Medicare OPPS,311.92,100,,,fee schedule,Pays 100% Medicare OPPS,311.92,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,311.92,100,,,fee schedule,100% of fee schedule,287.44,817.33,
"Spine Punct./Sub.-Space;Spine Punct., Lumbar, Diagnostic",5212,CDM,521,RC,62270,HCPCS,outpatient,,,377.3,282.98,,339.57,90,,,percent of total billed charges,90% of total billed charges,350.89,93,,,percent of total billed charges,93% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,307.12,81.4,,,percent of total billed charges,81.4% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,282.98,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,143.37,350.89,
Lumbar Puncture-G,5213,CDM,982,RC,62270,HCPCS,outpatient,,,787.43,590.57,,102.09,130,,,fee schedule,130% of fee schedule,102.09,130,,,fee schedule,130% of fee schedule,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,76.8,119,,,fee schedule,119% of fee schedule,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,100% of fee schedule,708.69,90,,,percent of total billed charges,90% of total billed charges,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,62.34,100,,,fee schedule,100% of fee schedule,62.34,708.69,
"Spine Punct./Sub.-Space;Spine Punct., Lumbar, Diagnostic-PRO",5214,CDM,981,RC,62270,HCPCS,outpatient,,,372.63,279.47,,102.09,130,,,fee schedule,130% of fee schedule,102.09,130,,,fee schedule,130% of fee schedule,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,76.8,119,,,fee schedule,119% of fee schedule,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,100% of fee schedule,335.37,90,,,percent of total billed charges,90% of total billed charges,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,62.34,100,,,fee schedule,100% of fee schedule,62.34,335.37,
"Spine Punct./Sub.-Space;Spine Punct., Lumbar, Diagnostic-PRO",5215,CDM,981,RC,62270,HCPCS,outpatient,,,372.63,279.47,,102.09,130,,,fee schedule,130% of fee schedule,102.09,130,,,fee schedule,130% of fee schedule,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,76.8,119,,,fee schedule,119% of fee schedule,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,100% of fee schedule,335.37,90,,,percent of total billed charges,90% of total billed charges,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,62.34,100,,,fee schedule,100% of fee schedule,62.34,335.37,
Occipital (greater) Block [Package],5216,CDM,521,RC,64405,HCPCS,outpatient,,,737.63,553.22,,663.87,90,,,percent of total billed charges,90% of total billed charges,686,93,,,percent of total billed charges,93% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,626.99,85,,,percent of total billed charges,85% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,600.43,81.4,,,percent of total billed charges,81.4% of total billed charges,663.87,90,,,percent of total billed charges,90% of total billed charges,663.87,90,,,percent of total billed charges,90% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,553.22,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,280.3,686,
Occipital (greater) Block [Package],5217,CDM,521,RC,64405,HCPCS,outpatient,,,737.63,553.22,,663.87,90,,,percent of total billed charges,90% of total billed charges,686,93,,,percent of total billed charges,93% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,626.99,85,,,percent of total billed charges,85% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,600.43,81.4,,,percent of total billed charges,81.4% of total billed charges,663.87,90,,,percent of total billed charges,90% of total billed charges,663.87,90,,,percent of total billed charges,90% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,280.3,38,,,percent of total billed charges,38% of total billed charges,553.22,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,280.3,686,
PM N BLOCK INJ OCCIPITAL PRO,5218,CDM,988,RC,64405,HCPCS,outpatient,,,454.62,340.97,,109.76,130,,,fee schedule,130% of fee schedule,109.76,130,,,fee schedule,130% of fee schedule,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.27,119,,,fee schedule,119% of fee schedule,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,100% of fee schedule,409.16,90,,,percent of total billed charges,90% of total billed charges,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,52.54,100,,,fee schedule,100% of fee schedule,52.54,409.16,
Occipital (greater) BLock-Pro,5219,CDM,981,RC,64405,HCPCS,outpatient,,,202.71,152.03,,109.76,130,,,fee schedule,130% of fee schedule,109.76,130,,,fee schedule,130% of fee schedule,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.27,119,,,fee schedule,119% of fee schedule,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,100% of fee schedule,182.44,90,,,percent of total billed charges,90% of total billed charges,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,52.54,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,52.54,100,,,fee schedule,100% of fee schedule,52.54,182.44,
PM N BLOCK INJ INTERCOST SNG PRO,5220,CDM,988,RC,64420,HCPCS,outpatient,,,865.95,649.46,,91.59,130,,,fee schedule,130% of fee schedule,91.59,130,,,fee schedule,130% of fee schedule,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,74.16,119,,,fee schedule,119% of fee schedule,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,100% of fee schedule,779.36,90,,,percent of total billed charges,90% of total billed charges,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,59.05,100,,,fee schedule,100% of fee schedule,59.05,779.36,
N block-Intercostal single-PRO,5221,CDM,981,RC,64420,HCPCS,outpatient,,,141.89,106.42,,91.59,130,,,fee schedule,130% of fee schedule,91.59,130,,,fee schedule,130% of fee schedule,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,74.16,119,,,fee schedule,119% of fee schedule,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,100% of fee schedule,127.7,90,,,percent of total billed charges,90% of total billed charges,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,59.05,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,59.05,100,,,fee schedule,100% of fee schedule,59.05,127.7,
PM N BLOCK INJ INTERCOST MLT PRO,5222,CDM,988,RC,64421,HCPCS,outpatient,,,947.13,710.35,,126,130,,,fee schedule,130% of fee schedule,126,130,,,fee schedule,130% of fee schedule,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,31.39,119,,,fee schedule,119% of fee schedule,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,100% of fee schedule,852.42,90,,,percent of total billed charges,90% of total billed charges,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,24.51,100,,,fee schedule,100% of fee schedule,24.51,852.42,
N block-Intercostal mult regional-pro,5223,CDM,981,RC,64421,HCPCS,outpatient,,,202.71,152.03,,126,130,,,fee schedule,130% of fee schedule,126,130,,,fee schedule,130% of fee schedule,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,31.39,119,,,fee schedule,119% of fee schedule,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,100% of fee schedule,182.44,90,,,percent of total billed charges,90% of total billed charges,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,24.51,100,,,fee schedule,100% of fee schedule,24.51,182.44,
Femoral nerve block,5224,CDM,975,RC,64447,HCPCS,outpatient,,,208.08,156.06,,87.07,130,,,fee schedule,130% of fee schedule,87.07,130,,,fee schedule,130% of fee schedule,63.19,100,,,fee schedule,Pays 100% Medicare OPPS,63.19,100,,,fee schedule,Pays 100% Medicare OPPS,65.82,119,,,fee schedule,119% of fee schedule,63.19,100,,,fee schedule,Pays 100% Medicare OPPS,63.19,100,,,fee schedule,100% of fee schedule,187.27,90,,,percent of total billed charges,90% of total billed charges,63.19,100,,,fee schedule,Pays 100% Medicare OPPS,63.19,100,,,fee schedule,Pays 100% Medicare OPPS,63.19,100,,,fee schedule,Pays 100% Medicare OPPS,63.19,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,63.19,100,,,fee schedule,100% of fee schedule,63.19,187.27,
WND Digital nerve block-G,5225,CDM,982,RC,64450,HCPCS,outpatient,,,1048.88,786.66,,91.05,130,,,fee schedule,130% of fee schedule,91.05,130,,,fee schedule,130% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,53,119,,,fee schedule,119% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,100% of fee schedule,943.99,90,,,percent of total billed charges,90% of total billed charges,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,42.29,100,,,fee schedule,100% of fee schedule,35.93,943.99,
Injection Morton's Neuroma anes PRO,5226,CDM,982,RC,64450,HCPCS,outpatient,,,486.91,365.18,,91.05,130,,,fee schedule,130% of fee schedule,91.05,130,,,fee schedule,130% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,53,119,,,fee schedule,119% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,100% of fee schedule,438.22,90,,,percent of total billed charges,90% of total billed charges,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,42.29,100,,,fee schedule,100% of fee schedule,35.93,438.22,
PM OTHER PERIPHERAL NERVE BLOCK PRO,5227,CDM,988,RC,64450,HCPCS,outpatient,,,487.09,365.32,,91.05,130,,,fee schedule,130% of fee schedule,91.05,130,,,fee schedule,130% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,53,119,,,fee schedule,119% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,100% of fee schedule,438.38,90,,,percent of total billed charges,90% of total billed charges,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,42.29,100,,,fee schedule,100% of fee schedule,35.93,438.38,
Digital Nerve Block - Other Periph.-PRO,5228,CDM,981,RC,64450,HCPCS,outpatient,,,186.94,140.21,,91.05,130,,,fee schedule,130% of fee schedule,91.05,130,,,fee schedule,130% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,53,119,,,fee schedule,119% of fee schedule,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,100% of fee schedule,168.25,90,,,percent of total billed charges,90% of total billed charges,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,42.29,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,42.29,100,,,fee schedule,100% of fee schedule,35.93,168.25,
OR PRO ulnar nerve transposition-elbow,5229,CDM,975,RC,64718,HCPCS,outpatient,,,1263.56,947.67,,784.54,130,,,fee schedule,130% of fee schedule,784.54,130,,,fee schedule,130% of fee schedule,624.08,100,,,fee schedule,Pays 100% Medicare OPPS,624.08,100,,,fee schedule,Pays 100% Medicare OPPS,742.3,119,,,fee schedule,119% of fee schedule,624.08,100,,,fee schedule,Pays 100% Medicare OPPS,624.08,100,,,fee schedule,100% of fee schedule,1137.2,90,,,percent of total billed charges,90% of total billed charges,624.08,100,,,fee schedule,Pays 100% Medicare OPPS,624.08,100,,,fee schedule,Pays 100% Medicare OPPS,624.08,100,,,fee schedule,Pays 100% Medicare OPPS,624.08,100,,,fee schedule,Pays 100% Medicare OPPS,862.32,100,,,fee schedule,100% of fee schedule,624.08,100,,,fee schedule,100% of fee schedule,624.08,1137.2,
OR CARPAL TUNNEL med rpr-PRO,5230,CDM,975,RC,64721,HCPCS,outpatient,,,1067.49,800.62,,561.65,130,,,fee schedule,130% of fee schedule,561.65,130,,,fee schedule,130% of fee schedule,453.78,100,,,fee schedule,Pays 100% Medicare OPPS,453.78,100,,,fee schedule,Pays 100% Medicare OPPS,536.45,119,,,fee schedule,119% of fee schedule,453.78,100,,,fee schedule,Pays 100% Medicare OPPS,453.78,100,,,fee schedule,100% of fee schedule,960.74,90,,,percent of total billed charges,90% of total billed charges,453.78,100,,,fee schedule,Pays 100% Medicare OPPS,453.78,100,,,fee schedule,Pays 100% Medicare OPPS,453.78,100,,,fee schedule,Pays 100% Medicare OPPS,453.78,100,,,fee schedule,Pays 100% Medicare OPPS,574.88,100,,,fee schedule,100% of fee schedule,453.78,100,,,fee schedule,100% of fee schedule,453.78,960.74,
OR PRO DECOMPRESS NERVE,5231,CDM,975,RC,64722,HCPCS,outpatient,,,1201.07,900.8,,465.48,130,,,fee schedule,130% of fee schedule,465.48,130,,,fee schedule,130% of fee schedule,375.47,100,,,fee schedule,Pays 100% Medicare OPPS,375.47,100,,,fee schedule,Pays 100% Medicare OPPS,447.65,119,,,fee schedule,119% of fee schedule,375.47,100,,,fee schedule,Pays 100% Medicare OPPS,375.47,100,,,fee schedule,100% of fee schedule,1080.96,90,,,percent of total billed charges,90% of total billed charges,375.47,100,,,fee schedule,Pays 100% Medicare OPPS,375.47,100,,,fee schedule,Pays 100% Medicare OPPS,375.47,100,,,fee schedule,Pays 100% Medicare OPPS,375.47,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,375.47,100,,,fee schedule,100% of fee schedule,375.47,1080.96,
FB Removal:Eye;Conjunctival Superficial,5232,CDM,521,RC,65205,HCPCS,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.09,117.69,
FB Removal:Eye;Conjunctival Superficial-PRO,5233,CDM,981,RC,65205,HCPCS,outpatient,,,77.35,58.01,,58.62,130,,,fee schedule,130% of fee schedule,58.62,130,,,fee schedule,130% of fee schedule,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,36.01,119,,,fee schedule,119% of fee schedule,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,100% of fee schedule,69.62,90,,,percent of total billed charges,90% of total billed charges,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,29.5,100,,,fee schedule,100% of fee schedule,28.74,69.62,
FB Removal:Eye;Conjunctival Superficial-PRO,5234,CDM,981,RC,65205,HCPCS,outpatient,,,77.35,58.01,,58.62,130,,,fee schedule,130% of fee schedule,58.62,130,,,fee schedule,130% of fee schedule,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,36.01,119,,,fee schedule,119% of fee schedule,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,100% of fee schedule,69.62,90,,,percent of total billed charges,90% of total billed charges,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,29.5,100,,,fee schedule,100% of fee schedule,28.74,69.62,
"FB Rmv:Eye;Conj Embedded,Sub./Scleral Nonper.",5235,CDM,521,RC,65210,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,45.86,112.24,
"FB Rmv:Eye;Conj Embedded,Sub./Scleral Nonper.-PRO",5236,CDM,981,RC,65210,HCPCS,outpatient,,,73.83,55.37,,72.46,130,,,fee schedule,130% of fee schedule,72.46,130,,,fee schedule,130% of fee schedule,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.1,119,,,fee schedule,119% of fee schedule,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,100% of fee schedule,66.45,90,,,percent of total billed charges,90% of total billed charges,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,36.44,100,,,fee schedule,100% of fee schedule,36.44,72.46,
"FB Rmv:Eye;Conj Embedded,Sub./Scleral Nonper.-PRO",5237,CDM,981,RC,65210,HCPCS,outpatient,,,73.83,55.37,,72.46,130,,,fee schedule,130% of fee schedule,72.46,130,,,fee schedule,130% of fee schedule,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.1,119,,,fee schedule,119% of fee schedule,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,100% of fee schedule,66.45,90,,,percent of total billed charges,90% of total billed charges,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,36.44,100,,,fee schedule,100% of fee schedule,36.44,72.46,
FBR-Corneal w/o slit lamp -PRO,5238,CDM,981,RC,65220,HCPCS,outpatient,,,120.69,90.52,,56.28,130,,,fee schedule,130% of fee schedule,56.28,130,,,fee schedule,130% of fee schedule,41.82,100,,,fee schedule,Pays 100% Medicare OPPS,41.82,100,,,fee schedule,Pays 100% Medicare OPPS,51.29,119,,,fee schedule,119% of fee schedule,41.82,100,,,fee schedule,Pays 100% Medicare OPPS,41.82,100,,,fee schedule,100% of fee schedule,108.62,90,,,percent of total billed charges,90% of total billed charges,41.82,100,,,fee schedule,Pays 100% Medicare OPPS,41.82,100,,,fee schedule,Pays 100% Medicare OPPS,41.82,100,,,fee schedule,Pays 100% Medicare OPPS,41.82,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,41.82,100,,,fee schedule,100% of fee schedule,41.82,108.62,
FBR Eye - Corneal with slit lamp - PRO,5239,CDM,981,RC,65222,HCPCS,outpatient,,,157.66,118.25,,79.07,130,,,fee schedule,130% of fee schedule,79.07,130,,,fee schedule,130% of fee schedule,50.68,100,,,fee schedule,Pays 100% Medicare OPPS,50.68,100,,,fee schedule,Pays 100% Medicare OPPS,63.3,119,,,fee schedule,119% of fee schedule,50.68,100,,,fee schedule,Pays 100% Medicare OPPS,50.68,100,,,fee schedule,100% of fee schedule,141.89,90,,,percent of total billed charges,90% of total billed charges,50.68,100,,,fee schedule,Pays 100% Medicare OPPS,50.68,100,,,fee schedule,Pays 100% Medicare OPPS,50.68,100,,,fee schedule,Pays 100% Medicare OPPS,50.68,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,50.68,100,,,fee schedule,100% of fee schedule,50.68,141.89,
FBR - eye Epithelium - PRO,5240,CDM,981,RC,65435,HCPCS,outpatient,,,190.33,142.75,,94.47,130,,,fee schedule,130% of fee schedule,94.47,130,,,fee schedule,130% of fee schedule,70.22,100,,,fee schedule,Pays 100% Medicare OPPS,70.22,100,,,fee schedule,Pays 100% Medicare OPPS,86.1,119,,,fee schedule,119% of fee schedule,70.22,100,,,fee schedule,Pays 100% Medicare OPPS,70.22,100,,,fee schedule,100% of fee schedule,171.3,90,,,percent of total billed charges,90% of total billed charges,70.22,100,,,fee schedule,Pays 100% Medicare OPPS,70.22,100,,,fee schedule,Pays 100% Medicare OPPS,70.22,100,,,fee schedule,Pays 100% Medicare OPPS,70.22,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,70.22,100,,,fee schedule,100% of fee schedule,70.22,171.3,
IUD (Copper)-Paragard,5241,CDM,521,RC,66453,HCPCS,outpatient,,,1059.27,794.45,,953.34,90,,,percent of total billed charges,90% of total billed charges,985.12,93,,,percent of total billed charges,93% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,900.38,85,,,percent of total billed charges,85% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,862.25,81.4,,,percent of total billed charges,81.4% of total billed charges,953.34,90,,,percent of total billed charges,90% of total billed charges,953.34,90,,,percent of total billed charges,90% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,402.52,38,,,percent of total billed charges,38% of total billed charges,794.45,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,402.52,985.12,
DERM INCISE BIOPSY EYELID - PRO,5242,CDM,982,RC,67810,HCPCS,outpatient,,,212.24,159.18,,123.44,130,,,fee schedule,130% of fee schedule,123.44,130,,,fee schedule,130% of fee schedule,68.77,100,,,fee schedule,Pays 100% Medicare OPPS,68.77,100,,,fee schedule,Pays 100% Medicare OPPS,86.44,119,,,fee schedule,119% of fee schedule,68.77,100,,,fee schedule,Pays 100% Medicare OPPS,68.77,100,,,fee schedule,100% of fee schedule,191.02,90,,,percent of total billed charges,90% of total billed charges,68.77,100,,,fee schedule,Pays 100% Medicare OPPS,68.77,100,,,fee schedule,Pays 100% Medicare OPPS,68.77,100,,,fee schedule,Pays 100% Medicare OPPS,68.77,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,68.77,100,,,fee schedule,100% of fee schedule,43.12,191.02,
WND FBR-Eyelid - PRO,5243,CDM,982,RC,67938,HCPCS,outpatient,,,573.21,429.91,,154.61,130,,,fee schedule,130% of fee schedule,154.61,130,,,fee schedule,130% of fee schedule,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,143.06,119,,,fee schedule,119% of fee schedule,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,100% of fee schedule,515.89,90,,,percent of total billed charges,90% of total billed charges,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,50.3,100,,,fee schedule,100% of fee schedule,121.21,100,,,fee schedule,100% of fee schedule,50.3,515.89,
FBR-Eyelid - PRO,5244,CDM,981,RC,67938,HCPCS,outpatient,,,573.21,429.91,,154.61,130,,,fee schedule,130% of fee schedule,154.61,130,,,fee schedule,130% of fee schedule,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,143.06,119,,,fee schedule,119% of fee schedule,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,100% of fee schedule,515.89,90,,,percent of total billed charges,90% of total billed charges,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,121.21,100,,,fee schedule,Pays 100% Medicare OPPS,50.3,100,,,fee schedule,100% of fee schedule,121.21,100,,,fee schedule,100% of fee schedule,50.3,515.89,
Inj. contrast medium for dacryo.,5245,CDM,521,RC,68850,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,0.44,1.08,
Drainage external auditory canal abscess-PRO,5246,CDM,981,RC,69020,HCPCS,outpatient,,,510.89,383.17,,193.74,130,,,fee schedule,130% of fee schedule,193.74,130,,,fee schedule,130% of fee schedule,150.56,100,,,fee schedule,Pays 100% Medicare OPPS,150.56,100,,,fee schedule,Pays 100% Medicare OPPS,174.51,119,,,fee schedule,119% of fee schedule,150.56,100,,,fee schedule,Pays 100% Medicare OPPS,150.56,100,,,fee schedule,100% of fee schedule,459.8,90,,,percent of total billed charges,90% of total billed charges,150.56,100,,,fee schedule,Pays 100% Medicare OPPS,150.56,100,,,fee schedule,Pays 100% Medicare OPPS,150.56,100,,,fee schedule,Pays 100% Medicare OPPS,150.56,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,150.56,100,,,fee schedule,100% of fee schedule,71.86,459.8,
"DERM BIOPSY, EAR EXTERNAL - PRO",5247,CDM,982,RC,69100,HCPCS,outpatient,,,212.24,159.18,,67.09,130,,,fee schedule,130% of fee schedule,67.09,130,,,fee schedule,130% of fee schedule,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,59.13,119,,,fee schedule,119% of fee schedule,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,100% of fee schedule,191.02,90,,,percent of total billed charges,90% of total billed charges,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,47.36,100,,,fee schedule,100% of fee schedule,43.12,191.02,
"DERM Biopsy, Ear External-G",5248,CDM,982,RC,69100,HCPCS,outpatient,,,742.85,557.14,,67.09,130,,,fee schedule,130% of fee schedule,67.09,130,,,fee schedule,130% of fee schedule,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,59.13,119,,,fee schedule,119% of fee schedule,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,100% of fee schedule,668.57,90,,,percent of total billed charges,90% of total billed charges,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,47.36,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,47.36,100,,,fee schedule,100% of fee schedule,43.12,668.57,
"Excis. Proc:Exter. Ear/Canal;Rmv from Canal,W/O Anes.",5249,CDM,521,RC,69200,HCPCS,outpatient,,,315.21,236.41,,283.69,90,,,percent of total billed charges,90% of total billed charges,293.15,93,,,percent of total billed charges,93% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,267.93,85,,,percent of total billed charges,85% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,256.58,81.4,,,percent of total billed charges,81.4% of total billed charges,283.69,90,,,percent of total billed charges,90% of total billed charges,283.69,90,,,percent of total billed charges,90% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,236.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,119.78,293.15,
"Excis. Proc:Exter. Ear/Canal;Rmv from Canal,W/O Anes.-PRO",5250,CDM,981,RC,69200,HCPCS,outpatient,,,189.84,142.38,,78.16,130,,,fee schedule,130% of fee schedule,78.16,130,,,fee schedule,130% of fee schedule,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,58.19,119,,,fee schedule,119% of fee schedule,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,100% of fee schedule,170.86,90,,,percent of total billed charges,90% of total billed charges,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,48.05,100,,,fee schedule,100% of fee schedule,48.05,170.86,
"Excis. Proc:Exter. Ear/Canal;Rmv from Canal,W/O Anes.-PRO",5251,CDM,981,RC,69200,HCPCS,outpatient,,,189.84,142.38,,78.16,130,,,fee schedule,130% of fee schedule,78.16,130,,,fee schedule,130% of fee schedule,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,58.19,119,,,fee schedule,119% of fee schedule,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,100% of fee schedule,170.86,90,,,percent of total billed charges,90% of total billed charges,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,48.05,100,,,fee schedule,100% of fee schedule,48.05,170.86,
Remove impacted Cerumen w/o instru-Pro,5252,CDM,982,RC,69202,HCPCS,outpatient,,,34.81,26.11,,27.85,80,,,percent of total billed charges,90% of total billed charges,27.85,80,,,percent of total billed charges,93% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,31.33,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,27.85,31.33,
Remove impacted Cerumen(irr/lav)-PRO,5253,CDM,981,RC,69209,HCPCS,outpatient,,,33.12,24.84,,26.5,80,,,percent of total billed charges,90% of total billed charges,26.5,80,,,percent of total billed charges,93% of total billed charges,16.28,100,,,fee schedule,Pays 100% Medicare OPPS,16.28,100,,,fee schedule,Pays 100% Medicare OPPS,17.68,119,,,fee schedule,119% of fee schedule,16.28,100,,,fee schedule,Pays 100% Medicare OPPS,16.28,100,,,fee schedule,100% of fee schedule,29.81,90,,,percent of total billed charges,90% of total billed charges,16.28,100,,,fee schedule,Pays 100% Medicare OPPS,16.28,100,,,fee schedule,Pays 100% Medicare OPPS,16.28,100,,,fee schedule,Pays 100% Medicare OPPS,16.28,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,16.28,100,,,fee schedule,100% of fee schedule,16.28,29.81,
"Exter Ear/Canal;Rmvl Cerumen, 1 or both [Panel]",5254,CDM,521,RC,69210,HCPCS,outpatient,,,116,87,,104.4,90,,,percent of total billed charges,90% of total billed charges,107.88,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,94.42,81.4,,,percent of total billed charges,81.4% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,44.08,107.88,
"WND Remove impacted Cerumen, 1 or both-PRO",5255,CDM,982,RC,69210,HCPCS,outpatient,,,70.31,52.73,,44.33,130,,,fee schedule,130% of fee schedule,44.33,130,,,fee schedule,130% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,41.22,119,,,fee schedule,119% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,100% of fee schedule,63.28,90,,,percent of total billed charges,90% of total billed charges,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,32.89,100,,,fee schedule,100% of fee schedule,32.89,63.28,
"Remove impacted Cerumen, 1 or both-PRO",5256,CDM,981,RC,69210,HCPCS,outpatient,,,70.31,52.73,,44.33,130,,,fee schedule,130% of fee schedule,44.33,130,,,fee schedule,130% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,41.22,119,,,fee schedule,119% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,100% of fee schedule,63.28,90,,,percent of total billed charges,90% of total billed charges,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,32.89,100,,,fee schedule,100% of fee schedule,32.89,63.28,
"Remove impacted Cerumen, 1 or both-PRO",5257,CDM,981,RC,69210,HCPCS,outpatient,,,70.31,52.73,,44.33,130,,,fee schedule,130% of fee schedule,44.33,130,,,fee schedule,130% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,41.22,119,,,fee schedule,119% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,100% of fee schedule,63.28,90,,,percent of total billed charges,90% of total billed charges,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,32.89,100,,,fee schedule,100% of fee schedule,32.89,63.28,
Sports Physical,5258,CDM,521,RC,,,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,16.92,41.41,
Sports Physical,5259,CDM,521,RC,,,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,16.92,41.41,
Insurance Physical,5260,CDM,521,RC,,,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.09,117.69,
Insurance Physical,5261,CDM,521,RC,,,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.09,117.69,
College Physical (Includes nursing),5262,CDM,521,RC,,,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.09,117.69,
College Physical (Includes nursing),5263,CDM,521,RC,,,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.09,117.69,
Employment Physical,5264,CDM,521,RC,,,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.09,117.69,
Employment Physical,5265,CDM,521,RC,,,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.09,117.69,
Brief Physical,5266,CDM,521,RC,,,outpatient,,,46.87,35.15,,42.18,90,,,percent of total billed charges,90% of total billed charges,43.59,93,,,percent of total billed charges,93% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,38.15,81.4,,,percent of total billed charges,81.4% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,35.15,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,17.81,43.59,
Brief Physical,5267,CDM,521,RC,,,outpatient,,,46.87,35.15,,42.18,90,,,percent of total billed charges,90% of total billed charges,43.59,93,,,percent of total billed charges,93% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,38.15,81.4,,,percent of total billed charges,81.4% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,35.15,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,17.81,43.59,
Grimmway Farms Physical,5268,CDM,521,RC,,,outpatient,,,101.95,76.46,,91.76,90,,,percent of total billed charges,90% of total billed charges,94.81,93,,,percent of total billed charges,93% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,86.66,85,,,percent of total billed charges,85% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,82.99,81.4,,,percent of total billed charges,81.4% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,76.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,38.74,94.81,
Grimmway Farms Physical,5269,CDM,521,RC,,,outpatient,,,101.95,76.46,,91.76,90,,,percent of total billed charges,90% of total billed charges,94.81,93,,,percent of total billed charges,93% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,86.66,85,,,percent of total billed charges,85% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,82.99,81.4,,,percent of total billed charges,81.4% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,76.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,38.74,94.81,
Portamedic,5270,CDM,521,RC,,,outpatient,,,101.95,76.46,,91.76,90,,,percent of total billed charges,90% of total billed charges,94.81,93,,,percent of total billed charges,93% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,86.66,85,,,percent of total billed charges,85% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,82.99,81.4,,,percent of total billed charges,81.4% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,76.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,38.74,94.81,
Portamedic,5271,CDM,521,RC,,,outpatient,,,101.95,76.46,,91.76,90,,,percent of total billed charges,90% of total billed charges,94.81,93,,,percent of total billed charges,93% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,86.66,85,,,percent of total billed charges,85% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,82.99,81.4,,,percent of total billed charges,81.4% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,76.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,38.74,94.81,
Tuberculosis;Intradermal,5272,CDM,521,RC,86580,HCPCS,outpatient,,,30.46,22.85,,27.41,90,,,percent of total billed charges,90% of total billed charges,28.33,93,,,percent of total billed charges,93% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,24.79,81.4,,,percent of total billed charges,81.4% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,22.85,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,11.57,28.33,
DERM PATH/CYST/TAG/DEBRIDE - PRO,5273,CDM,971,RC,88304,HCPCS,outpatient,,,49.88,37.41,,64.84,130,,,fee schedule,130% of fee schedule,64.84,130,,,fee schedule,130% of fee schedule,44.68,100,,,fee schedule,Pays 100% Medicare OPPS,44.68,100,,,fee schedule,Pays 100% Medicare OPPS,18.53,60,,,fee schedule,60% of fee schedule,44.68,100,,,fee schedule,Pays 100% Medicare OPPS,44.68,100,,,fee schedule,100% of fee schedule,44.89,90,,,percent of total billed charges,90% of total billed charges,44.68,100,,,fee schedule,Pays 100% Medicare OPPS,44.68,100,,,fee schedule,Pays 100% Medicare OPPS,44.68,100,,,fee schedule,Pays 100% Medicare OPPS,44.68,100,,,fee schedule,Pays 100% Medicare OPPS,62.4,100,,,fee schedule,100% of fee schedule,44.68,100,,,fee schedule,100% of fee schedule,18.53,64.84,
DERM PATHOLOGY SKIN - PRO,5274,CDM,971,RC,88305,HCPCS,outpatient,,,84.89,63.67,,110.36,130,,,fee schedule,130% of fee schedule,110.36,130,,,fee schedule,130% of fee schedule,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,19.88,60,,,fee schedule,60% of fee schedule,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,100% of fee schedule,76.4,90,,,percent of total billed charges,90% of total billed charges,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,87.6,100,,,fee schedule,100% of fee schedule,74.11,100,,,fee schedule,100% of fee schedule,19.88,110.36,
DERM PATHOLOGY SKIN - PRO,5275,CDM,971,RC,88305,HCPCS,outpatient,,,84.89,63.67,,110.36,130,,,fee schedule,130% of fee schedule,110.36,130,,,fee schedule,130% of fee schedule,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,19.88,60,,,fee schedule,60% of fee schedule,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,100% of fee schedule,76.4,90,,,percent of total billed charges,90% of total billed charges,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,74.11,100,,,fee schedule,Pays 100% Medicare OPPS,87.6,100,,,fee schedule,100% of fee schedule,74.11,100,,,fee schedule,100% of fee schedule,19.88,110.36,
DERM SPECIAL STAINS GROUP 1 - PRO,5276,CDM,971,RC,88312,HCPCS,outpatient,,,53.06,39.8,,68.98,130,,,fee schedule,130% of fee schedule,68.98,130,,,fee schedule,130% of fee schedule,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,31.84,60,,,fee schedule,60% of fee schedule,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,100% of fee schedule,47.75,90,,,percent of total billed charges,90% of total billed charges,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,20.4,100,,,fee schedule,100% of fee schedule,53.06,100,,,fee schedule,100% of fee schedule,20.4,68.98,
DERM SPECIAL STAIN REVIEW - PRO,5277,CDM,310,RC,88321,HCPCS,outpatient,,,212.24,159.18,,191.02,90,,,percent of total billed charges,90% of total billed charges,197.38,93,,,percent of total billed charges,93% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,180.4,85,,,percent of total billed charges,85% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,172.76,81.4,,,percent of total billed charges,81.4% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,191.02,90,,,percent of total billed charges,90% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,80.65,38,,,percent of total billed charges,38% of total billed charges,159.18,75,,,percent of total billed charges,75% of total billed charges,180.4,85,,,percent of total billed charges,85% of total billed charges,80.65,197.38,
DERM IMMUNOHISTO ANTIBODY SLIDE - PRO,5278,CDM,971,RC,88342,HCPCS,outpatient,,,53.06,39.8,,68.98,130,,,fee schedule,130% of fee schedule,68.98,130,,,fee schedule,130% of fee schedule,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,31.84,60,,,fee schedule,60% of fee schedule,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,100% of fee schedule,47.75,90,,,percent of total billed charges,90% of total billed charges,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,53.06,100,,,fee schedule,Pays 100% Medicare OPPS,48,100,,,fee schedule,100% of fee schedule,53.06,100,,,fee schedule,100% of fee schedule,31.84,68.98,
Admin Vaccine- 1st vaccine,5279,CDM,771,RC,90471,HCPCS,outpatient,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
VFC-Vaccine Admin 1st,5280,CDM,771,RC,90471,HCPCS,outpatient,,,22.55,16.91,,20.3,90,,,percent of total billed charges,90% of total billed charges,20.97,93,,,percent of total billed charges,93% of total billed charges,8.57,38,,,percent of total billed charges,38% of total billed charges,8.57,38,,,percent of total billed charges,38% of total billed charges,19.17,85,,,percent of total billed charges,85% of total billed charges,8.57,38,,,percent of total billed charges,38% of total billed charges,18.36,81.4,,,percent of total billed charges,81.4% of total billed charges,20.3,90,,,percent of total billed charges,90% of total billed charges,20.3,90,,,percent of total billed charges,90% of total billed charges,8.57,38,,,percent of total billed charges,38% of total billed charges,8.57,38,,,percent of total billed charges,38% of total billed charges,8.57,38,,,percent of total billed charges,38% of total billed charges,16.91,75,,,percent of total billed charges,75% of total billed charges,19.17,85,,,percent of total billed charges,85% of total billed charges,8.57,20.97,
Admin Flu vaccine,5281,CDM,636,RC,90471,HCPCS,both,,,38.64,28.98,,34.78,90,,,percent of total billed charges,90% of total billed charges,35.94,93,,,percent of total billed charges,93% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,32.84,85,,,percent of total billed charges,85% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,31.45,81.4,,,percent of total billed charges,81.4% of total billed charges,34.78,90,,,percent of total billed charges,90% of total billed charges,34.78,90,,,percent of total billed charges,90% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,28.98,75,,,percent of total billed charges,75% of total billed charges,32.84,85,,,percent of total billed charges,85% of total billed charges,14.68,35.94,
Admin Flu vaccine,5282,CDM,636,RC,90471,HCPCS,both,,,38.64,28.98,,34.78,90,,,percent of total billed charges,90% of total billed charges,35.94,93,,,percent of total billed charges,93% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,32.84,85,,,percent of total billed charges,85% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,31.45,81.4,,,percent of total billed charges,81.4% of total billed charges,34.78,90,,,percent of total billed charges,90% of total billed charges,34.78,90,,,percent of total billed charges,90% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,28.98,75,,,percent of total billed charges,75% of total billed charges,32.84,85,,,percent of total billed charges,85% of total billed charges,14.68,35.94,
Admin Vaccine Pneumovac,5283,CDM,636,RC,90471,HCPCS,both,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
Admin Vaccine Pneumovac,5284,CDM,636,RC,90471,HCPCS,both,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
ADMIN vaccine  Addt.,5285,CDM,771,RC,90472,HCPCS,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
ADMIN vaccine  Addt.,5286,CDM,771,RC,90472,HCPCS,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
Admin Vaccine;Oral/Intranasal,5287,CDM,771,RC,90473,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Admin Vaccine;Oral/Intranasal,5288,CDM,771,RC,90473,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Hearing&Speech tests:Pure Tone Audio;Air Only,5289,CDM,521,RC,92552,HCPCS,outpatient,,,57.41,43.06,,51.67,90,,,percent of total billed charges,90% of total billed charges,53.39,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,46.73,81.4,,,percent of total billed charges,81.4% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.06,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,21.82,53.39,
CPR-PRO,5290,CDM,981,RC,92950,HCPCS,outpatient,,,648,486,,228.2,130,,,fee schedule,130% of fee schedule,228.2,130,,,fee schedule,130% of fee schedule,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,229.97,119,,,fee schedule,119% of fee schedule,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,100% of fee schedule,583.2,90,,,percent of total billed charges,90% of total billed charges,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,201.32,100,,,fee schedule,100% of fee schedule,182.07,100,,,fee schedule,100% of fee schedule,182.07,583.2,
CPR-PRO,5291,CDM,981,RC,92950,HCPCS,outpatient,,,648,486,,228.2,130,,,fee schedule,130% of fee schedule,228.2,130,,,fee schedule,130% of fee schedule,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,229.97,119,,,fee schedule,119% of fee schedule,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,100% of fee schedule,583.2,90,,,percent of total billed charges,90% of total billed charges,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,182.07,100,,,fee schedule,Pays 100% Medicare OPPS,201.32,100,,,fee schedule,100% of fee schedule,182.07,100,,,fee schedule,100% of fee schedule,182.07,583.2,
Temporary External Pacing-PRO,5292,CDM,981,RC,92953,HCPCS,outpatient,,,445.28,333.96,,13.74,130,,,fee schedule,130% of fee schedule,13.74,130,,,fee schedule,130% of fee schedule,0.96,100,,,fee schedule,Pays 100% Medicare OPPS,0.96,100,,,fee schedule,Pays 100% Medicare OPPS,1.26,119,,,fee schedule,119% of fee schedule,0.96,100,,,fee schedule,Pays 100% Medicare OPPS,0.96,100,,,fee schedule,100% of fee schedule,400.75,90,,,percent of total billed charges,90% of total billed charges,0.96,100,,,fee schedule,Pays 100% Medicare OPPS,0.96,100,,,fee schedule,Pays 100% Medicare OPPS,0.96,100,,,fee schedule,Pays 100% Medicare OPPS,0.96,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,0.96,100,,,fee schedule,100% of fee schedule,0.96,400.75,
Defibrillation - Cardioversion-PRO,5293,CDM,981,RC,92960,HCPCS,outpatient,,,515.59,386.69,,156.53,130,,,fee schedule,130% of fee schedule,156.53,130,,,fee schedule,130% of fee schedule,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,134.86,119,,,fee schedule,119% of fee schedule,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,100% of fee schedule,464.03,90,,,percent of total billed charges,90% of total billed charges,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,201.32,100,,,fee schedule,100% of fee schedule,108.99,100,,,fee schedule,100% of fee schedule,108.99,464.03,
Defibrillation - Cardioversion-PRO,5294,CDM,981,RC,92960,HCPCS,outpatient,,,515.59,386.69,,156.53,130,,,fee schedule,130% of fee schedule,156.53,130,,,fee schedule,130% of fee schedule,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,134.86,119,,,fee schedule,119% of fee schedule,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,100% of fee schedule,464.03,90,,,percent of total billed charges,90% of total billed charges,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,108.99,100,,,fee schedule,Pays 100% Medicare OPPS,201.32,100,,,fee schedule,100% of fee schedule,108.99,100,,,fee schedule,100% of fee schedule,108.99,464.03,
*EKG Professional,5295,CDM,985,RC,93010,HCPCS,outpatient,,,45.7,34.28,,11.1,130,,,fee schedule,130% of fee schedule,11.1,130,,,fee schedule,130% of fee schedule,8.19,100,,,fee schedule,Pays 100% Medicare OPPS,8.19,100,,,fee schedule,Pays 100% Medicare OPPS,10.34,119,,,fee schedule,119% of fee schedule,8.19,100,,,fee schedule,Pays 100% Medicare OPPS,8.19,100,,,fee schedule,100% of fee schedule,41.13,90,,,percent of total billed charges,90% of total billed charges,8.19,100,,,fee schedule,Pays 100% Medicare OPPS,8.19,100,,,fee schedule,Pays 100% Medicare OPPS,8.19,100,,,fee schedule,Pays 100% Medicare OPPS,8.19,100,,,fee schedule,Pays 100% Medicare OPPS,26.96,100,,,fee schedule,100% of fee schedule,8.19,100,,,fee schedule,100% of fee schedule,8.19,41.13,
Stress test with interp and supv,5296,CDM,482,RC,93015,HCPCS,outpatient,,,888.2,666.15,,799.38,90,,,percent of total billed charges,90% of total billed charges,826.03,93,,,percent of total billed charges,93% of total billed charges,337.52,38,,,percent of total billed charges,38% of total billed charges,337.52,38,,,percent of total billed charges,38% of total billed charges,754.97,85,,,percent of total billed charges,85% of total billed charges,337.52,38,,,percent of total billed charges,38% of total billed charges,722.99,81.4,,,percent of total billed charges,81.4% of total billed charges,799.38,90,,,percent of total billed charges,90% of total billed charges,799.38,90,,,percent of total billed charges,90% of total billed charges,337.52,38,,,percent of total billed charges,38% of total billed charges,337.52,38,,,percent of total billed charges,38% of total billed charges,337.52,38,,,percent of total billed charges,38% of total billed charges,666.15,75,,,percent of total billed charges,75% of total billed charges,754.97,85,,,percent of total billed charges,85% of total billed charges,337.52,826.03,
STRESS TEST - SUPERVISION,5297,CDM,521,RC,93016,HCPCS,outpatient,,,178.11,133.58,,160.3,90,,,percent of total billed charges,90% of total billed charges,165.64,93,,,percent of total billed charges,93% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,144.98,81.4,,,percent of total billed charges,81.4% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,133.58,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,67.68,165.64,
STRESS TEST INTERP & REPT ONLY,5298,CDM,985,RC,93018,HCPCS,outpatient,,,236.69,177.52,,19.12,130,,,fee schedule,130% of fee schedule,19.12,130,,,fee schedule,130% of fee schedule,14.04,100,,,fee schedule,Pays 100% Medicare OPPS,14.04,100,,,fee schedule,Pays 100% Medicare OPPS,18.15,119,,,fee schedule,119% of fee schedule,14.04,100,,,fee schedule,Pays 100% Medicare OPPS,14.04,100,,,fee schedule,100% of fee schedule,213.02,90,,,percent of total billed charges,90% of total billed charges,14.04,100,,,fee schedule,Pays 100% Medicare OPPS,14.04,100,,,fee schedule,Pays 100% Medicare OPPS,14.04,100,,,fee schedule,Pays 100% Medicare OPPS,14.04,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,14.04,100,,,fee schedule,100% of fee schedule,14.04,213.02,
Holter Professional Read,5299,CDM,982,RC,93227,HCPCS,outpatient,,,130.06,97.55,,34.31,130,,,fee schedule,130% of fee schedule,34.31,130,,,fee schedule,130% of fee schedule,18.53,100,,,fee schedule,Pays 100% Medicare OPPS,18.53,100,,,fee schedule,Pays 100% Medicare OPPS,32.42,119,,,fee schedule,119% of fee schedule,18.53,100,,,fee schedule,Pays 100% Medicare OPPS,18.53,100,,,fee schedule,100% of fee schedule,117.05,90,,,percent of total billed charges,90% of total billed charges,18.53,100,,,fee schedule,Pays 100% Medicare OPPS,18.53,100,,,fee schedule,Pays 100% Medicare OPPS,18.53,100,,,fee schedule,Pays 100% Medicare OPPS,18.53,100,,,fee schedule,Pays 100% Medicare OPPS,104.26,100,,,fee schedule,100% of fee schedule,18.53,100,,,fee schedule,100% of fee schedule,18.53,117.05,
MCT Telemetry  Interp,5300,CDM,985,RC,93228,HCPCS,outpatient,,,39.41,29.56,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,25.61,100,,,fee schedule,Pays 100% Medicare OPPS,25.61,100,,,fee schedule,Pays 100% Medicare OPPS,32.7,119,,,fee schedule,119% of fee schedule,25.61,100,,,fee schedule,Pays 100% Medicare OPPS,25.61,100,,,fee schedule,100% of fee schedule,35.47,90,,,percent of total billed charges,90% of total billed charges,25.61,100,,,fee schedule,Pays 100% Medicare OPPS,25.61,100,,,fee schedule,Pays 100% Medicare OPPS,25.61,100,,,fee schedule,Pays 100% Medicare OPPS,25.61,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.61,100,,,fee schedule,100% of fee schedule,25.61,35.47,
Event Monitor- Hook Up,5301,CDM,731,RC,93270,HCPCS,outpatient,,,93.74,70.31,,84.37,90,,,percent of total billed charges,90% of total billed charges,87.18,93,,,percent of total billed charges,93% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,79.68,85,,,percent of total billed charges,85% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,76.3,81.4,,,percent of total billed charges,81.4% of total billed charges,84.37,90,,,percent of total billed charges,90% of total billed charges,84.37,90,,,percent of total billed charges,90% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,70.31,75,,,percent of total billed charges,75% of total billed charges,79.68,85,,,percent of total billed charges,85% of total billed charges,35.62,87.18,
Event Monitor- Reading,5302,CDM,985,RC,93272,HCPCS,outpatient,,,46.87,35.15,,32.49,130,,,fee schedule,130% of fee schedule,32.49,130,,,fee schedule,130% of fee schedule,24.29,100,,,fee schedule,Pays 100% Medicare OPPS,24.29,100,,,fee schedule,Pays 100% Medicare OPPS,31.09,119,,,fee schedule,119% of fee schedule,24.29,100,,,fee schedule,Pays 100% Medicare OPPS,24.29,100,,,fee schedule,100% of fee schedule,42.18,90,,,percent of total billed charges,90% of total billed charges,24.29,100,,,fee schedule,Pays 100% Medicare OPPS,24.29,100,,,fee schedule,Pays 100% Medicare OPPS,24.29,100,,,fee schedule,Pays 100% Medicare OPPS,24.29,100,,,fee schedule,Pays 100% Medicare OPPS,26.03,100,,,fee schedule,100% of fee schedule,24.29,100,,,fee schedule,100% of fee schedule,24.29,42.18,
WND ABI (Ankle-Brachial Index)-Pro,5303,CDM,920,RC,93922,HCPCS,outpatient,,,337.84,253.38,,304.06,90,,,percent of total billed charges,90% of total billed charges,314.19,93,,,percent of total billed charges,93% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,287.16,85,,,percent of total billed charges,85% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,275,81.4,,,percent of total billed charges,81.4% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,304.06,90,,,percent of total billed charges,90% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,128.38,38,,,percent of total billed charges,38% of total billed charges,253.38,75,,,percent of total billed charges,75% of total billed charges,287.16,85,,,percent of total billed charges,85% of total billed charges,128.38,314.19,
WND ABI (Ankle-Brachial Index)-G,5304,CDM,982,RC,93922,HCPCS,outpatient,,,506.77,380.08,,120.43,130,,,fee schedule,130% of fee schedule,120.43,130,,,fee schedule,130% of fee schedule,86.63,100,,,fee schedule,Pays 100% Medicare OPPS,86.63,100,,,fee schedule,Pays 100% Medicare OPPS,90.44,119,,,fee schedule,119% of fee schedule,86.63,100,,,fee schedule,Pays 100% Medicare OPPS,86.63,100,,,fee schedule,100% of fee schedule,456.09,90,,,percent of total billed charges,90% of total billed charges,86.63,100,,,fee schedule,Pays 100% Medicare OPPS,86.63,100,,,fee schedule,Pays 100% Medicare OPPS,86.63,100,,,fee schedule,Pays 100% Medicare OPPS,86.63,100,,,fee schedule,Pays 100% Medicare OPPS,82.69,100,,,fee schedule,100% of fee schedule,86.63,100,,,fee schedule,100% of fee schedule,82.69,456.09,
PFT Simple/Incent Spiro - PRO,5305,CDM,976,RC,94010,HCPCS,outpatient,,,87.88,65.91,,46.18,130,,,fee schedule,130% of fee schedule,46.18,130,,,fee schedule,130% of fee schedule,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,33.65,119,,,fee schedule,119% of fee schedule,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,100% of fee schedule,79.09,90,,,percent of total billed charges,90% of total billed charges,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,71.9,100,,,fee schedule,100% of fee schedule,28.03,100,,,fee schedule,100% of fee schedule,28.03,79.09,
PFT Simple/Incent Spiro - PRO,5306,CDM,976,RC,94010,HCPCS,outpatient,,,87.88,65.91,,46.18,130,,,fee schedule,130% of fee schedule,46.18,130,,,fee schedule,130% of fee schedule,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,33.65,119,,,fee schedule,119% of fee schedule,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,100% of fee schedule,79.09,90,,,percent of total billed charges,90% of total billed charges,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,71.9,100,,,fee schedule,100% of fee schedule,28.03,100,,,fee schedule,100% of fee schedule,28.03,79.09,
PFT pre & post Profession,5307,CDM,976,RC,94060,HCPCS,outpatient,,,126.55,94.91,,79.73,130,,,fee schedule,130% of fee schedule,79.73,130,,,fee schedule,130% of fee schedule,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,57.56,119,,,fee schedule,119% of fee schedule,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,100% of fee schedule,113.9,90,,,percent of total billed charges,90% of total billed charges,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,40.41,100,,,fee schedule,100% of fee schedule,40.41,113.9,
PFT pre & post Profession,5308,CDM,976,RC,94060,HCPCS,outpatient,,,126.55,94.91,,79.73,130,,,fee schedule,130% of fee schedule,79.73,130,,,fee schedule,130% of fee schedule,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,57.56,119,,,fee schedule,119% of fee schedule,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,100% of fee schedule,113.9,90,,,percent of total billed charges,90% of total billed charges,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,40.41,100,,,fee schedule,100% of fee schedule,40.41,113.9,
PFT N2 washout professional,5309,CDM,976,RC,94727,HCPCS,outpatient,,,108.97,81.73,,87.18,80,,,percent of total billed charges,90% of total billed charges,87.18,80,,,percent of total billed charges,93% of total billed charges,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,38.98,119,,,fee schedule,119% of fee schedule,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,100% of fee schedule,98.07,90,,,percent of total billed charges,90% of total billed charges,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,45.68,100,,,fee schedule,100% of fee schedule,38.98,98.07,
PFT N2 washout professional,5310,CDM,976,RC,94727,HCPCS,outpatient,,,108.97,81.73,,87.18,80,,,percent of total billed charges,90% of total billed charges,87.18,80,,,percent of total billed charges,93% of total billed charges,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,38.98,119,,,fee schedule,119% of fee schedule,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,100% of fee schedule,98.07,90,,,percent of total billed charges,90% of total billed charges,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,45.68,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,45.68,100,,,fee schedule,100% of fee schedule,38.98,98.07,
PFT Co2 diffusing professional,5311,CDM,976,RC,94729,HCPCS,outpatient,,,108.97,81.73,,87.18,80,,,percent of total billed charges,90% of total billed charges,87.18,80,,,percent of total billed charges,93% of total billed charges,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,58.94,119,,,fee schedule,119% of fee schedule,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,100% of fee schedule,98.07,90,,,percent of total billed charges,90% of total billed charges,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,59.67,100,,,fee schedule,100% of fee schedule,58.94,98.07,
PFT Co2 diffusing professional,5312,CDM,976,RC,94729,HCPCS,outpatient,,,108.97,81.73,,87.18,80,,,percent of total billed charges,90% of total billed charges,87.18,80,,,percent of total billed charges,93% of total billed charges,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,58.94,119,,,fee schedule,119% of fee schedule,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,100% of fee schedule,98.07,90,,,percent of total billed charges,90% of total billed charges,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,59.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,59.67,100,,,fee schedule,100% of fee schedule,58.94,98.07,
DERM PATCH T.R.U.E ALLERGENS.EA - PRO,5313,CDM,982,RC,95044,HCPCS,outpatient,,,10.61,7.96,,7.24,130,,,fee schedule,130% of fee schedule,7.24,130,,,fee schedule,130% of fee schedule,5.25,100,,,fee schedule,Pays 100% Medicare OPPS,5.25,100,,,fee schedule,Pays 100% Medicare OPPS,5.54,100,,,fee schedule,100% of fee schedule,5.25,100,,,fee schedule,Pays 100% Medicare OPPS,5.25,100,,,fee schedule,100% of fee schedule,9.55,90,,,percent of total billed charges,90% of total billed charges,5.25,100,,,fee schedule,Pays 100% Medicare OPPS,5.25,100,,,fee schedule,Pays 100% Medicare OPPS,5.25,100,,,fee schedule,Pays 100% Medicare OPPS,5.25,100,,,fee schedule,Pays 100% Medicare OPPS,4.03,100,,,fee schedule,100% of fee schedule,5.25,100,,,fee schedule,100% of fee schedule,4.03,9.55,
"Allergy Immuno.:Allergen,not Includ. Provision;Single Inj.",5314,CDM,521,RC,95115,HCPCS,outpatient,,,26.96,20.22,,24.26,90,,,percent of total billed charges,90% of total billed charges,25.07,93,,,percent of total billed charges,93% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,21.95,81.4,,,percent of total billed charges,81.4% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,20.22,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,10.24,25.07,
"Allergy Immuno.:Allergen,not Includ. Provision;Single Inj.",5315,CDM,521,RC,95115,HCPCS,outpatient,,,26.96,20.22,,24.26,90,,,percent of total billed charges,90% of total billed charges,25.07,93,,,percent of total billed charges,93% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,21.95,81.4,,,percent of total billed charges,81.4% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,20.22,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,10.24,25.07,
"Allergy Immuno.:Allergen,not Includ. Provision;2> Injections",5316,CDM,521,RC,95117,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,13.8,33.78,
"Allergy Immuno.:Allergen,not Includ. Provision;2> Injections",5317,CDM,521,RC,95117,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,13.8,33.78,
WND debride open wnd RHC,5318,CDM,521,RC,97597,HCPCS,outpatient,,,353.74,265.31,,318.37,90,,,percent of total billed charges,90% of total billed charges,328.98,93,,,percent of total billed charges,93% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,300.68,85,,,percent of total billed charges,85% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,287.94,81.4,,,percent of total billed charges,81.4% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,318.37,90,,,percent of total billed charges,90% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,134.42,38,,,percent of total billed charges,38% of total billed charges,265.31,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,134.42,328.98,
WC remove devit tis 20cm< -G,5319,CDM,982,RC,97597,HCPCS,outpatient,,,353.31,264.98,,31.37,130,,,fee schedule,130% of fee schedule,31.37,130,,,fee schedule,130% of fee schedule,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,70,100,,,case rate,100% of case rate,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,100% of fee schedule,317.98,90,,,percent of total billed charges,90% of total billed charges,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,35.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,35.67,100,,,fee schedule,100% of fee schedule,31.37,317.98,
Rmvl devital tissue addl 20cm,5320,CDM,982,RC,97598,HCPCS,outpatient,,,402.04,301.53,,14.99,130,,,fee schedule,130% of fee schedule,14.99,130,,,fee schedule,130% of fee schedule,24.69,100,,,fee schedule,Pays 100% Medicare OPPS,24.69,100,,,fee schedule,Pays 100% Medicare OPPS,70,100,,,case rate,100% of case rate,24.69,100,,,fee schedule,Pays 100% Medicare OPPS,24.69,100,,,fee schedule,100% of fee schedule,361.84,90,,,percent of total billed charges,90% of total billed charges,24.69,100,,,fee schedule,Pays 100% Medicare OPPS,24.69,100,,,fee schedule,Pays 100% Medicare OPPS,24.69,100,,,fee schedule,Pays 100% Medicare OPPS,24.69,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,24.69,100,,,fee schedule,100% of fee schedule,14.99,361.84,
WND -Neg Pressure wound therapy <50cm,5321,CDM,982,RC,97605,HCPCS,outpatient,,,149.33,112,,34.79,130,,,fee schedule,130% of fee schedule,34.79,130,,,fee schedule,130% of fee schedule,25.05,100,,,fee schedule,Pays 100% Medicare OPPS,25.05,100,,,fee schedule,Pays 100% Medicare OPPS,70,100,,,case rate,100% of case rate,25.05,100,,,fee schedule,Pays 100% Medicare OPPS,25.05,100,,,fee schedule,100% of fee schedule,134.4,90,,,percent of total billed charges,90% of total billed charges,25.05,100,,,fee schedule,Pays 100% Medicare OPPS,25.05,100,,,fee schedule,Pays 100% Medicare OPPS,25.05,100,,,fee schedule,Pays 100% Medicare OPPS,25.05,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.05,100,,,fee schedule,100% of fee schedule,25.05,134.4,
FITTING FOR BOOT EA 15 MIN,5322,CDM,983,RC,97760,HCPCS,outpatient,,,57.41,43.06,,48.45,130,,,fee schedule,130% of fee schedule,48.45,130,,,fee schedule,130% of fee schedule,50.74,100,,,fee schedule,Pays 100% Medicare OPPS,50.74,100,,,fee schedule,Pays 100% Medicare OPPS,70,100,,,case rate,100% of case rate,50.74,100,,,fee schedule,Pays 100% Medicare OPPS,50.74,100,,,fee schedule,100% of fee schedule,51.67,90,,,percent of total billed charges,90% of total billed charges,50.74,100,,,fee schedule,Pays 100% Medicare OPPS,50.74,100,,,fee schedule,Pays 100% Medicare OPPS,50.74,100,,,fee schedule,Pays 100% Medicare OPPS,50.74,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,50.74,100,,,fee schedule,100% of fee schedule,48.45,70,
Osteo.Manip;1-2 Body Regions,5323,CDM,521,RC,98925,HCPCS,outpatient,,,82.05,61.54,,73.85,90,,,percent of total billed charges,90% of total billed charges,76.31,93,,,percent of total billed charges,93% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,69.74,85,,,percent of total billed charges,85% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,66.79,81.4,,,percent of total billed charges,81.4% of total billed charges,73.85,90,,,percent of total billed charges,90% of total billed charges,73.85,90,,,percent of total billed charges,90% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,61.54,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,31.18,76.31,
Osteo.Manip.;3-4 Body Regions,5324,CDM,521,RC,98926,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,40.08,98.09,
OMIT 5-6 BODY REG,5325,CDM,521,RC,98927,HCPCS,outpatient,,,124.22,93.17,,111.8,90,,,percent of total billed charges,90% of total billed charges,115.52,93,,,percent of total billed charges,93% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,105.59,85,,,percent of total billed charges,85% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,101.12,81.4,,,percent of total billed charges,81.4% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,111.8,90,,,percent of total billed charges,90% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,47.2,38,,,percent of total billed charges,38% of total billed charges,93.17,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,47.2,115.52,
Osteo.Manip.;7-8 Body Regions,5326,CDM,521,RC,98928,HCPCS,outpatient,,,162.87,122.15,,146.58,90,,,percent of total billed charges,90% of total billed charges,151.47,93,,,percent of total billed charges,93% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,132.58,81.4,,,percent of total billed charges,81.4% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,122.15,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,61.89,151.47,
Osteo.Manip;9-10 Body Regions,5327,CDM,981,RC,98929,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,57.52,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,57.52,57.52,
Supplement&Supplies:Handling Specimen for Transfer,5328,CDM,521,RC,99000,HCPCS,outpatient,,,162.87,122.15,,146.58,90,,,percent of total billed charges,90% of total billed charges,151.47,93,,,percent of total billed charges,93% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,138.44,85,,,percent of total billed charges,85% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,132.58,81.4,,,percent of total billed charges,81.4% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,146.58,90,,,percent of total billed charges,90% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,61.89,38,,,percent of total billed charges,38% of total billed charges,122.15,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,61.89,151.47,
FOLLOW UP VISIT - NO CHARGE,5329,CDM,983,RC,99024,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.36,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.36,32.36,
FOLLOW UP VISIT - NO CHARGE,5330,CDM,983,RC,99024,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.36,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.36,32.36,
FOLLOW UP VISIT - NO CHARGE,5331,CDM,983,RC,99024,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.36,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.36,32.36,
FOLLOW UP VISIT - NO CHARGE,5332,CDM,983,RC,99024,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.36,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.36,32.36,
Supplement&Supplies:Office Emergaency;Disprupts other Scheduled Services,5333,CDM,521,RC,99058,HCPCS,outpatient,,,125.38,94.04,,112.84,90,,,percent of total billed charges,90% of total billed charges,116.6,93,,,percent of total billed charges,93% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,102.06,81.4,,,percent of total billed charges,81.4% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,94.04,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,47.64,116.6,
Mod sedation 1st 15min <5y,5334,CDM,964,RC,99151,HCPCS,outpatient,,,366.01,274.51,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,119,,,fee schedule,119% of fee schedule,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,100% of fee schedule,329.41,90,,,percent of total billed charges,90% of total billed charges,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,24.51,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,24.51,100,,,fee schedule,100% of fee schedule,24.51,329.41,
HBOT supervision,5335,CDM,982,RC,99183,HCPCS,outpatient,,,225.23,168.92,,158.91,130,,,fee schedule,130% of fee schedule,158.91,130,,,fee schedule,130% of fee schedule,106.27,100,,,fee schedule,Pays 100% Medicare OPPS,106.27,100,,,fee schedule,Pays 100% Medicare OPPS,135.71,119,,,fee schedule,119% of fee schedule,106.27,100,,,fee schedule,Pays 100% Medicare OPPS,106.27,100,,,fee schedule,100% of fee schedule,202.71,90,,,percent of total billed charges,90% of total billed charges,106.27,100,,,fee schedule,Pays 100% Medicare OPPS,106.27,100,,,fee schedule,Pays 100% Medicare OPPS,106.27,100,,,fee schedule,Pays 100% Medicare OPPS,106.27,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,106.27,100,,,fee schedule,100% of fee schedule,106.27,202.71,
Office Visit New Min,5336,CDM,521,RC,99201,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.41,101.34,
Office Visit New Min,5337,CDM,521,RC,99201,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.41,101.34,
Office Visit New Min,5338,CDM,521,RC,99201,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.41,101.34,
WND Wound New Min - PRO,5339,CDM,982,RC,99201,HCPCS,outpatient,,,67.56,50.67,,34.66,130,,,fee schedule,130% of fee schedule,34.66,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.31,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,60.8,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,35.95,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.31,60.8,
Office Visit New Min - PRO,5340,CDM,982,RC,99201,HCPCS,outpatient,,,66.79,50.09,,34.66,130,,,fee schedule,130% of fee schedule,34.66,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.31,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,60.11,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,35.95,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.31,60.11,
Office Visit New Brief,5341,CDM,521,RC,99202,HCPCS,outpatient,,,175.77,131.83,,158.19,90,,,percent of total billed charges,90% of total billed charges,163.47,93,,,percent of total billed charges,93% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,143.08,81.4,,,percent of total billed charges,81.4% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,131.83,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.79,163.47,
Office Visit New Brief,5342,CDM,521,RC,99202,HCPCS,outpatient,,,175.77,131.83,,158.19,90,,,percent of total billed charges,90% of total billed charges,163.47,93,,,percent of total billed charges,93% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,143.08,81.4,,,percent of total billed charges,81.4% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,131.83,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.79,163.47,
Office Visit New Brief,5343,CDM,521,RC,99202,HCPCS,outpatient,,,175.77,131.83,,158.19,90,,,percent of total billed charges,90% of total billed charges,163.47,93,,,percent of total billed charges,93% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,149.4,85,,,percent of total billed charges,85% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,143.08,81.4,,,percent of total billed charges,81.4% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,158.19,90,,,percent of total billed charges,90% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,66.79,38,,,percent of total billed charges,38% of total billed charges,131.83,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,66.79,163.47,
DERM Office Visit New Brief-G,5344,CDM,982,RC,99202,HCPCS,outpatient,,,175.1,131.33,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,157.59,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,157.59,
WND Wound New Brief-G,5345,CDM,982,RC,99202,HCPCS,outpatient,,,175.76,131.82,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,158.18,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,158.18,
ORTHO Office Visit New Brief-G,5346,CDM,982,RC,99202,HCPCS,outpatient,,,175.76,131.82,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,158.18,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,158.18,
WND Wound New Brief -PRO,5347,CDM,982,RC,99202,HCPCS,outpatient,,,126.55,94.91,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,113.9,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,113.9,
CONSULT BRIEF NEW PRO,5348,CDM,988,RC,99202,HCPCS,outpatient,,,135.3,101.48,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,121.77,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,121.77,
DERM OFFICE VISIT NEW BRIEF - PRO,5349,CDM,982,RC,99202,HCPCS,outpatient,,,126.29,94.72,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,113.66,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,113.66,
Office Visit New Brief -PRO,5350,CDM,981,RC,99202,HCPCS,outpatient,,,126.55,94.91,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,113.9,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,113.9,
Office Visit New Brief -PRO,5351,CDM,981,RC,99202,HCPCS,outpatient,,,126.55,94.91,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,113.9,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,113.9,
Office Visit New Int.,5352,CDM,521,RC,99203,HCPCS,outpatient,,,234.37,175.78,,210.93,90,,,percent of total billed charges,90% of total billed charges,217.96,93,,,percent of total billed charges,93% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,199.21,85,,,percent of total billed charges,85% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,190.78,81.4,,,percent of total billed charges,81.4% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,175.78,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,89.06,217.96,
Office Visit New Int.,5353,CDM,521,RC,99203,HCPCS,outpatient,,,234.37,175.78,,210.93,90,,,percent of total billed charges,90% of total billed charges,217.96,93,,,percent of total billed charges,93% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,199.21,85,,,percent of total billed charges,85% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,190.78,81.4,,,percent of total billed charges,81.4% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,175.78,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,89.06,217.96,
Office Visit New Int.,5354,CDM,521,RC,99203,HCPCS,outpatient,,,234.37,175.78,,210.93,90,,,percent of total billed charges,90% of total billed charges,217.96,93,,,percent of total billed charges,93% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,199.21,85,,,percent of total billed charges,85% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,190.78,81.4,,,percent of total billed charges,81.4% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,175.78,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,89.06,217.96,
Office Visit New Int.,5355,CDM,521,RC,99203,HCPCS,outpatient,,,234.37,175.78,,210.93,90,,,percent of total billed charges,90% of total billed charges,217.96,93,,,percent of total billed charges,93% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,199.21,85,,,percent of total billed charges,85% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,190.78,81.4,,,percent of total billed charges,81.4% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,175.78,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,89.06,217.96,
Pre-OP exam-new,5356,CDM,982,RC,99203,HCPCS,outpatient,,,237.37,178.03,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,213.63,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,213.63,
DERM Office Visit New Int.-G,5357,CDM,982,RC,99203,HCPCS,outpatient,,,290.77,218.08,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,261.69,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,261.69,
ORTHO Office Visit New Int.-G,5358,CDM,982,RC,99203,HCPCS,outpatient,,,290.77,218.08,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,261.69,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,261.69,
WND Wound New Int-G,5359,CDM,982,RC,99203,HCPCS,outpatient,,,291.99,218.99,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,262.79,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,262.79,
CONSULT INT NEW-G,5360,CDM,982,RC,99203,HCPCS,outpatient,,,474.67,356,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,427.2,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,427.2,
WND Wound  New Int. -PRO,5361,CDM,982,RC,99203,HCPCS,outpatient,,,197.07,147.8,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,177.36,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,177.36,
CONSULT INT NEW PRO,5362,CDM,988,RC,99203,HCPCS,outpatient,,,216.48,162.36,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,194.83,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,194.83,
DERM OFFICE VISIT NEW INT - PRO,5363,CDM,982,RC,99203,HCPCS,outpatient,,,196.32,147.24,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,176.69,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,176.69,
Office Visit New Int. -PRO,5364,CDM,981,RC,99203,HCPCS,outpatient,,,139.45,104.59,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,125.51,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,125.51,
Office Visit New Int. -PRO,5365,CDM,981,RC,99203,HCPCS,outpatient,,,139.45,104.59,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,125.51,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,125.51,
Office Visit New Ext.,5366,CDM,521,RC,99204,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.46,309.49,
Office Visit New Ext.,5367,CDM,521,RC,99204,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.46,309.49,
Office Visit New Ext.,5368,CDM,521,RC,99204,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.46,309.49,
DERM OFFICE VISIT NEW EXT - PRO,5369,CDM,982,RC,99204,HCPCS,outpatient,,,286.53,214.9,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,257.88,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,257.88,
CONSULT EXT NEW-G,5370,CDM,982,RC,99204,HCPCS,outpatient,,,454.62,340.97,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,409.16,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,409.16,
DERM OFFICE VISIT NEW EXT - G,5371,CDM,982,RC,99204,HCPCS,outpatient,,,573.06,429.8,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,515.75,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,515.75,
ORTHO Office Visit New Ext.-G,5372,CDM,982,RC,99204,HCPCS,outpatient,,,573.06,429.8,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,515.75,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,515.75,
WND Wound  New Ext.-PRO,5373,CDM,982,RC,99204,HCPCS,outpatient,,,281.54,211.16,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,253.39,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,253.39,
CONSULT EXT NEW PRO,5374,CDM,988,RC,99204,HCPCS,outpatient,,,324.73,243.55,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,292.26,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,292.26,
RC Office Visit New Ext.-G,5375,CDM,982,RC,99204,HCPCS,outpatient,,,454.62,340.97,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,409.16,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,409.16,
WND Wound New Ext.-G,5376,CDM,982,RC,99204,HCPCS,outpatient,,,413.97,310.48,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,372.57,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,372.57,
Office Visit New Ext.-PRO,5377,CDM,982,RC,99204,HCPCS,outpatient,,,200.38,150.29,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,180.34,
Office Visit New Ext.-PRO,5378,CDM,982,RC,99204,HCPCS,outpatient,,,200.38,150.29,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,180.34,
Office Visit New Ext. +,5379,CDM,521,RC,99205,HCPCS,outpatient,,,385.51,289.13,,346.96,90,,,percent of total billed charges,90% of total billed charges,358.52,93,,,percent of total billed charges,93% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,327.68,85,,,percent of total billed charges,85% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,313.81,81.4,,,percent of total billed charges,81.4% of total billed charges,346.96,90,,,percent of total billed charges,90% of total billed charges,346.96,90,,,percent of total billed charges,90% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,289.13,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,146.49,358.52,
Office Visit New Ext. +,5380,CDM,521,RC,99205,HCPCS,outpatient,,,385.51,289.13,,346.96,90,,,percent of total billed charges,90% of total billed charges,358.52,93,,,percent of total billed charges,93% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,327.68,85,,,percent of total billed charges,85% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,313.81,81.4,,,percent of total billed charges,81.4% of total billed charges,346.96,90,,,percent of total billed charges,90% of total billed charges,346.96,90,,,percent of total billed charges,90% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,289.13,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,146.49,358.52,
Office Visit New Ext. +,5381,CDM,521,RC,99205,HCPCS,outpatient,,,385.51,289.13,,346.96,90,,,percent of total billed charges,90% of total billed charges,358.52,93,,,percent of total billed charges,93% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,327.68,85,,,percent of total billed charges,85% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,313.81,81.4,,,percent of total billed charges,81.4% of total billed charges,346.96,90,,,percent of total billed charges,90% of total billed charges,346.96,90,,,percent of total billed charges,90% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,146.49,38,,,percent of total billed charges,38% of total billed charges,289.13,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,146.49,358.52,
CONSULT Office Visit New Ext. +-G,5382,CDM,982,RC,99205,HCPCS,outpatient,,,385.51,289.13,,218.79,130,,,fee schedule,130% of fee schedule,218.79,130,,,fee schedule,130% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,206.02,119,,,fee schedule,119% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,100% of fee schedule,346.96,90,,,percent of total billed charges,90% of total billed charges,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.8,100,,,fee schedule,100% of fee schedule,182.36,100,,,fee schedule,100% of fee schedule,143.8,346.96,
DERM Wound New Ext+-PRO,5383,CDM,982,RC,99205,HCPCS,outpatient,,,337.84,253.38,,218.79,130,,,fee schedule,130% of fee schedule,218.79,130,,,fee schedule,130% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,206.02,119,,,fee schedule,119% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,100% of fee schedule,304.06,90,,,percent of total billed charges,90% of total billed charges,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.8,100,,,fee schedule,100% of fee schedule,182.36,100,,,fee schedule,100% of fee schedule,143.8,304.06,
WND Wound New Ext. + -PRO,5384,CDM,982,RC,99205,HCPCS,outpatient,,,337.84,253.38,,218.79,130,,,fee schedule,130% of fee schedule,218.79,130,,,fee schedule,130% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,206.02,119,,,fee schedule,119% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,100% of fee schedule,304.06,90,,,percent of total billed charges,90% of total billed charges,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.8,100,,,fee schedule,100% of fee schedule,182.36,100,,,fee schedule,100% of fee schedule,143.8,304.06,
DERM Office Visit New Ext. +-G,5385,CDM,982,RC,99205,HCPCS,outpatient,,,491.35,368.51,,218.79,130,,,fee schedule,130% of fee schedule,218.79,130,,,fee schedule,130% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,206.02,119,,,fee schedule,119% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,100% of fee schedule,442.22,90,,,percent of total billed charges,90% of total billed charges,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.8,100,,,fee schedule,100% of fee schedule,182.36,100,,,fee schedule,100% of fee schedule,143.8,442.22,
Office Visit New Ext. + -PRO,5386,CDM,981,RC,99205,HCPCS,outpatient,,,232.01,174.01,,218.79,130,,,fee schedule,130% of fee schedule,218.79,130,,,fee schedule,130% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,206.02,119,,,fee schedule,119% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,100% of fee schedule,208.81,90,,,percent of total billed charges,90% of total billed charges,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.8,100,,,fee schedule,100% of fee schedule,182.36,100,,,fee schedule,100% of fee schedule,143.8,218.79,
Office Visit New Ext. + -PRO,5387,CDM,981,RC,99205,HCPCS,outpatient,,,232.01,174.01,,218.79,130,,,fee schedule,130% of fee schedule,218.79,130,,,fee schedule,130% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,206.02,119,,,fee schedule,119% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,100% of fee schedule,208.81,90,,,percent of total billed charges,90% of total billed charges,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.8,100,,,fee schedule,100% of fee schedule,182.36,100,,,fee schedule,100% of fee schedule,143.8,218.79,
Office/Outpatient;Est. 5min.Visit,5388,CDM,982,RC,99211,HCPCS,outpatient,,,57.41,43.06,,12,130,,,fee schedule,130% of fee schedule,12,130,,,fee schedule,130% of fee schedule,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,11.22,119,,,fee schedule,119% of fee schedule,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,100% of fee schedule,51.67,90,,,percent of total billed charges,90% of total billed charges,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,28.76,100,,,fee schedule,100% of fee schedule,8.89,100,,,fee schedule,100% of fee schedule,8.89,51.67,
Office/Outpatient;Est. 5min.Visit,5389,CDM,982,RC,99211,HCPCS,outpatient,,,57.41,43.06,,12,130,,,fee schedule,130% of fee schedule,12,130,,,fee schedule,130% of fee schedule,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,11.22,119,,,fee schedule,119% of fee schedule,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,100% of fee schedule,51.67,90,,,percent of total billed charges,90% of total billed charges,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,28.76,100,,,fee schedule,100% of fee schedule,8.89,100,,,fee schedule,100% of fee schedule,8.89,51.67,
WND Office/Outpatient;Est. 5min.Visit-PRO,5390,CDM,982,RC,99211,HCPCS,outpatient,,,57.41,43.06,,12,130,,,fee schedule,130% of fee schedule,12,130,,,fee schedule,130% of fee schedule,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,11.22,119,,,fee schedule,119% of fee schedule,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,100% of fee schedule,51.67,90,,,percent of total billed charges,90% of total billed charges,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,8.89,100,,,fee schedule,Pays 100% Medicare OPPS,28.76,100,,,fee schedule,100% of fee schedule,8.89,100,,,fee schedule,100% of fee schedule,8.89,51.67,
Office Visit Est. Brief[Package],5391,CDM,521,RC,99212,HCPCS,outpatient,,,93.74,70.31,,84.37,90,,,percent of total billed charges,90% of total billed charges,87.18,93,,,percent of total billed charges,93% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,79.68,85,,,percent of total billed charges,85% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,76.3,81.4,,,percent of total billed charges,81.4% of total billed charges,84.37,90,,,percent of total billed charges,90% of total billed charges,84.37,90,,,percent of total billed charges,90% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,70.31,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,35.62,87.18,
Office Visit Est. Brief[Package],5392,CDM,521,RC,99212,HCPCS,outpatient,,,93.74,70.31,,84.37,90,,,percent of total billed charges,90% of total billed charges,87.18,93,,,percent of total billed charges,93% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,79.68,85,,,percent of total billed charges,85% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,76.3,81.4,,,percent of total billed charges,81.4% of total billed charges,84.37,90,,,percent of total billed charges,90% of total billed charges,84.37,90,,,percent of total billed charges,90% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,35.62,38,,,percent of total billed charges,38% of total billed charges,70.31,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,35.62,87.18,
COA Office Visit Est Brief,5393,CDM,982,RC,99212,HCPCS,outpatient,,,93.74,70.31,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,84.37,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,84.37,
DERM Office Visit Est. Brief-G,5394,CDM,982,RC,99212,HCPCS,outpatient,,,123.1,92.33,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,110.79,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,110.79,
ORTHO Office Visit Est. Brief-G,5395,CDM,982,RC,99212,HCPCS,outpatient,,,123.1,92.33,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,110.79,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,110.79,
WND Wound Est. Brief-G,5396,CDM,982,RC,99212,HCPCS,outpatient,,,123.12,92.34,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,110.81,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,110.81,
WND Wound Est. Brief-PRO,5397,CDM,982,RC,99212,HCPCS,outpatient,,,84.46,63.35,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,76.01,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,76.01,
Telehealth visit Brief  RHC,5398,CDM,521,RC,99212,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.13,100.66,
Telehealth visit Brief  RHC,5399,CDM,521,RC,99212,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.13,100.66,
Telehealth visit Brief  RHC,5400,CDM,521,RC,99212,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.13,100.66,
Telehealth visit Brief  RHC,5401,CDM,521,RC,99212,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.13,100.66,
CONSULT BRIEF EST PRO,5402,CDM,988,RC,99212,HCPCS,outpatient,,,84.43,63.32,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,75.99,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,75.99,
DERM OFFICE VISIT EST BRIEF- PRO,5403,CDM,982,RC,99212,HCPCS,outpatient,,,83.83,62.87,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,75.45,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,75.45,
Office Visit Est. Brief-PRO,5404,CDM,982,RC,99212,HCPCS,outpatient,,,53.92,40.44,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,48.53,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,48.53,
Office Visit Est. Int.,5405,CDM,521,RC,99213,HCPCS,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.09,117.69,
Office Visit Est. Int.,5406,CDM,521,RC,99213,HCPCS,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.09,117.69,
COA Office Visit exam Init,5407,CDM,982,RC,99213,HCPCS,outpatient,,,120.69,90.52,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,108.62,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,108.62,
CONSULT INT EST-G,5408,CDM,982,RC,99213,HCPCS,outpatient,,,216.48,162.36,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,194.83,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,194.83,
Pre-OP exam-est,5409,CDM,982,RC,99213,HCPCS,outpatient,,,132.5,99.38,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,119.25,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,119.25,
DERM Office Visit Est. Int.-G,5410,CDM,982,RC,99213,HCPCS,outpatient,,,194.2,145.65,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,174.78,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,174.78,
ORTHO Office Visit Est. Int.-G,5411,CDM,982,RC,99213,HCPCS,outpatient,,,194.2,145.65,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,174.78,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,174.78,
WND Wound Est. Int.-G,5412,CDM,982,RC,99213,HCPCS,outpatient,,,195.62,146.72,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,176.06,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,176.06,
RC Office Visit Est. Int.-G,5413,CDM,982,RC,99213,HCPCS,outpatient,,,263.18,197.39,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,236.86,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,236.86,
WND Wound Est. Int.-PRO,5414,CDM,982,RC,99213,HCPCS,outpatient,,,146.4,109.8,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,131.76,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,131.76,
Telehealth visit INT,5415,CDM,521,RC,99213,HCPCS,outpatient,,,119.06,89.3,,107.15,90,,,percent of total billed charges,90% of total billed charges,110.73,93,,,percent of total billed charges,93% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,101.2,85,,,percent of total billed charges,85% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,96.91,81.4,,,percent of total billed charges,81.4% of total billed charges,107.15,90,,,percent of total billed charges,90% of total billed charges,107.15,90,,,percent of total billed charges,90% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,89.3,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,45.24,110.73,
Telehealth visit INT,5416,CDM,521,RC,99213,HCPCS,outpatient,,,119.06,89.3,,107.15,90,,,percent of total billed charges,90% of total billed charges,110.73,93,,,percent of total billed charges,93% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,101.2,85,,,percent of total billed charges,85% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,96.91,81.4,,,percent of total billed charges,81.4% of total billed charges,107.15,90,,,percent of total billed charges,90% of total billed charges,107.15,90,,,percent of total billed charges,90% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,89.3,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,45.24,110.73,
Telehealth visit INT,5417,CDM,521,RC,99213,HCPCS,outpatient,,,119.06,89.3,,107.15,90,,,percent of total billed charges,90% of total billed charges,110.73,93,,,percent of total billed charges,93% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,101.2,85,,,percent of total billed charges,85% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,96.91,81.4,,,percent of total billed charges,81.4% of total billed charges,107.15,90,,,percent of total billed charges,90% of total billed charges,107.15,90,,,percent of total billed charges,90% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,89.3,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,45.24,110.73,
CONSULT INT EST PRO,5418,CDM,988,RC,99213,HCPCS,outpatient,,,167.78,125.84,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,151,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,151,
DERM OFFICE VISIT EST INT - PRO,5419,CDM,982,RC,99213,HCPCS,outpatient,,,145.38,109.04,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,130.84,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,130.84,
Office Visit Est. Int.-PRO,5420,CDM,982,RC,99213,HCPCS,outpatient,,,77.35,58.01,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,69.62,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,69.62,
Office Visit Est. Ext.,5421,CDM,521,RC,99214,HCPCS,outpatient,,,194.51,145.88,,175.06,90,,,percent of total billed charges,90% of total billed charges,180.89,93,,,percent of total billed charges,93% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,165.33,85,,,percent of total billed charges,85% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,158.33,81.4,,,percent of total billed charges,81.4% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,145.88,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,73.91,180.89,
Office Visit Est. Ext.,5422,CDM,521,RC,99214,HCPCS,outpatient,,,194.51,145.88,,175.06,90,,,percent of total billed charges,90% of total billed charges,180.89,93,,,percent of total billed charges,93% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,165.33,85,,,percent of total billed charges,85% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,158.33,81.4,,,percent of total billed charges,81.4% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,145.88,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,73.91,180.89,
Office Visit Est. Ext.,5423,CDM,521,RC,99214,HCPCS,outpatient,,,194.51,145.88,,175.06,90,,,percent of total billed charges,90% of total billed charges,180.89,93,,,percent of total billed charges,93% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,165.33,85,,,percent of total billed charges,85% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,158.33,81.4,,,percent of total billed charges,81.4% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,175.06,90,,,percent of total billed charges,90% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,73.91,38,,,percent of total billed charges,38% of total billed charges,145.88,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,73.91,180.89,
COA Office Vivist EST EXT,5424,CDM,982,RC,99214,HCPCS,outpatient,,,194.51,145.88,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,175.06,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,175.06,
DERM Office Visit Est. Ext.-G,5425,CDM,982,RC,99214,HCPCS,outpatient,,,263.18,197.39,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,236.86,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,236.86,
CONSULT EXT EST FAC-G,5426,CDM,982,RC,99214,HCPCS,outpatient,,,216.48,162.36,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,194.83,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,194.83,
ORTHO Office Visit Est. Ext.-G,5427,CDM,982,RC,99214,HCPCS,outpatient,,,263.18,197.39,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,236.86,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,236.86,
RC Office Visit Est. Ext.-G,5428,CDM,982,RC,99214,HCPCS,outpatient,,,194.51,145.88,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,175.06,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,175.06,
WND Wound Est Ext-PRO,5429,CDM,982,RC,99214,HCPCS,outpatient,,,197.07,147.8,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,177.36,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,177.36,
Telehealth Visit EXT,5430,CDM,521,RC,99214,HCPCS,outpatient,,,129.9,97.43,,116.91,90,,,percent of total billed charges,90% of total billed charges,120.81,93,,,percent of total billed charges,93% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,110.42,85,,,percent of total billed charges,85% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,105.74,81.4,,,percent of total billed charges,81.4% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,97.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,49.36,120.81,
Telehealth Visit EXT,5431,CDM,521,RC,99214,HCPCS,outpatient,,,129.9,97.43,,116.91,90,,,percent of total billed charges,90% of total billed charges,120.81,93,,,percent of total billed charges,93% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,110.42,85,,,percent of total billed charges,85% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,105.74,81.4,,,percent of total billed charges,81.4% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,97.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,49.36,120.81,
Telehealth Visit EXT,5432,CDM,521,RC,99214,HCPCS,outpatient,,,129.9,97.43,,116.91,90,,,percent of total billed charges,90% of total billed charges,120.81,93,,,percent of total billed charges,93% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,110.42,85,,,percent of total billed charges,85% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,105.74,81.4,,,percent of total billed charges,81.4% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,97.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,49.36,120.81,
CONSULT EXT EST PRO,5433,CDM,988,RC,99214,HCPCS,outpatient,,,162.36,121.77,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,146.12,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,146.12,
DERM OFFICE VISIT EST EXT - PRO,5434,CDM,982,RC,99214,HCPCS,outpatient,,,185.71,139.28,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,167.14,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,167.14,
Office Visit Est. Ext.-PRO,5435,CDM,982,RC,99214,HCPCS,outpatient,,,116,87,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,104.4,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,104.4,
Office Visit Est. Ext. +,5436,CDM,521,RC,99215,HCPCS,outpatient,,,294.11,220.58,,264.7,90,,,percent of total billed charges,90% of total billed charges,273.52,93,,,percent of total billed charges,93% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,249.99,85,,,percent of total billed charges,85% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,239.41,81.4,,,percent of total billed charges,81.4% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,220.58,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,111.76,273.52,
Office Visit Est. Ext. +,5437,CDM,521,RC,99215,HCPCS,outpatient,,,294.11,220.58,,264.7,90,,,percent of total billed charges,90% of total billed charges,273.52,93,,,percent of total billed charges,93% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,249.99,85,,,percent of total billed charges,85% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,239.41,81.4,,,percent of total billed charges,81.4% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,220.58,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,111.76,273.52,
Office Visit Est. Ext. +,5438,CDM,521,RC,99215,HCPCS,outpatient,,,294.11,220.58,,264.7,90,,,percent of total billed charges,90% of total billed charges,273.52,93,,,percent of total billed charges,93% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,249.99,85,,,percent of total billed charges,85% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,239.41,81.4,,,percent of total billed charges,81.4% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,220.58,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,111.76,273.52,
RC Office Visit Est. Ext. -G,5439,CDM,982,RC,99215,HCPCS,outpatient,,,294.11,220.58,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,264.7,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,264.7,
DERM OFFICE VISIT EXT + EST - G,5440,CDM,982,RC,99215,HCPCS,outpatient,,,342.77,257.08,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,308.49,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,308.49,
WND Wound Est ext+PRO,5441,CDM,982,RC,99215,HCPCS,outpatient,,,225.23,168.92,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,202.71,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,202.71,
CONSULT EXT+ EST PRO,5442,CDM,988,RC,99215,HCPCS,outpatient,,,276.02,207.02,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,248.42,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,248.42,
DERM OFFICE VISIT EXT + EST - PRO,5443,CDM,982,RC,99215,HCPCS,outpatient,,,224.97,168.73,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,202.47,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,202.47,
CONSULT EXT+ EST -G,5444,CDM,982,RC,99215,HCPCS,outpatient,,,335.55,251.66,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,302,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,302,
Office Visit Est. Ext. +-PRO,5445,CDM,982,RC,99215,HCPCS,outpatient,,,175.77,131.83,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,158.19,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,158.19,
Discharge Observation Care,5446,CDM,987,RC,99217,HCPCS,outpatient,,,172.25,129.19,,93.04,130,,,fee schedule,130% of fee schedule,93.04,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,88.63,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,155.03,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,64.71,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,64.71,155.03,
Initial Observation Care (mod),5447,CDM,987,RC,99219,HCPCS,outpatient,,,288.25,216.19,,144.82,130,,,fee schedule,130% of fee schedule,144.82,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,165.23,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,259.43,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,154.59,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,144.82,259.43,
Initial Hospital Care/Admission (low),5448,CDM,987,RC,99221,HCPCS,outpatient,,,253.12,189.84,,131.24,130,,,fee schedule,130% of fee schedule,131.24,130,,,fee schedule,130% of fee schedule,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,124,119,,,fee schedule,119% of fee schedule,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,100% of fee schedule,227.81,90,,,percent of total billed charges,90% of total billed charges,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,83.5,100,,,fee schedule,100% of fee schedule,53.93,227.81,
Initial Hospital Care/Admission (mod),5449,CDM,987,RC,99222,HCPCS,outpatient,,,342.17,256.63,,178.83,130,,,fee schedule,130% of fee schedule,178.83,130,,,fee schedule,130% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,167.66,119,,,fee schedule,119% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,100% of fee schedule,307.95,90,,,percent of total billed charges,90% of total billed charges,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,131.13,100,,,fee schedule,100% of fee schedule,89.88,307.95,
initial Hospital Care/Admission (high),5450,CDM,987,RC,99223,HCPCS,outpatient,,,421.83,316.37,,262.83,130,,,fee schedule,130% of fee schedule,262.83,130,,,fee schedule,130% of fee schedule,174.96,100,,,fee schedule,Pays 100% Medicare OPPS,174.96,100,,,fee schedule,Pays 100% Medicare OPPS,246.31,119,,,fee schedule,119% of fee schedule,174.96,100,,,fee schedule,Pays 100% Medicare OPPS,174.96,100,,,fee schedule,100% of fee schedule,379.65,90,,,percent of total billed charges,90% of total billed charges,174.96,100,,,fee schedule,Pays 100% Medicare OPPS,174.96,100,,,fee schedule,Pays 100% Medicare OPPS,174.96,100,,,fee schedule,Pays 100% Medicare OPPS,174.96,100,,,fee schedule,Pays 100% Medicare OPPS,125.83,100,,,fee schedule,100% of fee schedule,174.96,100,,,fee schedule,100% of fee schedule,125.83,379.65,
Subsequent Hospital Care/Day (low),5451,CDM,987,RC,99231,HCPCS,outpatient,,,130.06,97.55,,51.08,130,,,fee schedule,130% of fee schedule,51.08,130,,,fee schedule,130% of fee schedule,49.92,100,,,fee schedule,Pays 100% Medicare OPPS,49.92,100,,,fee schedule,Pays 100% Medicare OPPS,47.83,119,,,fee schedule,119% of fee schedule,49.92,100,,,fee schedule,Pays 100% Medicare OPPS,49.92,100,,,fee schedule,100% of fee schedule,117.05,90,,,percent of total billed charges,90% of total billed charges,49.92,100,,,fee schedule,Pays 100% Medicare OPPS,49.92,100,,,fee schedule,Pays 100% Medicare OPPS,49.92,100,,,fee schedule,Pays 100% Medicare OPPS,49.92,100,,,fee schedule,Pays 100% Medicare OPPS,43.14,100,,,fee schedule,100% of fee schedule,49.92,100,,,fee schedule,100% of fee schedule,43.14,117.05,
Subsequent Hospital Care/Day (mod),5452,CDM,987,RC,99232,HCPCS,outpatient,,,183.98,137.99,,93.33,130,,,fee schedule,130% of fee schedule,93.33,130,,,fee schedule,130% of fee schedule,79.8,100,,,fee schedule,Pays 100% Medicare OPPS,79.8,100,,,fee schedule,Pays 100% Medicare OPPS,88.04,119,,,fee schedule,119% of fee schedule,79.8,100,,,fee schedule,Pays 100% Medicare OPPS,79.8,100,,,fee schedule,100% of fee schedule,165.58,90,,,percent of total billed charges,90% of total billed charges,79.8,100,,,fee schedule,Pays 100% Medicare OPPS,79.8,100,,,fee schedule,Pays 100% Medicare OPPS,79.8,100,,,fee schedule,Pays 100% Medicare OPPS,79.8,100,,,fee schedule,Pays 100% Medicare OPPS,71.9,100,,,fee schedule,100% of fee schedule,79.8,100,,,fee schedule,100% of fee schedule,71.9,165.58,
Subsequent Hospital Care/Day (high),5453,CDM,987,RC,99233,HCPCS,outpatient,,,205.05,153.79,,134.2,130,,,fee schedule,130% of fee schedule,134.2,130,,,fee schedule,130% of fee schedule,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,119,,,fee schedule,119% of fee schedule,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,100% of fee schedule,184.55,90,,,percent of total billed charges,90% of total billed charges,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,120.04,100,,,fee schedule,100% of fee schedule,89.88,184.55,
Same Day OBS adm/discharge -Low PRO,5454,CDM,982,RC,99235,HCPCS,outpatient,,,275.71,206.78,,230.53,130,,,fee schedule,130% of fee schedule,230.53,130,,,fee schedule,130% of fee schedule,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,205.75,119,,,fee schedule,119% of fee schedule,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,100% of fee schedule,248.14,90,,,percent of total billed charges,90% of total billed charges,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,160.67,100,,,fee schedule,100% of fee schedule,160.67,248.14,
Same Day OBS Admit/Discharge mod-PRO,5455,CDM,982,RC,99235,HCPCS,outpatient,,,234.09,175.57,,230.53,130,,,fee schedule,130% of fee schedule,230.53,130,,,fee schedule,130% of fee schedule,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,205.75,119,,,fee schedule,119% of fee schedule,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,100% of fee schedule,210.68,90,,,percent of total billed charges,90% of total billed charges,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,160.67,100,,,fee schedule,100% of fee schedule,160.67,230.53,
Same day IP admit/discharge - mod pro,5456,CDM,987,RC,99235,HCPCS,outpatient,,,445.28,333.96,,230.53,130,,,fee schedule,130% of fee schedule,230.53,130,,,fee schedule,130% of fee schedule,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,205.75,119,,,fee schedule,119% of fee schedule,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,100% of fee schedule,400.75,90,,,percent of total billed charges,90% of total billed charges,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,160.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,160.67,100,,,fee schedule,100% of fee schedule,160.67,400.75,
same day OBS admit/discharge-high,5457,CDM,982,RC,99236,HCPCS,outpatient,,,420.32,315.24,,285.99,130,,,fee schedule,130% of fee schedule,285.99,130,,,fee schedule,130% of fee schedule,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,264.79,119,,,fee schedule,119% of fee schedule,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,100% of fee schedule,378.29,90,,,percent of total billed charges,90% of total billed charges,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,210.4,100,,,fee schedule,100% of fee schedule,210.4,378.29,
Same day IP admit discharge E&M high PRO,5458,CDM,987,RC,99236,HCPCS,outpatient,,,592.92,444.69,,285.99,130,,,fee schedule,130% of fee schedule,285.99,130,,,fee schedule,130% of fee schedule,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,264.79,119,,,fee schedule,119% of fee schedule,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,100% of fee schedule,533.63,90,,,percent of total billed charges,90% of total billed charges,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,210.4,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,210.4,100,,,fee schedule,100% of fee schedule,210.4,533.63,
Discharge OBS (30-),5459,CDM,987,RC,99238,HCPCS,outpatient,,,160.22,120.17,,93.09,130,,,fee schedule,130% of fee schedule,93.09,130,,,fee schedule,130% of fee schedule,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,89.07,119,,,fee schedule,119% of fee schedule,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,100% of fee schedule,144.2,90,,,percent of total billed charges,90% of total billed charges,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,71.9,100,,,fee schedule,100% of fee schedule,81.8,100,,,fee schedule,100% of fee schedule,71.9,144.2,
Discharge Hospital Care (30 min or less),5460,CDM,987,RC,99238,HCPCS,outpatient,,,160.55,120.41,,93.09,130,,,fee schedule,130% of fee schedule,93.09,130,,,fee schedule,130% of fee schedule,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,89.07,119,,,fee schedule,119% of fee schedule,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,100% of fee schedule,144.5,90,,,percent of total billed charges,90% of total billed charges,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,81.8,100,,,fee schedule,Pays 100% Medicare OPPS,71.9,100,,,fee schedule,100% of fee schedule,81.8,100,,,fee schedule,100% of fee schedule,71.9,144.5,
Discharge Hospital Care (30 min or more),5461,CDM,987,RC,99239,HCPCS,outpatient,,,173.41,130.06,,138.05,130,,,fee schedule,130% of fee schedule,138.05,130,,,fee schedule,130% of fee schedule,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,130.63,119,,,fee schedule,119% of fee schedule,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,100% of fee schedule,156.07,90,,,percent of total billed charges,90% of total billed charges,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,115.88,100,,,fee schedule,Pays 100% Medicare OPPS,179.75,100,,,fee schedule,100% of fee schedule,115.88,100,,,fee schedule,100% of fee schedule,115.88,179.75,
OFFICE CONSULT-MINOR- 15 MIN,5462,CDM,521,RC,99241,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,75.7,185.27,
OFFICE CONSULT-MINOR- 15 MIN,5463,CDM,521,RC,99241,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,75.7,185.27,
OFFICE CONSULT-MINOR- 15 MIN,5464,CDM,521,RC,99241,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,75.7,185.27,
OFFICE CONSULT-MINOR- 15 MIN,5465,CDM,521,RC,99241,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,75.7,185.27,
OFFICE CONSULT-MINOR- 15 MIN-PRO,5466,CDM,982,RC,99241,HCPCS,outpatient,,,103.12,77.34,,42.02,130,,,fee schedule,130% of fee schedule,42.02,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,40.07,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,92.81,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,53.93,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,40.07,92.81,
OFFICE CONSULT-LOW-30 MIN[Package],5467,CDM,521,RC,99242,HCPCS,outpatient,,,248.42,186.32,,223.58,90,,,percent of total billed charges,90% of total billed charges,231.03,93,,,percent of total billed charges,93% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,211.16,85,,,percent of total billed charges,85% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,202.21,81.4,,,percent of total billed charges,81.4% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,186.32,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,94.4,231.03,
OFFICE CONSULT-LOW-30 MIN[Package],5468,CDM,521,RC,99242,HCPCS,outpatient,,,248.42,186.32,,223.58,90,,,percent of total billed charges,90% of total billed charges,231.03,93,,,percent of total billed charges,93% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,211.16,85,,,percent of total billed charges,85% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,202.21,81.4,,,percent of total billed charges,81.4% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,186.32,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,94.4,231.03,
OFFICE CONSULT-LOW-30 MIN[Package],5469,CDM,521,RC,99242,HCPCS,outpatient,,,248.42,186.32,,223.58,90,,,percent of total billed charges,90% of total billed charges,231.03,93,,,percent of total billed charges,93% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,211.16,85,,,percent of total billed charges,85% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,202.21,81.4,,,percent of total billed charges,81.4% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,186.32,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,94.4,231.03,
OFFICE CONSULT-LOW-30 MIN[Package],5470,CDM,521,RC,99242,HCPCS,outpatient,,,248.42,186.32,,223.58,90,,,percent of total billed charges,90% of total billed charges,231.03,93,,,percent of total billed charges,93% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,211.16,85,,,percent of total billed charges,85% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,202.21,81.4,,,percent of total billed charges,81.4% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,186.32,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,94.4,231.03,
OFFICE COUSULT-LOW-PRO 30 MIN,5471,CDM,982,RC,99242,HCPCS,outpatient,,,120.69,90.52,,88.05,130,,,fee schedule,130% of fee schedule,88.05,130,,,fee schedule,130% of fee schedule,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,84.44,119,,,fee schedule,119% of fee schedule,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,100% of fee schedule,108.62,90,,,percent of total billed charges,90% of total billed charges,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,56.81,100,,,fee schedule,100% of fee schedule,56.81,108.62,
OFFICE COUSULT-LOW-PRO 30 MIN,5472,CDM,982,RC,99242,HCPCS,outpatient,,,120.69,90.52,,88.05,130,,,fee schedule,130% of fee schedule,88.05,130,,,fee schedule,130% of fee schedule,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,84.44,119,,,fee schedule,119% of fee schedule,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,100% of fee schedule,108.62,90,,,percent of total billed charges,90% of total billed charges,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,56.81,100,,,fee schedule,100% of fee schedule,56.81,108.62,
OFFICE COUSULT-LOW-PRO 30 MIN,5473,CDM,982,RC,99242,HCPCS,outpatient,,,120.69,90.52,,88.05,130,,,fee schedule,130% of fee schedule,88.05,130,,,fee schedule,130% of fee schedule,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,84.44,119,,,fee schedule,119% of fee schedule,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,100% of fee schedule,108.62,90,,,percent of total billed charges,90% of total billed charges,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,56.81,100,,,fee schedule,100% of fee schedule,56.81,108.62,
OFFICE CONSULT-MODERATE-40 MIN,5474,CDM,521,RC,99243,HCPCS,outpatient,,,316.38,237.29,,284.74,90,,,percent of total billed charges,90% of total billed charges,294.23,93,,,percent of total billed charges,93% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,257.53,81.4,,,percent of total billed charges,81.4% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,237.29,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,120.22,294.23,
OFFICE CONSULT-MODERATE-40 MIN,5475,CDM,521,RC,99243,HCPCS,outpatient,,,316.38,237.29,,284.74,90,,,percent of total billed charges,90% of total billed charges,294.23,93,,,percent of total billed charges,93% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,257.53,81.4,,,percent of total billed charges,81.4% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,237.29,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,120.22,294.23,
OFFICE CONSULT-MODERATE-40 MIN,5476,CDM,521,RC,99243,HCPCS,outpatient,,,316.38,237.29,,284.74,90,,,percent of total billed charges,90% of total billed charges,294.23,93,,,percent of total billed charges,93% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,257.53,81.4,,,percent of total billed charges,81.4% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,237.29,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,120.22,294.23,
OFFICE CONSULT-MODERATE-40 MIN,5477,CDM,521,RC,99243,HCPCS,outpatient,,,316.38,237.29,,284.74,90,,,percent of total billed charges,90% of total billed charges,294.23,93,,,percent of total billed charges,93% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,257.53,81.4,,,percent of total billed charges,81.4% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,237.29,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,120.22,294.23,
OFFICE CONSULT-MODERATE-40 MIN-PRO,5478,CDM,982,RC,99243,HCPCS,outpatient,,,191.01,143.26,,122.62,130,,,fee schedule,130% of fee schedule,122.62,130,,,fee schedule,130% of fee schedule,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,118.06,119,,,fee schedule,119% of fee schedule,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,100% of fee schedule,171.91,90,,,percent of total billed charges,90% of total billed charges,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,107.85,100,,,fee schedule,100% of fee schedule,89.53,100,,,fee schedule,100% of fee schedule,89.53,171.91,
OFFICE CONSULT-MOD/HIGH-60 MIN,5479,CDM,521,RC,99244,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-MOD/HIGH-60 MIN,5480,CDM,521,RC,99244,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-MOD/HIGH-60 MIN,5481,CDM,521,RC,99244,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-MOD/HIGH-60 MIN,5482,CDM,521,RC,99244,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-MOD/HIGH-60 MIN-PRO,5483,CDM,982,RC,99244,HCPCS,outpatient,,,247.24,185.43,,194.19,130,,,fee schedule,130% of fee schedule,194.19,130,,,fee schedule,130% of fee schedule,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,189.98,119,,,fee schedule,119% of fee schedule,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,100% of fee schedule,222.52,90,,,percent of total billed charges,90% of total billed charges,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,125.83,100,,,fee schedule,100% of fee schedule,136.76,100,,,fee schedule,100% of fee schedule,125.83,222.52,
OFFICE CONSULT-HIGH-HIGH-80 MIN,5484,CDM,521,RC,99245,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-HIGH-HIGH-80 MIN,5485,CDM,521,RC,99245,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-HIGH-HIGH-80 MIN,5486,CDM,521,RC,99245,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-HIGH-HIGH-80 MIN,5487,CDM,521,RC,99245,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-HIGH-HIGH-80 MIN-PRO,5488,CDM,982,RC,99245,HCPCS,outpatient,,,239.06,179.3,,241.07,130,,,fee schedule,130% of fee schedule,241.07,130,,,fee schedule,130% of fee schedule,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,234.79,119,,,fee schedule,119% of fee schedule,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,100% of fee schedule,215.15,90,,,percent of total billed charges,90% of total billed charges,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,230.08,100,,,fee schedule,100% of fee schedule,182.75,100,,,fee schedule,100% of fee schedule,182.75,241.07,
ORTHO-INPATIENT CONSULT-MINOR,5489,CDM,988,RC,99251,HCPCS,outpatient,,,233.17,174.88,,61.57,130,,,fee schedule,130% of fee schedule,61.57,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,60.63,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,209.85,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,53.93,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,53.93,209.85,
ORTHO-INPATIENT CONSULT-MINOR,5490,CDM,988,RC,99251,HCPCS,outpatient,,,233.17,174.88,,61.57,130,,,fee schedule,130% of fee schedule,61.57,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,60.63,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,209.85,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,53.93,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,53.93,209.85,
ORTHO-INPATIENT CONSULT-MINOR,5491,CDM,988,RC,99251,HCPCS,outpatient,,,233.17,174.88,,61.57,130,,,fee schedule,130% of fee schedule,61.57,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,60.63,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,209.85,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,53.93,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,53.93,209.85,
INPATIENT CONSULT LOW,5492,CDM,988,RC,99252,HCPCS,outpatient,,,291.77,218.83,,94.77,130,,,fee schedule,130% of fee schedule,94.77,130,,,fee schedule,130% of fee schedule,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,91.76,119,,,fee schedule,119% of fee schedule,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,100% of fee schedule,262.59,90,,,percent of total billed charges,90% of total billed charges,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,107.85,100,,,fee schedule,100% of fee schedule,72.28,100,,,fee schedule,100% of fee schedule,72.28,262.59,
INPATIENT CONSULT LOW,5493,CDM,988,RC,99252,HCPCS,outpatient,,,291.77,218.83,,94.77,130,,,fee schedule,130% of fee schedule,94.77,130,,,fee schedule,130% of fee schedule,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,91.76,119,,,fee schedule,119% of fee schedule,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,100% of fee schedule,262.59,90,,,percent of total billed charges,90% of total billed charges,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,107.85,100,,,fee schedule,100% of fee schedule,72.28,100,,,fee schedule,100% of fee schedule,72.28,262.59,
INPATIENT CONSULT LOW,5494,CDM,988,RC,99252,HCPCS,outpatient,,,291.77,218.83,,94.77,130,,,fee schedule,130% of fee schedule,94.77,130,,,fee schedule,130% of fee schedule,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,91.76,119,,,fee schedule,119% of fee schedule,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,100% of fee schedule,262.59,90,,,percent of total billed charges,90% of total billed charges,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,72.28,100,,,fee schedule,Pays 100% Medicare OPPS,107.85,100,,,fee schedule,100% of fee schedule,72.28,100,,,fee schedule,100% of fee schedule,72.28,262.59,
INPATIENT CONSULT 40 min,5495,CDM,988,RC,99253,HCPCS,outpatient,,,367.2,275.4,,144.59,130,,,fee schedule,130% of fee schedule,144.59,130,,,fee schedule,130% of fee schedule,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,141.74,119,,,fee schedule,119% of fee schedule,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,100% of fee schedule,330.48,90,,,percent of total billed charges,90% of total billed charges,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,107.85,100,,,fee schedule,100% of fee schedule,101.24,100,,,fee schedule,100% of fee schedule,101.24,330.48,
INPATIENT CONSULT 40 min,5496,CDM,988,RC,99253,HCPCS,outpatient,,,367.2,275.4,,144.59,130,,,fee schedule,130% of fee schedule,144.59,130,,,fee schedule,130% of fee schedule,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,141.74,119,,,fee schedule,119% of fee schedule,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,100% of fee schedule,330.48,90,,,percent of total billed charges,90% of total billed charges,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,107.85,100,,,fee schedule,100% of fee schedule,101.24,100,,,fee schedule,100% of fee schedule,101.24,330.48,
INPATIENT CONSULT 40 min,5497,CDM,988,RC,99253,HCPCS,outpatient,,,367.2,275.4,,144.59,130,,,fee schedule,130% of fee schedule,144.59,130,,,fee schedule,130% of fee schedule,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,141.74,119,,,fee schedule,119% of fee schedule,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,100% of fee schedule,330.48,90,,,percent of total billed charges,90% of total billed charges,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,101.24,100,,,fee schedule,Pays 100% Medicare OPPS,107.85,100,,,fee schedule,100% of fee schedule,101.24,100,,,fee schedule,100% of fee schedule,101.24,330.48,
INPATIENT CONSULT 60 min,5498,CDM,988,RC,99254,HCPCS,outpatient,,,456.96,342.72,,208.62,130,,,fee schedule,130% of fee schedule,208.62,130,,,fee schedule,130% of fee schedule,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,206.35,119,,,fee schedule,119% of fee schedule,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,100% of fee schedule,411.26,90,,,percent of total billed charges,90% of total billed charges,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,125.83,100,,,fee schedule,100% of fee schedule,140.99,100,,,fee schedule,100% of fee schedule,125.83,411.26,
INPATIENT CONSULT 60 min,5499,CDM,988,RC,99254,HCPCS,outpatient,,,456.96,342.72,,208.62,130,,,fee schedule,130% of fee schedule,208.62,130,,,fee schedule,130% of fee schedule,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,206.35,119,,,fee schedule,119% of fee schedule,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,100% of fee schedule,411.26,90,,,percent of total billed charges,90% of total billed charges,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,125.83,100,,,fee schedule,100% of fee schedule,140.99,100,,,fee schedule,100% of fee schedule,125.83,411.26,
INPATIENT CONSULT 60 min,5500,CDM,988,RC,99254,HCPCS,outpatient,,,456.96,342.72,,208.62,130,,,fee schedule,130% of fee schedule,208.62,130,,,fee schedule,130% of fee schedule,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,206.35,119,,,fee schedule,119% of fee schedule,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,100% of fee schedule,411.26,90,,,percent of total billed charges,90% of total billed charges,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,140.99,100,,,fee schedule,Pays 100% Medicare OPPS,125.83,100,,,fee schedule,100% of fee schedule,140.99,100,,,fee schedule,100% of fee schedule,125.83,411.26,
"ED Visit, Minor-PRO",5501,CDM,981,RC,99281,HCPCS,outpatient,,,50.38,37.79,,27.46,130,,,fee schedule,130% of fee schedule,27.46,130,,,fee schedule,130% of fee schedule,11.72,100,,,fee schedule,Pays 100% Medicare OPPS,11.72,100,,,fee schedule,Pays 100% Medicare OPPS,27.43,119,,,fee schedule,119% of fee schedule,11.72,100,,,fee schedule,Pays 100% Medicare OPPS,11.72,100,,,fee schedule,100% of fee schedule,45.34,90,,,percent of total billed charges,90% of total billed charges,11.72,100,,,fee schedule,Pays 100% Medicare OPPS,11.72,100,,,fee schedule,Pays 100% Medicare OPPS,11.72,100,,,fee schedule,Pays 100% Medicare OPPS,11.72,100,,,fee schedule,Pays 100% Medicare OPPS,17.98,100,,,fee schedule,100% of fee schedule,11.72,100,,,fee schedule,100% of fee schedule,11.72,45.34,
"ED Visit, Low Moderate-PRO",5502,CDM,981,RC,99282,HCPCS,outpatient,,,96.09,72.07,,53.98,130,,,fee schedule,130% of fee schedule,53.98,130,,,fee schedule,130% of fee schedule,41.84,100,,,fee schedule,Pays 100% Medicare OPPS,41.84,100,,,fee schedule,Pays 100% Medicare OPPS,52.75,119,,,fee schedule,119% of fee schedule,41.84,100,,,fee schedule,Pays 100% Medicare OPPS,41.84,100,,,fee schedule,100% of fee schedule,86.48,90,,,percent of total billed charges,90% of total billed charges,41.84,100,,,fee schedule,Pays 100% Medicare OPPS,41.84,100,,,fee schedule,Pays 100% Medicare OPPS,41.84,100,,,fee schedule,Pays 100% Medicare OPPS,41.84,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,41.84,100,,,fee schedule,100% of fee schedule,41.84,86.48,
"ED Visit, Moderate-PRO",5503,CDM,981,RC,99283,HCPCS,outpatient,,,153.5,115.13,,80.98,130,,,fee schedule,130% of fee schedule,80.98,130,,,fee schedule,130% of fee schedule,71.8,100,,,fee schedule,Pays 100% Medicare OPPS,71.8,100,,,fee schedule,Pays 100% Medicare OPPS,78.9,119,,,fee schedule,119% of fee schedule,71.8,100,,,fee schedule,Pays 100% Medicare OPPS,71.8,100,,,fee schedule,100% of fee schedule,138.15,90,,,percent of total billed charges,90% of total billed charges,71.8,100,,,fee schedule,Pays 100% Medicare OPPS,71.8,100,,,fee schedule,Pays 100% Medicare OPPS,71.8,100,,,fee schedule,Pays 100% Medicare OPPS,71.8,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,71.8,100,,,fee schedule,100% of fee schedule,71.8,138.15,
"ED Visit, Moderate Complex-PRO",5504,CDM,981,RC,99284,HCPCS,outpatient,,,331.61,248.71,,152.43,130,,,fee schedule,130% of fee schedule,152.43,130,,,fee schedule,130% of fee schedule,120.88,100,,,fee schedule,Pays 100% Medicare OPPS,120.88,100,,,fee schedule,Pays 100% Medicare OPPS,144.78,119,,,fee schedule,119% of fee schedule,120.88,100,,,fee schedule,Pays 100% Medicare OPPS,120.88,100,,,fee schedule,100% of fee schedule,298.45,90,,,percent of total billed charges,90% of total billed charges,120.88,100,,,fee schedule,Pays 100% Medicare OPPS,120.88,100,,,fee schedule,Pays 100% Medicare OPPS,120.88,100,,,fee schedule,Pays 100% Medicare OPPS,120.88,100,,,fee schedule,Pays 100% Medicare OPPS,127.98,100,,,fee schedule,100% of fee schedule,120.88,100,,,fee schedule,100% of fee schedule,120.88,298.45,
"ED Visit, High Complex-PRO",5505,CDM,981,RC,99285,HCPCS,outpatient,,,421.83,316.37,,221.35,130,,,fee schedule,130% of fee schedule,221.35,130,,,fee schedule,130% of fee schedule,175.67,100,,,fee schedule,Pays 100% Medicare OPPS,175.67,100,,,fee schedule,Pays 100% Medicare OPPS,210.24,119,,,fee schedule,119% of fee schedule,175.67,100,,,fee schedule,Pays 100% Medicare OPPS,175.67,100,,,fee schedule,100% of fee schedule,379.65,90,,,percent of total billed charges,90% of total billed charges,175.67,100,,,fee schedule,Pays 100% Medicare OPPS,175.67,100,,,fee schedule,Pays 100% Medicare OPPS,175.67,100,,,fee schedule,Pays 100% Medicare OPPS,175.67,100,,,fee schedule,Pays 100% Medicare OPPS,251.65,100,,,fee schedule,100% of fee schedule,175.67,100,,,fee schedule,100% of fee schedule,175.67,379.65,
CRITICAL CARE First Hour-PRO,5506,CDM,981,RC,99291,HCPCS,outpatient,,,1223.34,917.51,,288.55,130,,,fee schedule,130% of fee schedule,288.55,130,,,fee schedule,130% of fee schedule,214.05,100,,,fee schedule,Pays 100% Medicare OPPS,214.05,100,,,fee schedule,Pays 100% Medicare OPPS,270.02,119,,,fee schedule,119% of fee schedule,214.05,100,,,fee schedule,Pays 100% Medicare OPPS,214.05,100,,,fee schedule,100% of fee schedule,1101.01,90,,,percent of total billed charges,90% of total billed charges,214.05,100,,,fee schedule,Pays 100% Medicare OPPS,214.05,100,,,fee schedule,Pays 100% Medicare OPPS,214.05,100,,,fee schedule,Pays 100% Medicare OPPS,214.05,100,,,fee schedule,Pays 100% Medicare OPPS,215.7,100,,,fee schedule,100% of fee schedule,214.05,100,,,fee schedule,100% of fee schedule,214.05,1101.01,
CRITICAL CARE; each additional 30 mins-PRO,5507,CDM,981,RC,99292,HCPCS,outpatient,,,287.08,215.31,,144.9,130,,,fee schedule,130% of fee schedule,144.9,130,,,fee schedule,130% of fee schedule,107.47,100,,,fee schedule,Pays 100% Medicare OPPS,107.47,100,,,fee schedule,Pays 100% Medicare OPPS,135.84,119,,,fee schedule,119% of fee schedule,107.47,100,,,fee schedule,Pays 100% Medicare OPPS,107.47,100,,,fee schedule,100% of fee schedule,258.37,90,,,percent of total billed charges,90% of total billed charges,107.47,100,,,fee schedule,Pays 100% Medicare OPPS,107.47,100,,,fee schedule,Pays 100% Medicare OPPS,107.47,100,,,fee schedule,Pays 100% Medicare OPPS,107.47,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,107.47,100,,,fee schedule,100% of fee schedule,107.47,258.37,
Nursing Facility  Patient;Low PRO  RHC,5508,CDM,521,RC,99304,HCPCS,outpatient,,,189.84,142.38,,170.86,90,,,percent of total billed charges,90% of total billed charges,176.55,93,,,percent of total billed charges,93% of total billed charges,72.14,38,,,percent of total billed charges,38% of total billed charges,72.14,38,,,percent of total billed charges,38% of total billed charges,161.36,85,,,percent of total billed charges,85% of total billed charges,72.14,38,,,percent of total billed charges,38% of total billed charges,154.53,81.4,,,percent of total billed charges,81.4% of total billed charges,170.86,90,,,percent of total billed charges,90% of total billed charges,170.86,90,,,percent of total billed charges,90% of total billed charges,72.14,38,,,percent of total billed charges,38% of total billed charges,72.14,38,,,percent of total billed charges,38% of total billed charges,72.14,38,,,percent of total billed charges,38% of total billed charges,142.38,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,72.14,176.55,
Nursing Facility ;Low SB. NH-PRO,5509,CDM,987,RC,99304,HCPCS,outpatient,,,171.07,128.3,,120.91,130,,,fee schedule,130% of fee schedule,120.91,130,,,fee schedule,130% of fee schedule,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,110.19,119,,,fee schedule,119% of fee schedule,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,100% of fee schedule,153.96,90,,,percent of total billed charges,90% of total billed charges,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,81.45,100,,,fee schedule,100% of fee schedule,81.45,153.96,
Nursing Facility ;Low SB. NH-PRO,5510,CDM,987,RC,99304,HCPCS,outpatient,,,171.07,128.3,,120.91,130,,,fee schedule,130% of fee schedule,120.91,130,,,fee schedule,130% of fee schedule,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,110.19,119,,,fee schedule,119% of fee schedule,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,100% of fee schedule,153.96,90,,,percent of total billed charges,90% of total billed charges,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,81.45,100,,,fee schedule,100% of fee schedule,81.45,153.96,
Nursing FacilitT;Mod RHC,5511,CDM,521,RC,99305,HCPCS,outpatient,,,256.62,192.47,,230.96,90,,,percent of total billed charges,90% of total billed charges,238.66,93,,,percent of total billed charges,93% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,218.13,85,,,percent of total billed charges,85% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,208.89,81.4,,,percent of total billed charges,81.4% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,192.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,97.52,238.66,
"Nursing Facility ;Mod  SB,NH PRO",5512,CDM,987,RC,99305,HCPCS,outpatient,,,234.37,175.78,,169.73,130,,,fee schedule,130% of fee schedule,169.73,130,,,fee schedule,130% of fee schedule,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,157.88,119,,,fee schedule,119% of fee schedule,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,100% of fee schedule,210.93,90,,,percent of total billed charges,90% of total billed charges,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,134.83,100,,,fee schedule,100% of fee schedule,134.83,210.93,
"Nursing Facility ;Mod  SB,NH PRO",5513,CDM,987,RC,99305,HCPCS,outpatient,,,234.37,175.78,,169.73,130,,,fee schedule,130% of fee schedule,169.73,130,,,fee schedule,130% of fee schedule,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,157.88,119,,,fee schedule,119% of fee schedule,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,100% of fee schedule,210.93,90,,,percent of total billed charges,90% of total billed charges,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,134.83,100,,,fee schedule,100% of fee schedule,134.83,210.93,
Nursing Facility Patient;High -pro,5514,CDM,521,RC,99306,HCPCS,outpatient,,,318.73,239.05,,286.86,90,,,percent of total billed charges,90% of total billed charges,296.42,93,,,percent of total billed charges,93% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,270.92,85,,,percent of total billed charges,85% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,259.45,81.4,,,percent of total billed charges,81.4% of total billed charges,286.86,90,,,percent of total billed charges,90% of total billed charges,286.86,90,,,percent of total billed charges,90% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,121.12,38,,,percent of total billed charges,38% of total billed charges,239.05,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,121.12,296.42,
Nursing Facility ;High-SB NH PRO,5515,CDM,981,RC,99306,HCPCS,outpatient,,,288.25,216.19,,216.44,130,,,fee schedule,130% of fee schedule,216.44,130,,,fee schedule,130% of fee schedule,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,203.56,119,,,fee schedule,119% of fee schedule,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,100% of fee schedule,259.43,90,,,percent of total billed charges,90% of total billed charges,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,184.2,100,,,fee schedule,100% of fee schedule,184.2,259.43,
Nursing Facility ;High-SB NH PRO,5516,CDM,981,RC,99306,HCPCS,outpatient,,,288.25,216.19,,216.44,130,,,fee schedule,130% of fee schedule,216.44,130,,,fee schedule,130% of fee schedule,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,203.56,119,,,fee schedule,119% of fee schedule,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,100% of fee schedule,259.43,90,,,percent of total billed charges,90% of total billed charges,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,184.2,100,,,fee schedule,100% of fee schedule,184.2,259.43,
Nursing Facility subse-:Low minorPRO,5517,CDM,521,RC,99307,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.41,101.34,
Nursing Facility subse-:Low minorPRO,5518,CDM,521,RC,99307,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.41,101.34,
Nursing Facility subse-:Low minorPRO,5519,CDM,521,RC,99307,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.41,101.34,
Nursing Facility Subset:Low stable SB NH-PRO,5520,CDM,987,RC,99307,HCPCS,outpatient,,,108.97,81.73,,57.51,130,,,fee schedule,130% of fee schedule,57.51,130,,,fee schedule,130% of fee schedule,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,53.66,119,,,fee schedule,119% of fee schedule,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,100% of fee schedule,98.07,90,,,percent of total billed charges,90% of total billed charges,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,40.22,100,,,fee schedule,100% of fee schedule,40.22,98.07,
Nursing Facility Subset:Low stable SB NH-PRO,5521,CDM,987,RC,99307,HCPCS,outpatient,,,108.97,81.73,,57.51,130,,,fee schedule,130% of fee schedule,57.51,130,,,fee schedule,130% of fee schedule,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,53.66,119,,,fee schedule,119% of fee schedule,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,100% of fee schedule,98.07,90,,,percent of total billed charges,90% of total billed charges,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,40.22,100,,,fee schedule,100% of fee schedule,40.22,98.07,
Nursing Facility Subse Pt;Low -RHC,5522,CDM,521,RC,99308,HCPCS,outpatient,,,167.58,125.69,,150.82,90,,,percent of total billed charges,90% of total billed charges,155.85,93,,,percent of total billed charges,93% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,142.44,85,,,percent of total billed charges,85% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,136.41,81.4,,,percent of total billed charges,81.4% of total billed charges,150.82,90,,,percent of total billed charges,90% of total billed charges,150.82,90,,,percent of total billed charges,90% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,125.69,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,63.68,155.85,
Nursing Facility Subse Pt;Low -RHC,5523,CDM,521,RC,99308,HCPCS,outpatient,,,167.58,125.69,,150.82,90,,,percent of total billed charges,90% of total billed charges,155.85,93,,,percent of total billed charges,93% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,142.44,85,,,percent of total billed charges,85% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,136.41,81.4,,,percent of total billed charges,81.4% of total billed charges,150.82,90,,,percent of total billed charges,90% of total billed charges,150.82,90,,,percent of total billed charges,90% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,63.68,38,,,percent of total billed charges,38% of total billed charges,125.69,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,63.68,155.85,
Nursing facility Subsequent Visit SB NH (minor mod),5524,CDM,987,RC,99308,HCPCS,outpatient,,,153.5,115.13,,88.7,130,,,fee schedule,130% of fee schedule,88.7,130,,,fee schedule,130% of fee schedule,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,84.42,119,,,fee schedule,119% of fee schedule,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,100% of fee schedule,138.15,90,,,percent of total billed charges,90% of total billed charges,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,75.43,100,,,fee schedule,100% of fee schedule,75.43,138.15,
Nursing facility Subsequent Visit SB NH (minor mod),5525,CDM,987,RC,99308,HCPCS,outpatient,,,153.5,115.13,,88.7,130,,,fee schedule,130% of fee schedule,88.7,130,,,fee schedule,130% of fee schedule,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,84.42,119,,,fee schedule,119% of fee schedule,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,100% of fee schedule,138.15,90,,,percent of total billed charges,90% of total billed charges,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,75.43,100,,,fee schedule,100% of fee schedule,75.43,138.15,
"Nursing Fac Subsequent new prob, RHC pro",5526,CDM,521,RC,99309,HCPCS,outpatient,,,227.33,170.5,,204.6,90,,,percent of total billed charges,90% of total billed charges,211.42,93,,,percent of total billed charges,93% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,193.23,85,,,percent of total billed charges,85% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,185.05,81.4,,,percent of total billed charges,81.4% of total billed charges,204.6,90,,,percent of total billed charges,90% of total billed charges,204.6,90,,,percent of total billed charges,90% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,170.5,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,86.39,211.42,
"Nursing Fac Subsequent new prob, RHC pro",5527,CDM,521,RC,99309,HCPCS,outpatient,,,227.33,170.5,,204.6,90,,,percent of total billed charges,90% of total billed charges,211.42,93,,,percent of total billed charges,93% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,193.23,85,,,percent of total billed charges,85% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,185.05,81.4,,,percent of total billed charges,81.4% of total billed charges,204.6,90,,,percent of total billed charges,90% of total billed charges,204.6,90,,,percent of total billed charges,90% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,170.5,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,86.39,211.42,
"Nursing fac Subsequent Visit SB, NH (new problem)pro",5528,CDM,987,RC,99309,HCPCS,outpatient,,,205.05,153.79,,116.82,130,,,fee schedule,130% of fee schedule,116.82,130,,,fee schedule,130% of fee schedule,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,111.31,119,,,fee schedule,119% of fee schedule,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,100% of fee schedule,184.55,90,,,percent of total billed charges,90% of total billed charges,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,108.12,100,,,fee schedule,100% of fee schedule,108.12,184.55,
"Nursing fac Subsequent Visit SB, NH (new problem)pro",5529,CDM,987,RC,99309,HCPCS,outpatient,,,205.05,153.79,,116.82,130,,,fee schedule,130% of fee schedule,116.82,130,,,fee schedule,130% of fee schedule,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,111.31,119,,,fee schedule,119% of fee schedule,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,100% of fee schedule,184.55,90,,,percent of total billed charges,90% of total billed charges,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,108.12,100,,,fee schedule,100% of fee schedule,108.12,184.55,
Nursing Facility ;Medium NH pro,5530,CDM,521,RC,99310,HCPCS,outpatient,,,278.88,209.16,,250.99,90,,,percent of total billed charges,90% of total billed charges,259.36,93,,,percent of total billed charges,93% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,237.05,85,,,percent of total billed charges,85% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,227.01,81.4,,,percent of total billed charges,81.4% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,209.16,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,105.97,259.36,
"Nursing fac Subsequent SB,NH (immed)pro",5531,CDM,960,RC,99310,HCPCS,outpatient,,,258.96,194.22,,173.72,130,,,fee schedule,130% of fee schedule,173.72,130,,,fee schedule,130% of fee schedule,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,164.09,119,,,fee schedule,119% of fee schedule,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,100% of fee schedule,233.06,90,,,percent of total billed charges,90% of total billed charges,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,155.28,100,,,fee schedule,100% of fee schedule,155.28,233.06,
"Nursing fac Subsequent SB,NH (immed)pro",5532,CDM,960,RC,99310,HCPCS,outpatient,,,258.96,194.22,,173.72,130,,,fee schedule,130% of fee schedule,173.72,130,,,fee schedule,130% of fee schedule,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,164.09,119,,,fee schedule,119% of fee schedule,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,100% of fee schedule,233.06,90,,,percent of total billed charges,90% of total billed charges,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,155.28,100,,,fee schedule,100% of fee schedule,155.28,233.06,
Nursing Facility E-M RGH Discharge <30min,5533,CDM,521,RC,99315,HCPCS,outpatient,,,160.55,120.41,,144.5,90,,,percent of total billed charges,90% of total billed charges,149.31,93,,,percent of total billed charges,93% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,136.47,85,,,percent of total billed charges,85% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,130.69,81.4,,,percent of total billed charges,81.4% of total billed charges,144.5,90,,,percent of total billed charges,90% of total billed charges,144.5,90,,,percent of total billed charges,90% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,120.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,61.01,149.31,
Discharge Care Swingbed NH PRO (30 min or less),5534,CDM,960,RC,99315,HCPCS,outpatient,,,235.53,176.65,,84.19,130,,,fee schedule,130% of fee schedule,84.19,130,,,fee schedule,130% of fee schedule,82.6,100,,,fee schedule,Pays 100% Medicare OPPS,82.6,100,,,fee schedule,Pays 100% Medicare OPPS,89.52,119,,,fee schedule,119% of fee schedule,82.6,100,,,fee schedule,Pays 100% Medicare OPPS,82.6,100,,,fee schedule,100% of fee schedule,211.98,90,,,percent of total billed charges,90% of total billed charges,82.6,100,,,fee schedule,Pays 100% Medicare OPPS,82.6,100,,,fee schedule,Pays 100% Medicare OPPS,82.6,100,,,fee schedule,Pays 100% Medicare OPPS,82.6,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,82.6,100,,,fee schedule,100% of fee schedule,82.6,211.98,
Nursing Facility E-M:Established Patient:High,5535,CDM,521,RC,99316,HCPCS,outpatient,,,183.98,137.99,,165.58,90,,,percent of total billed charges,90% of total billed charges,171.1,93,,,percent of total billed charges,93% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,156.38,85,,,percent of total billed charges,85% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,149.76,81.4,,,percent of total billed charges,81.4% of total billed charges,165.58,90,,,percent of total billed charges,90% of total billed charges,165.58,90,,,percent of total billed charges,90% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,137.99,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,69.91,171.1,
Discharge Care Swingbed (30 min or more),5536,CDM,960,RC,99316,HCPCS,outpatient,,,277.71,208.28,,109.14,130,,,fee schedule,130% of fee schedule,109.14,130,,,fee schedule,130% of fee schedule,132.7,100,,,fee schedule,Pays 100% Medicare OPPS,132.7,100,,,fee schedule,Pays 100% Medicare OPPS,128.46,119,,,fee schedule,119% of fee schedule,132.7,100,,,fee schedule,Pays 100% Medicare OPPS,132.7,100,,,fee schedule,100% of fee schedule,249.94,90,,,percent of total billed charges,90% of total billed charges,132.7,100,,,fee schedule,Pays 100% Medicare OPPS,132.7,100,,,fee schedule,Pays 100% Medicare OPPS,132.7,100,,,fee schedule,Pays 100% Medicare OPPS,132.7,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,132.7,100,,,fee schedule,100% of fee schedule,109.14,249.94,
Nursing facility Assess-Pro,5537,CDM,982,RC,99318,HCPCS,outpatient,,,196.87,147.65,,124.24,130,,,fee schedule,130% of fee schedule,124.24,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,117.19,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,177.18,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,117.19,177.18,
Nursing facility Assess-Pro,5538,CDM,982,RC,99318,HCPCS,outpatient,,,196.87,147.65,,124.24,130,,,fee schedule,130% of fee schedule,124.24,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,117.19,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,177.18,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,117.19,177.18,
Nursing facility Assess-Pro,5539,CDM,982,RC,99318,HCPCS,outpatient,,,196.87,147.65,,124.24,130,,,fee schedule,130% of fee schedule,124.24,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,117.19,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,177.18,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,117.19,177.18,
Dom Care- New- Mod -Pro,5540,CDM,982,RC,99325,HCPCS,outpatient,,,229.67,172.25,,103.97,130,,,fee schedule,130% of fee schedule,103.97,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,96.77,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,206.7,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,96.77,206.7,
Dom Care- New-High- Pro,5541,CDM,982,RC,99326,HCPCS,outpatient,,,260.13,195.1,,182.33,130,,,fee schedule,130% of fee schedule,182.33,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,168.58,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,234.12,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,168.58,234.12,
Dom Care- New-High- 60-Pro,5542,CDM,982,RC,99327,HCPCS,outpatient,,,445.28,333.96,,241.01,130,,,fee schedule,130% of fee schedule,241.01,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,226.52,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,400.75,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,226.52,400.75,
Dom Care- Est- High- 40- Pro,5543,CDM,982,RC,99336,HCPCS,outpatient,,,316.38,237.29,,174.02,130,,,fee schedule,130% of fee schedule,174.02,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,164.37,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,284.74,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,164.37,284.74,
Dom Care- Est- High- 60-Pro,5544,CDM,982,RC,99337,HCPCS,outpatient,,,502.69,377.02,,250.81,130,,,fee schedule,130% of fee schedule,250.81,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,236.82,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,452.42,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,236.82,452.42,
Prev New < 1yr.,5545,CDM,521,RC,99381,HCPCS,outpatient,,,154.67,116,,139.2,90,,,percent of total billed charges,90% of total billed charges,143.84,93,,,percent of total billed charges,93% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,125.9,81.4,,,percent of total billed charges,81.4% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,116,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,58.77,143.84,
Prev New < 1yr.,5546,CDM,521,RC,99381,HCPCS,outpatient,,,154.67,116,,139.2,90,,,percent of total billed charges,90% of total billed charges,143.84,93,,,percent of total billed charges,93% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,125.9,81.4,,,percent of total billed charges,81.4% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,116,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,58.77,143.84,
Prev. New 1-4 yrs.,5547,CDM,521,RC,99382,HCPCS,outpatient,,,154.67,116,,139.2,90,,,percent of total billed charges,90% of total billed charges,143.84,93,,,percent of total billed charges,93% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,125.9,81.4,,,percent of total billed charges,81.4% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,116,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,58.77,143.84,
Prev. New 1-4 yrs.,5548,CDM,521,RC,99382,HCPCS,outpatient,,,154.67,116,,139.2,90,,,percent of total billed charges,90% of total billed charges,143.84,93,,,percent of total billed charges,93% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,125.9,81.4,,,percent of total billed charges,81.4% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,116,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,58.77,143.84,
Prev. New 5-11 yrs.,5549,CDM,521,RC,99383,HCPCS,outpatient,,,243.73,182.8,,219.36,90,,,percent of total billed charges,90% of total billed charges,226.67,93,,,percent of total billed charges,93% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,207.17,85,,,percent of total billed charges,85% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,198.4,81.4,,,percent of total billed charges,81.4% of total billed charges,219.36,90,,,percent of total billed charges,90% of total billed charges,219.36,90,,,percent of total billed charges,90% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,182.8,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,92.62,226.67,
Prev. New 5-11 yrs.,5550,CDM,521,RC,99383,HCPCS,outpatient,,,243.73,182.8,,219.36,90,,,percent of total billed charges,90% of total billed charges,226.67,93,,,percent of total billed charges,93% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,207.17,85,,,percent of total billed charges,85% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,198.4,81.4,,,percent of total billed charges,81.4% of total billed charges,219.36,90,,,percent of total billed charges,90% of total billed charges,219.36,90,,,percent of total billed charges,90% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,92.62,38,,,percent of total billed charges,38% of total billed charges,182.8,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,92.62,226.67,
Prev New;12-17yrs.,5551,CDM,521,RC,99384,HCPCS,outpatient,,,258.96,194.22,,233.06,90,,,percent of total billed charges,90% of total billed charges,240.83,93,,,percent of total billed charges,93% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,220.12,85,,,percent of total billed charges,85% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,210.79,81.4,,,percent of total billed charges,81.4% of total billed charges,233.06,90,,,percent of total billed charges,90% of total billed charges,233.06,90,,,percent of total billed charges,90% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,194.22,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,98.4,240.83,
Prev New;12-17yrs.,5552,CDM,521,RC,99384,HCPCS,outpatient,,,258.96,194.22,,233.06,90,,,percent of total billed charges,90% of total billed charges,240.83,93,,,percent of total billed charges,93% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,220.12,85,,,percent of total billed charges,85% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,210.79,81.4,,,percent of total billed charges,81.4% of total billed charges,233.06,90,,,percent of total billed charges,90% of total billed charges,233.06,90,,,percent of total billed charges,90% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,98.4,38,,,percent of total billed charges,38% of total billed charges,194.22,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,98.4,240.83,
Prev New;18-39 yrs.,5553,CDM,521,RC,99385,HCPCS,outpatient,,,352.71,264.53,,317.44,90,,,percent of total billed charges,90% of total billed charges,328.02,93,,,percent of total billed charges,93% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,299.8,85,,,percent of total billed charges,85% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,287.11,81.4,,,percent of total billed charges,81.4% of total billed charges,317.44,90,,,percent of total billed charges,90% of total billed charges,317.44,90,,,percent of total billed charges,90% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,134.03,38,,,percent of total billed charges,38% of total billed charges,264.53,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,134.03,328.02,
CDL Physical- Age 18-39,5554,CDM,521,RC,99385,HCPCS,outpatient,,,121.86,91.4,,109.67,90,,,percent of total billed charges,90% of total billed charges,113.33,93,,,percent of total billed charges,93% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,99.19,81.4,,,percent of total billed charges,81.4% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,91.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,46.31,113.33,
CDL Physical- Age 18-39,5555,CDM,521,RC,99385,HCPCS,outpatient,,,121.86,91.4,,109.67,90,,,percent of total billed charges,90% of total billed charges,113.33,93,,,percent of total billed charges,93% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,99.19,81.4,,,percent of total billed charges,81.4% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,91.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,46.31,113.33,
Prev. New;40-64yrs.,5556,CDM,521,RC,99386,HCPCS,outpatient,,,379.65,284.74,,341.69,90,,,percent of total billed charges,90% of total billed charges,353.07,93,,,percent of total billed charges,93% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,322.7,85,,,percent of total billed charges,85% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,309.04,81.4,,,percent of total billed charges,81.4% of total billed charges,341.69,90,,,percent of total billed charges,90% of total billed charges,341.69,90,,,percent of total billed charges,90% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,284.74,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,144.27,353.07,
Prev. New;40-64yrs.,5557,CDM,521,RC,99386,HCPCS,outpatient,,,379.65,284.74,,341.69,90,,,percent of total billed charges,90% of total billed charges,353.07,93,,,percent of total billed charges,93% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,322.7,85,,,percent of total billed charges,85% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,309.04,81.4,,,percent of total billed charges,81.4% of total billed charges,341.69,90,,,percent of total billed charges,90% of total billed charges,341.69,90,,,percent of total billed charges,90% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,144.27,38,,,percent of total billed charges,38% of total billed charges,284.74,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,144.27,353.07,
CDL Physical 40-64,5558,CDM,521,RC,99386,HCPCS,outpatient,,,121.86,91.4,,109.67,90,,,percent of total billed charges,90% of total billed charges,113.33,93,,,percent of total billed charges,93% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,99.19,81.4,,,percent of total billed charges,81.4% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,91.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,46.31,113.33,
Prev.New;65 and >,5559,CDM,521,RC,99387,HCPCS,outpatient,,,434.73,326.05,,391.26,90,,,percent of total billed charges,90% of total billed charges,404.3,93,,,percent of total billed charges,93% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,369.52,85,,,percent of total billed charges,85% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,353.87,81.4,,,percent of total billed charges,81.4% of total billed charges,391.26,90,,,percent of total billed charges,90% of total billed charges,391.26,90,,,percent of total billed charges,90% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,326.05,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,165.2,404.3,
Prev.New;65 and >,5560,CDM,521,RC,99387,HCPCS,outpatient,,,434.73,326.05,,391.26,90,,,percent of total billed charges,90% of total billed charges,404.3,93,,,percent of total billed charges,93% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,369.52,85,,,percent of total billed charges,85% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,353.87,81.4,,,percent of total billed charges,81.4% of total billed charges,391.26,90,,,percent of total billed charges,90% of total billed charges,391.26,90,,,percent of total billed charges,90% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,326.05,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,165.2,404.3,
CDL Physical 65 +,5561,CDM,521,RC,99387,HCPCS,outpatient,,,121.86,91.4,,109.67,90,,,percent of total billed charges,90% of total billed charges,113.33,93,,,percent of total billed charges,93% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,99.19,81.4,,,percent of total billed charges,81.4% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,91.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,46.31,113.33,
Prev. Est;< 1yr.,5562,CDM,521,RC,99391,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,40.08,98.09,
Prev. Est;< 1yr.,5563,CDM,521,RC,99391,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,40.08,98.09,
Prev. Est.;1-4yrs.,5564,CDM,521,RC,99392,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,40.08,98.09,
Prev. Est.;1-4yrs.,5565,CDM,521,RC,99392,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,40.08,98.09,
Prev. Est.;5-11yrs,5566,CDM,521,RC,99393,HCPCS,outpatient,,,200.38,150.29,,180.34,90,,,percent of total billed charges,90% of total billed charges,186.35,93,,,percent of total billed charges,93% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,170.32,85,,,percent of total billed charges,85% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,163.11,81.4,,,percent of total billed charges,81.4% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,150.29,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,76.14,186.35,
Prev. Est.;5-11yrs,5567,CDM,521,RC,99393,HCPCS,outpatient,,,200.38,150.29,,180.34,90,,,percent of total billed charges,90% of total billed charges,186.35,93,,,percent of total billed charges,93% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,170.32,85,,,percent of total billed charges,85% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,163.11,81.4,,,percent of total billed charges,81.4% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,150.29,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,76.14,186.35,
Prev. Est.;12-17 yrs.,5568,CDM,521,RC,99394,HCPCS,outpatient,,,217.95,163.46,,196.16,90,,,percent of total billed charges,90% of total billed charges,202.69,93,,,percent of total billed charges,93% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,185.26,85,,,percent of total billed charges,85% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,177.41,81.4,,,percent of total billed charges,81.4% of total billed charges,196.16,90,,,percent of total billed charges,90% of total billed charges,196.16,90,,,percent of total billed charges,90% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,163.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,82.82,202.69,
Prev. Est.;12-17 yrs.,5569,CDM,521,RC,99394,HCPCS,outpatient,,,217.95,163.46,,196.16,90,,,percent of total billed charges,90% of total billed charges,202.69,93,,,percent of total billed charges,93% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,185.26,85,,,percent of total billed charges,85% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,177.41,81.4,,,percent of total billed charges,81.4% of total billed charges,196.16,90,,,percent of total billed charges,90% of total billed charges,196.16,90,,,percent of total billed charges,90% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,82.82,38,,,percent of total billed charges,38% of total billed charges,163.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,82.82,202.69,
Prev. Est.;18-39yrs.,5570,CDM,521,RC,99395,HCPCS,outpatient,,,291.77,218.83,,262.59,90,,,percent of total billed charges,90% of total billed charges,271.35,93,,,percent of total billed charges,93% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,248,85,,,percent of total billed charges,85% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,237.5,81.4,,,percent of total billed charges,81.4% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,218.83,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,110.87,271.35,
Prev. Est.;18-39yrs.,5571,CDM,521,RC,99395,HCPCS,outpatient,,,291.77,218.83,,262.59,90,,,percent of total billed charges,90% of total billed charges,271.35,93,,,percent of total billed charges,93% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,248,85,,,percent of total billed charges,85% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,237.5,81.4,,,percent of total billed charges,81.4% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,218.83,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,110.87,271.35,
Prev. Est.;18-39yrs.,5572,CDM,521,RC,99395,HCPCS,outpatient,,,291.77,218.83,,262.59,90,,,percent of total billed charges,90% of total billed charges,271.35,93,,,percent of total billed charges,93% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,248,85,,,percent of total billed charges,85% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,237.5,81.4,,,percent of total billed charges,81.4% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,218.83,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,110.87,271.35,
Prev. Est.;40-64 yrs.,5573,CDM,521,RC,99396,HCPCS,outpatient,,,333.95,250.46,,300.56,90,,,percent of total billed charges,90% of total billed charges,310.57,93,,,percent of total billed charges,93% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,283.86,85,,,percent of total billed charges,85% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,271.84,81.4,,,percent of total billed charges,81.4% of total billed charges,300.56,90,,,percent of total billed charges,90% of total billed charges,300.56,90,,,percent of total billed charges,90% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,250.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.9,310.57,
Prev. Est.;40-64 yrs.,5574,CDM,521,RC,99396,HCPCS,outpatient,,,333.95,250.46,,300.56,90,,,percent of total billed charges,90% of total billed charges,310.57,93,,,percent of total billed charges,93% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,283.86,85,,,percent of total billed charges,85% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,271.84,81.4,,,percent of total billed charges,81.4% of total billed charges,300.56,90,,,percent of total billed charges,90% of total billed charges,300.56,90,,,percent of total billed charges,90% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,126.9,38,,,percent of total billed charges,38% of total billed charges,250.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.9,310.57,
Prev. Est.;65 and up,5575,CDM,521,RC,99397,HCPCS,outpatient,,,363.24,272.43,,326.92,90,,,percent of total billed charges,90% of total billed charges,337.81,93,,,percent of total billed charges,93% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,308.75,85,,,percent of total billed charges,85% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,295.68,81.4,,,percent of total billed charges,81.4% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,272.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,138.03,337.81,
Prev. Est.;65 and up,5576,CDM,521,RC,99397,HCPCS,outpatient,,,363.24,272.43,,326.92,90,,,percent of total billed charges,90% of total billed charges,337.81,93,,,percent of total billed charges,93% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,308.75,85,,,percent of total billed charges,85% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,295.68,81.4,,,percent of total billed charges,81.4% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,272.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,138.03,337.81,
Smoking/tobacco cessation-3-10min clinic,5577,CDM,521,RC,99406,HCPCS,outpatient,,,29.28,21.96,,26.35,90,,,percent of total billed charges,90% of total billed charges,27.23,93,,,percent of total billed charges,93% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,23.83,81.4,,,percent of total billed charges,81.4% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,21.96,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,11.13,27.23,
Smoking/tobacco cessation-3-10min clinic,5578,CDM,521,RC,99406,HCPCS,outpatient,,,29.28,21.96,,26.35,90,,,percent of total billed charges,90% of total billed charges,27.23,93,,,percent of total billed charges,93% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,23.83,81.4,,,percent of total billed charges,81.4% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,21.96,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,11.13,27.23,
Smoking Counseling,5579,CDM,521,RC,99407,HCPCS,outpatient,,,59.76,44.82,,53.78,90,,,percent of total billed charges,90% of total billed charges,55.58,93,,,percent of total billed charges,93% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,50.8,85,,,percent of total billed charges,85% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,48.64,81.4,,,percent of total billed charges,81.4% of total billed charges,53.78,90,,,percent of total billed charges,90% of total billed charges,53.78,90,,,percent of total billed charges,90% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,44.82,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,22.71,55.58,
Smoking Counseling,5580,CDM,521,RC,99407,HCPCS,outpatient,,,59.76,44.82,,53.78,90,,,percent of total billed charges,90% of total billed charges,55.58,93,,,percent of total billed charges,93% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,50.8,85,,,percent of total billed charges,85% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,48.64,81.4,,,percent of total billed charges,81.4% of total billed charges,53.78,90,,,percent of total billed charges,90% of total billed charges,53.78,90,,,percent of total billed charges,90% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,22.71,38,,,percent of total billed charges,38% of total billed charges,44.82,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,22.71,55.58,
Telephone E & M 11-20 min,5581,CDM,988,RC,99442,HCPCS,outpatient,,,81.18,60.89,,33.32,130,,,fee schedule,130% of fee schedule,33.32,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,73.06,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,66.54,100,,,fee schedule,100% of fee schedule,33.32,73.06,
Telephone E&M 21-30min,5582,CDM,988,RC,99443,HCPCS,outpatient,,,108.24,81.18,,50.18,130,,,fee schedule,130% of fee schedule,50.18,130,,,fee schedule,130% of fee schedule,97.8,100,,,fee schedule,Pays 100% Medicare OPPS,97.8,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,97.8,100,,,fee schedule,Pays 100% Medicare OPPS,97.8,100,,,fee schedule,100% of fee schedule,97.42,90,,,percent of total billed charges,90% of total billed charges,97.8,100,,,fee schedule,Pays 100% Medicare OPPS,97.8,100,,,fee schedule,Pays 100% Medicare OPPS,97.8,100,,,fee schedule,Pays 100% Medicare OPPS,97.8,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,97.8,100,,,fee schedule,100% of fee schedule,50.18,97.8,
complex CCM 60m,5583,CDM,521,RC,99487,HCPCS,outpatient,,,163.2,122.4,,146.88,90,,,percent of total billed charges,90% of total billed charges,151.78,93,,,percent of total billed charges,93% of total billed charges,62.02,38,,,percent of total billed charges,38% of total billed charges,62.02,38,,,percent of total billed charges,38% of total billed charges,138.72,85,,,percent of total billed charges,85% of total billed charges,62.02,38,,,percent of total billed charges,38% of total billed charges,132.84,81.4,,,percent of total billed charges,81.4% of total billed charges,146.88,90,,,percent of total billed charges,90% of total billed charges,146.88,90,,,percent of total billed charges,90% of total billed charges,62.02,38,,,percent of total billed charges,38% of total billed charges,62.02,38,,,percent of total billed charges,38% of total billed charges,62.02,38,,,percent of total billed charges,38% of total billed charges,122.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,62.02,151.78,
Complex CCM add 30 min to 99487,5584,CDM,983,RC,99489,HCPCS,outpatient,,,91.8,68.85,,73.44,80,,,percent of total billed charges,90% of total billed charges,73.44,80,,,percent of total billed charges,93% of total billed charges,50.53,100,,,fee schedule,Pays 100% Medicare OPPS,50.53,100,,,fee schedule,Pays 100% Medicare OPPS,31.51,119,,,fee schedule,119% of fee schedule,50.53,100,,,fee schedule,Pays 100% Medicare OPPS,50.53,100,,,fee schedule,100% of fee schedule,82.62,90,,,percent of total billed charges,90% of total billed charges,50.53,100,,,fee schedule,Pays 100% Medicare OPPS,50.53,100,,,fee schedule,Pays 100% Medicare OPPS,50.53,100,,,fee schedule,Pays 100% Medicare OPPS,50.53,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,50.53,100,,,fee schedule,100% of fee schedule,31.51,82.62,
Advanced Care Planning 30 minutes,5585,CDM,521,RC,99497,HCPCS,outpatient,,,142.8,107.1,,128.52,90,,,percent of total billed charges,90% of total billed charges,132.8,93,,,percent of total billed charges,93% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,121.38,85,,,percent of total billed charges,85% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,116.24,81.4,,,percent of total billed charges,81.4% of total billed charges,128.52,90,,,percent of total billed charges,90% of total billed charges,128.52,90,,,percent of total billed charges,90% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,107.1,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,54.26,132.8,
Advanced Care Planning 30 minutes,5586,CDM,521,RC,99497,HCPCS,outpatient,,,142.8,107.1,,128.52,90,,,percent of total billed charges,90% of total billed charges,132.8,93,,,percent of total billed charges,93% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,121.38,85,,,percent of total billed charges,85% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,116.24,81.4,,,percent of total billed charges,81.4% of total billed charges,128.52,90,,,percent of total billed charges,90% of total billed charges,128.52,90,,,percent of total billed charges,90% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,54.26,38,,,percent of total billed charges,38% of total billed charges,107.1,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,54.26,132.8,
Advanced Care planning addt 30 min,5587,CDM,521,RC,99498,HCPCS,outpatient,,,127.5,95.63,,114.75,90,,,percent of total billed charges,90% of total billed charges,118.58,93,,,percent of total billed charges,93% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,103.79,81.4,,,percent of total billed charges,81.4% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,95.63,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.45,118.58,
Advanced Care planning addt 30 min,5588,CDM,521,RC,99498,HCPCS,outpatient,,,127.5,95.63,,114.75,90,,,percent of total billed charges,90% of total billed charges,118.58,93,,,percent of total billed charges,93% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,103.79,81.4,,,percent of total billed charges,81.4% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,95.63,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,48.45,118.58,
Pessary,5589,CDM,270,RC,A4561,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
Pessary,5590,CDM,270,RC,A4561,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
Oral eval with counseling less than 3 yo,5591,CDM,521,RC,D0145,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,21.37,52.3,
Oral eval with counseling less than 3 yo,5592,CDM,521,RC,D0145,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,21.37,52.3,
Oral eval with counselling age 3-4 yr,5593,CDM,521,RC,D0190,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,21.37,52.3,
Oral eval with counselling age 3-4 yr,5594,CDM,521,RC,D0190,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,21.37,52.3,
Floride Varnish Administation,5595,CDM,250,RC,D1206,HCPCS,outpatient,,,22.08,16.56,,19.87,90,,,percent of total billed charges,90% of total billed charges,20.53,93,,,percent of total billed charges,93% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,18.77,85,,,percent of total billed charges,85% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,17.97,81.4,,,percent of total billed charges,81.4% of total billed charges,19.87,90,,,percent of total billed charges,90% of total billed charges,19.87,90,,,percent of total billed charges,90% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,16.56,75,,,percent of total billed charges,75% of total billed charges,18.77,85,,,percent of total billed charges,85% of total billed charges,8.39,20.53,
Floride Varnish Administation,5596,CDM,250,RC,D1206,HCPCS,outpatient,,,22.08,16.56,,19.87,90,,,percent of total billed charges,90% of total billed charges,20.53,93,,,percent of total billed charges,93% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,18.77,85,,,percent of total billed charges,85% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,17.97,81.4,,,percent of total billed charges,81.4% of total billed charges,19.87,90,,,percent of total billed charges,90% of total billed charges,19.87,90,,,percent of total billed charges,90% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,16.56,75,,,percent of total billed charges,75% of total billed charges,18.77,85,,,percent of total billed charges,85% of total billed charges,8.39,20.53,
Flight Physical Basic Med,5597,CDM,521,RC,,,outpatient,,,56.3,42.23,,50.67,90,,,percent of total billed charges,90% of total billed charges,52.36,93,,,percent of total billed charges,93% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,45.83,81.4,,,percent of total billed charges,81.4% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,42.23,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,21.39,52.36,
Admin vaccine  Pneumovax,5598,CDM,771,RC,G0009,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
"Virtual Communication services, RHC",5599,CDM,521,RC,G0071,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,16.45,40.27,
"Virtual Communication services, RHC",5600,CDM,521,RC,G0071,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,16.45,40.27,
Screening PAP/Breast-Medicare annual,5601,CDM,521,RC,G0101,HCPCS,outpatient,,,141.79,106.34,,127.61,90,,,percent of total billed charges,90% of total billed charges,131.86,93,,,percent of total billed charges,93% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,115.42,81.4,,,percent of total billed charges,81.4% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,106.34,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,53.88,131.86,
Screening PAP/Breast-Medicare annual,5602,CDM,521,RC,G0101,HCPCS,outpatient,,,141.79,106.34,,127.61,90,,,percent of total billed charges,90% of total billed charges,131.86,93,,,percent of total billed charges,93% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,115.42,81.4,,,percent of total billed charges,81.4% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,106.34,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,53.88,131.86,
OR PRO Colonoscopy-Screening (high risk),5603,CDM,975,RC,G0105,HCPCS,outpatient,,,958.5,718.88,,289.68,130,,,fee schedule,130% of fee schedule,289.68,130,,,fee schedule,130% of fee schedule,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,230.07,119,,,fee schedule,119% of fee schedule,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,100% of fee schedule,862.65,90,,,percent of total billed charges,90% of total billed charges,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,184.27,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,184.27,100,,,fee schedule,100% of fee schedule,184.27,862.65,
OR PRO Colonoscopy Screening,5604,CDM,975,RC,G0121,HCPCS,outpatient,,,366.76,275.07,,289.68,130,,,fee schedule,130% of fee schedule,289.68,130,,,fee schedule,130% of fee schedule,184.55,100,,,fee schedule,Pays 100% Medicare OPPS,184.55,100,,,fee schedule,Pays 100% Medicare OPPS,230.86,119,,,fee schedule,119% of fee schedule,184.55,100,,,fee schedule,Pays 100% Medicare OPPS,184.55,100,,,fee schedule,100% of fee schedule,330.08,90,,,percent of total billed charges,90% of total billed charges,184.55,100,,,fee schedule,Pays 100% Medicare OPPS,184.55,100,,,fee schedule,Pays 100% Medicare OPPS,184.55,100,,,fee schedule,Pays 100% Medicare OPPS,184.55,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,184.55,100,,,fee schedule,100% of fee schedule,184.55,330.08,
Counselling for Lung cancer scrrening,5605,CDM,982,RC,G0296,HCPCS,outpatient,,,107,80.25,,85.6,80,,,percent of total billed charges,90% of total billed charges,85.6,80,,,percent of total billed charges,93% of total billed charges,25.9,100,,,fee schedule,Pays 100% Medicare OPPS,25.9,100,,,fee schedule,Pays 100% Medicare OPPS,33.14,119,,,fee schedule,119% of fee schedule,25.9,100,,,fee schedule,Pays 100% Medicare OPPS,25.9,100,,,fee schedule,100% of fee schedule,96.3,90,,,percent of total billed charges,90% of total billed charges,25.9,100,,,fee schedule,Pays 100% Medicare OPPS,25.9,100,,,fee schedule,Pays 100% Medicare OPPS,25.9,100,,,fee schedule,Pays 100% Medicare OPPS,25.9,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.9,100,,,fee schedule,100% of fee schedule,25.9,96.3,
Welcome to Medicare Exam,5606,CDM,521,RC,G0402,HCPCS,outpatient,,,402.67,302,,362.4,90,,,percent of total billed charges,90% of total billed charges,374.48,93,,,percent of total billed charges,93% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,342.27,85,,,percent of total billed charges,85% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,327.77,81.4,,,percent of total billed charges,81.4% of total billed charges,362.4,90,,,percent of total billed charges,90% of total billed charges,362.4,90,,,percent of total billed charges,90% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,302,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,153.01,374.48,
Welcome to Medicare Exam,5607,CDM,521,RC,G0402,HCPCS,outpatient,,,402.67,302,,362.4,90,,,percent of total billed charges,90% of total billed charges,374.48,93,,,percent of total billed charges,93% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,342.27,85,,,percent of total billed charges,85% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,327.77,81.4,,,percent of total billed charges,81.4% of total billed charges,362.4,90,,,percent of total billed charges,90% of total billed charges,362.4,90,,,percent of total billed charges,90% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,153.01,38,,,percent of total billed charges,38% of total billed charges,302,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,153.01,374.48,
EKG- Welcome to medicare pro,5608,CDM,985,RC,G0404,HCPCS,outpatient,,,45.7,34.28,,11.8,130,,,fee schedule,130% of fee schedule,11.8,130,,,fee schedule,130% of fee schedule,6.67,100,,,fee schedule,Pays 100% Medicare OPPS,6.67,100,,,fee schedule,Pays 100% Medicare OPPS,10.59,119,,,fee schedule,119% of fee schedule,6.67,100,,,fee schedule,Pays 100% Medicare OPPS,6.67,100,,,fee schedule,100% of fee schedule,41.13,90,,,percent of total billed charges,90% of total billed charges,6.67,100,,,fee schedule,Pays 100% Medicare OPPS,6.67,100,,,fee schedule,Pays 100% Medicare OPPS,6.67,100,,,fee schedule,Pays 100% Medicare OPPS,6.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,6.67,100,,,fee schedule,100% of fee schedule,6.67,41.13,
Telehealth followup 25m consult,5609,CDM,988,RC,G0407,HCPCS,outpatient,,,151.54,113.66,,93.33,130,,,fee schedule,130% of fee schedule,93.33,130,,,fee schedule,130% of fee schedule,72.99,100,,,fee schedule,Pays 100% Medicare OPPS,72.99,100,,,fee schedule,Pays 100% Medicare OPPS,87.64,119,,,fee schedule,119% of fee schedule,72.99,100,,,fee schedule,Pays 100% Medicare OPPS,72.99,100,,,fee schedule,100% of fee schedule,136.39,90,,,percent of total billed charges,90% of total billed charges,72.99,100,,,fee schedule,Pays 100% Medicare OPPS,72.99,100,,,fee schedule,Pays 100% Medicare OPPS,72.99,100,,,fee schedule,Pays 100% Medicare OPPS,72.99,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,72.99,100,,,fee schedule,100% of fee schedule,72.99,136.39,
Telehealth followup 35 min consult,5610,CDM,988,RC,G0408,HCPCS,outpatient,,,221.9,166.43,,134.2,130,,,fee schedule,130% of fee schedule,134.2,130,,,fee schedule,130% of fee schedule,106.42,100,,,fee schedule,Pays 100% Medicare OPPS,106.42,100,,,fee schedule,Pays 100% Medicare OPPS,126.09,119,,,fee schedule,119% of fee schedule,106.42,100,,,fee schedule,Pays 100% Medicare OPPS,106.42,100,,,fee schedule,100% of fee schedule,199.71,90,,,percent of total billed charges,90% of total billed charges,106.42,100,,,fee schedule,Pays 100% Medicare OPPS,106.42,100,,,fee schedule,Pays 100% Medicare OPPS,106.42,100,,,fee schedule,Pays 100% Medicare OPPS,106.42,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,106.42,100,,,fee schedule,100% of fee schedule,106.42,199.71,
Telehealth consult 70 min,5611,CDM,988,RC,G0427,HCPCS,outpatient,,,324.73,243.55,,262.83,130,,,fee schedule,130% of fee schedule,262.83,130,,,fee schedule,130% of fee schedule,187.22,100,,,fee schedule,Pays 100% Medicare OPPS,187.22,100,,,fee schedule,Pays 100% Medicare OPPS,245.14,119,,,fee schedule,119% of fee schedule,187.22,100,,,fee schedule,Pays 100% Medicare OPPS,187.22,100,,,fee schedule,100% of fee schedule,292.26,90,,,percent of total billed charges,90% of total billed charges,187.22,100,,,fee schedule,Pays 100% Medicare OPPS,187.22,100,,,fee schedule,Pays 100% Medicare OPPS,187.22,100,,,fee schedule,Pays 100% Medicare OPPS,187.22,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,187.22,100,,,fee schedule,100% of fee schedule,187.22,292.26,
Medicare Annual Wellness,5612,CDM,521,RC,G0438,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.46,309.49,
Medicare Annual Wellness,5613,CDM,521,RC,G0438,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.46,309.49,
Medicare Annual Wellness- subsequent,5614,CDM,521,RC,G0439,HCPCS,outpatient,,,265.2,198.9,,238.68,90,,,percent of total billed charges,90% of total billed charges,246.64,93,,,percent of total billed charges,93% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,225.42,85,,,percent of total billed charges,85% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,215.87,81.4,,,percent of total billed charges,81.4% of total billed charges,238.68,90,,,percent of total billed charges,90% of total billed charges,238.68,90,,,percent of total billed charges,90% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,198.9,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,100.78,246.64,
Medicare Annual Wellness- subsequent,5615,CDM,521,RC,G0439,HCPCS,outpatient,,,265.2,198.9,,238.68,90,,,percent of total billed charges,90% of total billed charges,246.64,93,,,percent of total billed charges,93% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,225.42,85,,,percent of total billed charges,85% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,215.87,81.4,,,percent of total billed charges,81.4% of total billed charges,238.68,90,,,percent of total billed charges,90% of total billed charges,238.68,90,,,percent of total billed charges,90% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,100.78,38,,,percent of total billed charges,38% of total billed charges,198.9,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,100.78,246.64,
depression annual screening Medicare,5616,CDM,521,RC,G0444,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
depression annual screening Medicare,5617,CDM,521,RC,G0444,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
"Virtual Communication services, OP",5618,CDM,983,RC,G2012,HCPCS,outpatient,,,26.53,19.9,,21.22,80,,,percent of total billed charges,90% of total billed charges,21.22,80,,,percent of total billed charges,93% of total billed charges,12.61,100,,,fee schedule,Pays 100% Medicare OPPS,12.61,100,,,fee schedule,Pays 100% Medicare OPPS,15.95,119,,,fee schedule,119% of fee schedule,12.61,100,,,fee schedule,Pays 100% Medicare OPPS,12.61,100,,,fee schedule,100% of fee schedule,23.88,90,,,percent of total billed charges,90% of total billed charges,12.61,100,,,fee schedule,Pays 100% Medicare OPPS,12.61,100,,,fee schedule,Pays 100% Medicare OPPS,12.61,100,,,fee schedule,Pays 100% Medicare OPPS,12.61,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,12.61,100,,,fee schedule,100% of fee schedule,12.61,23.88,
Med rec attestation,5619,CDM,969,RC,G8427,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Telehealth Facility Charge,5620,CDM,521,RC,Q3014,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,14.25,34.88,
Telehealth Facility Charge,5621,CDM,521,RC,Q3014,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,14.25,34.88,
WC Initial Report,5622,CDM,510,RC,Z0750,HCPCS,outpatient,,,80.85,60.64,,72.77,90,,,percent of total billed charges,90% of total billed charges,75.19,93,,,percent of total billed charges,93% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,30.72,38,,,percent of total billed charges,38% of total billed charges,65.81,81.4,,,percent of total billed charges,81.4% of total billed charges,72.77,90,,,percent of total billed charges,90% of total billed charges,72.77,90,,,percent of total billed charges,90% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,60.64,75,,,percent of total billed charges,75% of total billed charges,68.72,85,,,percent of total billed charges,85% of total billed charges,30.72,75.19,
WC Progress Report,5623,CDM,510,RC,Z0751,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
WC Closing Report,5624,CDM,510,RC,Z0752,HCPCS,outpatient,,,80.85,60.64,,72.77,90,,,percent of total billed charges,90% of total billed charges,75.19,93,,,percent of total billed charges,93% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,30.72,38,,,percent of total billed charges,38% of total billed charges,65.81,81.4,,,percent of total billed charges,81.4% of total billed charges,72.77,90,,,percent of total billed charges,90% of total billed charges,72.77,90,,,percent of total billed charges,90% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,60.64,75,,,percent of total billed charges,75% of total billed charges,68.72,85,,,percent of total billed charges,85% of total billed charges,30.72,75.19,
WC Initial and Closing Report,5625,CDM,510,RC,Z0753,HCPCS,outpatient,,,80.85,60.64,,72.77,90,,,percent of total billed charges,90% of total billed charges,75.19,93,,,percent of total billed charges,93% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,30.72,38,,,percent of total billed charges,38% of total billed charges,65.81,81.4,,,percent of total billed charges,81.4% of total billed charges,72.77,90,,,percent of total billed charges,90% of total billed charges,72.77,90,,,percent of total billed charges,90% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,60.64,75,,,percent of total billed charges,75% of total billed charges,68.72,85,,,percent of total billed charges,85% of total billed charges,30.72,75.19,
WC Completion of Form,5626,CDM,510,RC,Z0754,HCPCS,outpatient,,,80.85,60.64,,72.77,90,,,percent of total billed charges,90% of total billed charges,75.19,93,,,percent of total billed charges,93% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,30.72,38,,,percent of total billed charges,38% of total billed charges,65.81,81.4,,,percent of total billed charges,81.4% of total billed charges,72.77,90,,,percent of total billed charges,90% of total billed charges,72.77,90,,,percent of total billed charges,90% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,30.72,38,,,percent of total billed charges,38% of total billed charges,60.64,75,,,percent of total billed charges,75% of total billed charges,68.72,85,,,percent of total billed charges,85% of total billed charges,30.72,75.19,
Eye Detection For Foreign Body,5628,CDM,510,RC,70030,HCPCS,outpatient,,,69.14,51.86,,62.23,90,,,percent of total billed charges,90% of total billed charges,64.3,93,,,percent of total billed charges,93% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,26.27,38,,,percent of total billed charges,38% of total billed charges,56.28,81.4,,,percent of total billed charges,81.4% of total billed charges,62.23,90,,,percent of total billed charges,90% of total billed charges,62.23,90,,,percent of total billed charges,90% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,26.27,38,,,percent of total billed charges,38% of total billed charges,51.86,75,,,percent of total billed charges,75% of total billed charges,58.77,85,,,percent of total billed charges,85% of total billed charges,26.27,64.3,
Mandible,5629,CDM,320,RC,70110,HCPCS,outpatient,,,322.23,241.67,,290.01,90,,,percent of total billed charges,90% of total billed charges,299.67,93,,,percent of total billed charges,93% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,273.9,85,,,percent of total billed charges,85% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,262.3,81.4,,,percent of total billed charges,81.4% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,241.67,75,,,percent of total billed charges,75% of total billed charges,273.9,85,,,percent of total billed charges,85% of total billed charges,122.45,299.67,
Mastoids,5630,CDM,320,RC,70130,HCPCS,outpatient,,,322.23,241.67,,290.01,90,,,percent of total billed charges,90% of total billed charges,299.67,93,,,percent of total billed charges,93% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,273.9,85,,,percent of total billed charges,85% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,262.3,81.4,,,percent of total billed charges,81.4% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,241.67,75,,,percent of total billed charges,75% of total billed charges,273.9,85,,,percent of total billed charges,85% of total billed charges,122.45,299.67,
Facial Bones 2V (PA&LAT),5631,CDM,320,RC,70140,HCPCS,outpatient,,,246.08,184.56,,221.47,90,,,percent of total billed charges,90% of total billed charges,228.85,93,,,percent of total billed charges,93% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,209.17,85,,,percent of total billed charges,85% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,200.31,81.4,,,percent of total billed charges,81.4% of total billed charges,221.47,90,,,percent of total billed charges,90% of total billed charges,221.47,90,,,percent of total billed charges,90% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,184.56,75,,,percent of total billed charges,75% of total billed charges,209.17,85,,,percent of total billed charges,85% of total billed charges,93.51,228.85,
Zygomatic Arches,5632,CDM,320,RC,70140,HCPCS,outpatient,,,246.08,184.56,,221.47,90,,,percent of total billed charges,90% of total billed charges,228.85,93,,,percent of total billed charges,93% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,209.17,85,,,percent of total billed charges,85% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,200.31,81.4,,,percent of total billed charges,81.4% of total billed charges,221.47,90,,,percent of total billed charges,90% of total billed charges,221.47,90,,,percent of total billed charges,90% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,184.56,75,,,percent of total billed charges,75% of total billed charges,209.17,85,,,percent of total billed charges,85% of total billed charges,93.51,228.85,
Facial Bones Complete,5633,CDM,320,RC,70150,HCPCS,outpatient,,,330.45,247.84,,297.41,90,,,percent of total billed charges,90% of total billed charges,307.32,93,,,percent of total billed charges,93% of total billed charges,125.57,38,,,percent of total billed charges,38% of total billed charges,125.57,38,,,percent of total billed charges,38% of total billed charges,280.88,85,,,percent of total billed charges,85% of total billed charges,125.57,38,,,percent of total billed charges,38% of total billed charges,268.99,81.4,,,percent of total billed charges,81.4% of total billed charges,297.41,90,,,percent of total billed charges,90% of total billed charges,297.41,90,,,percent of total billed charges,90% of total billed charges,125.57,38,,,percent of total billed charges,38% of total billed charges,125.57,38,,,percent of total billed charges,38% of total billed charges,125.57,38,,,percent of total billed charges,38% of total billed charges,247.84,75,,,percent of total billed charges,75% of total billed charges,280.88,85,,,percent of total billed charges,85% of total billed charges,125.57,307.32,
Nasal Bones,5634,CDM,320,RC,70160,HCPCS,outpatient,,,234.37,175.78,,210.93,90,,,percent of total billed charges,90% of total billed charges,217.96,93,,,percent of total billed charges,93% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,199.21,85,,,percent of total billed charges,85% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,190.78,81.4,,,percent of total billed charges,81.4% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,210.93,90,,,percent of total billed charges,90% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,89.06,38,,,percent of total billed charges,38% of total billed charges,175.78,75,,,percent of total billed charges,75% of total billed charges,199.21,85,,,percent of total billed charges,85% of total billed charges,89.06,217.96,
Orbits,5635,CDM,320,RC,70200,HCPCS,outpatient,,,322.23,241.67,,290.01,90,,,percent of total billed charges,90% of total billed charges,299.67,93,,,percent of total billed charges,93% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,273.9,85,,,percent of total billed charges,85% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,262.3,81.4,,,percent of total billed charges,81.4% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,241.67,75,,,percent of total billed charges,75% of total billed charges,273.9,85,,,percent of total billed charges,85% of total billed charges,122.45,299.67,
Sinus 1 V,5636,CDM,320,RC,70210,HCPCS,outpatient,,,193.34,145.01,,174.01,90,,,percent of total billed charges,90% of total billed charges,179.81,93,,,percent of total billed charges,93% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,164.34,85,,,percent of total billed charges,85% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,157.38,81.4,,,percent of total billed charges,81.4% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,145.01,75,,,percent of total billed charges,75% of total billed charges,164.34,85,,,percent of total billed charges,85% of total billed charges,73.47,179.81,
Waters View,5637,CDM,320,RC,70210,HCPCS,outpatient,,,196.87,147.65,,177.18,90,,,percent of total billed charges,90% of total billed charges,183.09,93,,,percent of total billed charges,93% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,167.34,85,,,percent of total billed charges,85% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,160.25,81.4,,,percent of total billed charges,81.4% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,147.65,75,,,percent of total billed charges,75% of total billed charges,167.34,85,,,percent of total billed charges,85% of total billed charges,74.81,183.09,
Sinus 2 V,5638,CDM,320,RC,70220,HCPCS,outpatient,,,287.08,215.31,,258.37,90,,,percent of total billed charges,90% of total billed charges,266.98,93,,,percent of total billed charges,93% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,244.02,85,,,percent of total billed charges,85% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,233.68,81.4,,,percent of total billed charges,81.4% of total billed charges,258.37,90,,,percent of total billed charges,90% of total billed charges,258.37,90,,,percent of total billed charges,90% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,215.31,75,,,percent of total billed charges,75% of total billed charges,244.02,85,,,percent of total billed charges,85% of total billed charges,109.09,266.98,
Sinus Comp,5639,CDM,320,RC,70220,HCPCS,outpatient,,,287.08,215.31,,258.37,90,,,percent of total billed charges,90% of total billed charges,266.98,93,,,percent of total billed charges,93% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,244.02,85,,,percent of total billed charges,85% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,233.68,81.4,,,percent of total billed charges,81.4% of total billed charges,258.37,90,,,percent of total billed charges,90% of total billed charges,258.37,90,,,percent of total billed charges,90% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,109.09,38,,,percent of total billed charges,38% of total billed charges,215.31,75,,,percent of total billed charges,75% of total billed charges,244.02,85,,,percent of total billed charges,85% of total billed charges,109.09,266.98,
Skull 2 V,5640,CDM,320,RC,70250,HCPCS,outpatient,,,283.57,212.68,,255.21,90,,,percent of total billed charges,90% of total billed charges,263.72,93,,,percent of total billed charges,93% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,241.03,85,,,percent of total billed charges,85% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,230.83,81.4,,,percent of total billed charges,81.4% of total billed charges,255.21,90,,,percent of total billed charges,90% of total billed charges,255.21,90,,,percent of total billed charges,90% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,107.76,38,,,percent of total billed charges,38% of total billed charges,212.68,75,,,percent of total billed charges,75% of total billed charges,241.03,85,,,percent of total billed charges,85% of total billed charges,107.76,263.72,
Skull Comp,5641,CDM,320,RC,70260,HCPCS,outpatient,,,367.93,275.95,,331.14,90,,,percent of total billed charges,90% of total billed charges,342.17,93,,,percent of total billed charges,93% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,312.74,85,,,percent of total billed charges,85% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,299.5,81.4,,,percent of total billed charges,81.4% of total billed charges,331.14,90,,,percent of total billed charges,90% of total billed charges,331.14,90,,,percent of total billed charges,90% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,275.95,75,,,percent of total billed charges,75% of total billed charges,312.74,85,,,percent of total billed charges,85% of total billed charges,139.81,342.17,
TMJS,5642,CDM,320,RC,70330,HCPCS,outpatient,,,303.49,227.62,,273.14,90,,,percent of total billed charges,90% of total billed charges,282.25,93,,,percent of total billed charges,93% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,247.04,81.4,,,percent of total billed charges,81.4% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,227.62,75,,,percent of total billed charges,75% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,282.25,
Neck Soft Tissue,5643,CDM,320,RC,70360,HCPCS,outpatient,,,166.39,124.79,,149.75,90,,,percent of total billed charges,90% of total billed charges,154.74,93,,,percent of total billed charges,93% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,141.43,85,,,percent of total billed charges,85% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,135.44,81.4,,,percent of total billed charges,81.4% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,124.79,75,,,percent of total billed charges,75% of total billed charges,141.43,85,,,percent of total billed charges,85% of total billed charges,63.23,154.74,
Chest 1 View  PA/AP,5644,CDM,320,RC,71045,HCPCS,outpatient,,,137.77,103.33,,123.99,90,,,percent of total billed charges,90% of total billed charges,128.13,93,,,percent of total billed charges,93% of total billed charges,52.35,38,,,percent of total billed charges,38% of total billed charges,52.35,38,,,percent of total billed charges,38% of total billed charges,117.1,85,,,percent of total billed charges,85% of total billed charges,52.35,38,,,percent of total billed charges,38% of total billed charges,112.14,81.4,,,percent of total billed charges,81.4% of total billed charges,123.99,90,,,percent of total billed charges,90% of total billed charges,123.99,90,,,percent of total billed charges,90% of total billed charges,52.35,38,,,percent of total billed charges,38% of total billed charges,52.35,38,,,percent of total billed charges,38% of total billed charges,52.35,38,,,percent of total billed charges,38% of total billed charges,103.33,75,,,percent of total billed charges,75% of total billed charges,117.1,85,,,percent of total billed charges,85% of total billed charges,52.35,128.13,
Chest Apical/Lordotic/decub 1V,5645,CDM,320,RC,71045,HCPCS,outpatient,,,137.39,103.04,,123.65,90,,,percent of total billed charges,90% of total billed charges,127.77,93,,,percent of total billed charges,93% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,116.78,85,,,percent of total billed charges,85% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,111.84,81.4,,,percent of total billed charges,81.4% of total billed charges,123.65,90,,,percent of total billed charges,90% of total billed charges,123.65,90,,,percent of total billed charges,90% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,52.21,38,,,percent of total billed charges,38% of total billed charges,103.04,75,,,percent of total billed charges,75% of total billed charges,116.78,85,,,percent of total billed charges,85% of total billed charges,52.21,127.77,
Chest -2 view  PA/LAT,5646,CDM,320,RC,71046,HCPCS,outpatient,,,146.4,109.8,,131.76,90,,,percent of total billed charges,90% of total billed charges,136.15,93,,,percent of total billed charges,93% of total billed charges,55.63,38,,,percent of total billed charges,38% of total billed charges,55.63,38,,,percent of total billed charges,38% of total billed charges,124.44,85,,,percent of total billed charges,85% of total billed charges,55.63,38,,,percent of total billed charges,38% of total billed charges,119.17,81.4,,,percent of total billed charges,81.4% of total billed charges,131.76,90,,,percent of total billed charges,90% of total billed charges,131.76,90,,,percent of total billed charges,90% of total billed charges,55.63,38,,,percent of total billed charges,38% of total billed charges,55.63,38,,,percent of total billed charges,38% of total billed charges,55.63,38,,,percent of total billed charges,38% of total billed charges,109.8,75,,,percent of total billed charges,75% of total billed charges,124.44,85,,,percent of total billed charges,85% of total billed charges,55.63,136.15,
Ribs Unilat w/o PA CXR,5647,CDM,320,RC,71100,HCPCS,outpatient,,,264.81,198.61,,238.33,90,,,percent of total billed charges,90% of total billed charges,246.27,93,,,percent of total billed charges,93% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,225.09,85,,,percent of total billed charges,85% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,215.56,81.4,,,percent of total billed charges,81.4% of total billed charges,238.33,90,,,percent of total billed charges,90% of total billed charges,238.33,90,,,percent of total billed charges,90% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,198.61,75,,,percent of total billed charges,75% of total billed charges,225.09,85,,,percent of total billed charges,85% of total billed charges,100.63,246.27,
Rib Unilateral w/ PA CXR,5648,CDM,320,RC,71101,HCPCS,outpatient,,,322.23,241.67,,290.01,90,,,percent of total billed charges,90% of total billed charges,299.67,93,,,percent of total billed charges,93% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,273.9,85,,,percent of total billed charges,85% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,262.3,81.4,,,percent of total billed charges,81.4% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,290.01,90,,,percent of total billed charges,90% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,122.45,38,,,percent of total billed charges,38% of total billed charges,241.67,75,,,percent of total billed charges,75% of total billed charges,273.9,85,,,percent of total billed charges,85% of total billed charges,122.45,299.67,
Ribs Bilat w/o PA CXR,5649,CDM,320,RC,71110,HCPCS,outpatient,,,317.55,238.16,,285.8,90,,,percent of total billed charges,90% of total billed charges,295.32,93,,,percent of total billed charges,93% of total billed charges,120.67,38,,,percent of total billed charges,38% of total billed charges,120.67,38,,,percent of total billed charges,38% of total billed charges,269.92,85,,,percent of total billed charges,85% of total billed charges,120.67,38,,,percent of total billed charges,38% of total billed charges,258.49,81.4,,,percent of total billed charges,81.4% of total billed charges,285.8,90,,,percent of total billed charges,90% of total billed charges,285.8,90,,,percent of total billed charges,90% of total billed charges,120.67,38,,,percent of total billed charges,38% of total billed charges,120.67,38,,,percent of total billed charges,38% of total billed charges,120.67,38,,,percent of total billed charges,38% of total billed charges,238.16,75,,,percent of total billed charges,75% of total billed charges,269.92,85,,,percent of total billed charges,85% of total billed charges,120.67,295.32,
Ribs Bilat w/ PA CXR,5650,CDM,320,RC,71111,HCPCS,outpatient,,,428.87,321.65,,385.98,90,,,percent of total billed charges,90% of total billed charges,398.85,93,,,percent of total billed charges,93% of total billed charges,162.97,38,,,percent of total billed charges,38% of total billed charges,162.97,38,,,percent of total billed charges,38% of total billed charges,364.54,85,,,percent of total billed charges,85% of total billed charges,162.97,38,,,percent of total billed charges,38% of total billed charges,349.1,81.4,,,percent of total billed charges,81.4% of total billed charges,385.98,90,,,percent of total billed charges,90% of total billed charges,385.98,90,,,percent of total billed charges,90% of total billed charges,162.97,38,,,percent of total billed charges,38% of total billed charges,162.97,38,,,percent of total billed charges,38% of total billed charges,162.97,38,,,percent of total billed charges,38% of total billed charges,321.65,75,,,percent of total billed charges,75% of total billed charges,364.54,85,,,percent of total billed charges,85% of total billed charges,162.97,398.85,
Sternum,5651,CDM,320,RC,71120,HCPCS,outpatient,,,230.85,173.14,,207.77,90,,,percent of total billed charges,90% of total billed charges,214.69,93,,,percent of total billed charges,93% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,196.22,85,,,percent of total billed charges,85% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,187.91,81.4,,,percent of total billed charges,81.4% of total billed charges,207.77,90,,,percent of total billed charges,90% of total billed charges,207.77,90,,,percent of total billed charges,90% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,173.14,75,,,percent of total billed charges,75% of total billed charges,196.22,85,,,percent of total billed charges,85% of total billed charges,87.72,214.69,
Sterno/Clavicular Jts,5652,CDM,320,RC,71130,HCPCS,outpatient,,,215.6,161.7,,194.04,90,,,percent of total billed charges,90% of total billed charges,200.51,93,,,percent of total billed charges,93% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,175.5,81.4,,,percent of total billed charges,81.4% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,161.7,75,,,percent of total billed charges,75% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,200.51,
C-Spine 3 View or Less,5653,CDM,320,RC,72040,HCPCS,outpatient,,,248.42,186.32,,223.58,90,,,percent of total billed charges,90% of total billed charges,231.03,93,,,percent of total billed charges,93% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,211.16,85,,,percent of total billed charges,85% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,202.21,81.4,,,percent of total billed charges,81.4% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,186.32,75,,,percent of total billed charges,75% of total billed charges,211.16,85,,,percent of total billed charges,85% of total billed charges,94.4,231.03,
C-Spine 4-5 views(Complete),5654,CDM,320,RC,72050,HCPCS,outpatient,,,325.76,244.32,,293.18,90,,,percent of total billed charges,90% of total billed charges,302.96,93,,,percent of total billed charges,93% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,276.9,85,,,percent of total billed charges,85% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,265.17,81.4,,,percent of total billed charges,81.4% of total billed charges,293.18,90,,,percent of total billed charges,90% of total billed charges,293.18,90,,,percent of total billed charges,90% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,123.79,38,,,percent of total billed charges,38% of total billed charges,244.32,75,,,percent of total billed charges,75% of total billed charges,276.9,85,,,percent of total billed charges,85% of total billed charges,123.79,302.96,
C-Spine 6 or More Views (Flexion&Extension),5655,CDM,320,RC,72052,HCPCS,outpatient,,,367.93,275.95,,331.14,90,,,percent of total billed charges,90% of total billed charges,342.17,93,,,percent of total billed charges,93% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,312.74,85,,,percent of total billed charges,85% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,299.5,81.4,,,percent of total billed charges,81.4% of total billed charges,331.14,90,,,percent of total billed charges,90% of total billed charges,331.14,90,,,percent of total billed charges,90% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,275.95,75,,,percent of total billed charges,75% of total billed charges,312.74,85,,,percent of total billed charges,85% of total billed charges,139.81,342.17,
T-Spine 2 V,5656,CDM,320,RC,72070,HCPCS,outpatient,,,270.67,203,,243.6,90,,,percent of total billed charges,90% of total billed charges,251.72,93,,,percent of total billed charges,93% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,230.07,85,,,percent of total billed charges,85% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,220.33,81.4,,,percent of total billed charges,81.4% of total billed charges,243.6,90,,,percent of total billed charges,90% of total billed charges,243.6,90,,,percent of total billed charges,90% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,203,75,,,percent of total billed charges,75% of total billed charges,230.07,85,,,percent of total billed charges,85% of total billed charges,102.85,251.72,
T-Spine Comp,5657,CDM,320,RC,72072,HCPCS,outpatient,,,341.01,255.76,,306.91,90,,,percent of total billed charges,90% of total billed charges,317.14,93,,,percent of total billed charges,93% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,289.86,85,,,percent of total billed charges,85% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,277.58,81.4,,,percent of total billed charges,81.4% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,255.76,75,,,percent of total billed charges,75% of total billed charges,289.86,85,,,percent of total billed charges,85% of total billed charges,129.58,317.14,
Thoraco-Lumbar Spine,5658,CDM,320,RC,72080,HCPCS,outpatient,,,270.67,203,,243.6,90,,,percent of total billed charges,90% of total billed charges,251.72,93,,,percent of total billed charges,93% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,230.07,85,,,percent of total billed charges,85% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,220.33,81.4,,,percent of total billed charges,81.4% of total billed charges,243.6,90,,,percent of total billed charges,90% of total billed charges,243.6,90,,,percent of total billed charges,90% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,203,75,,,percent of total billed charges,75% of total billed charges,230.07,85,,,percent of total billed charges,85% of total billed charges,102.85,251.72,
Scoliosis one view,5659,CDM,320,RC,72081,HCPCS,outpatient,,,225.08,168.81,,202.57,90,,,percent of total billed charges,90% of total billed charges,209.32,93,,,percent of total billed charges,93% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,191.32,85,,,percent of total billed charges,85% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,183.22,81.4,,,percent of total billed charges,81.4% of total billed charges,202.57,90,,,percent of total billed charges,90% of total billed charges,202.57,90,,,percent of total billed charges,90% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,168.81,75,,,percent of total billed charges,75% of total billed charges,191.32,85,,,percent of total billed charges,85% of total billed charges,85.53,209.32,
Scoliosis  2 v,5660,CDM,320,RC,72082,HCPCS,outpatient,,,232.03,174.02,,208.83,90,,,percent of total billed charges,90% of total billed charges,215.79,93,,,percent of total billed charges,93% of total billed charges,88.17,38,,,percent of total billed charges,38% of total billed charges,88.17,38,,,percent of total billed charges,38% of total billed charges,197.23,85,,,percent of total billed charges,85% of total billed charges,88.17,38,,,percent of total billed charges,38% of total billed charges,188.87,81.4,,,percent of total billed charges,81.4% of total billed charges,208.83,90,,,percent of total billed charges,90% of total billed charges,208.83,90,,,percent of total billed charges,90% of total billed charges,88.17,38,,,percent of total billed charges,38% of total billed charges,88.17,38,,,percent of total billed charges,38% of total billed charges,88.17,38,,,percent of total billed charges,38% of total billed charges,174.02,75,,,percent of total billed charges,75% of total billed charges,197.23,85,,,percent of total billed charges,85% of total billed charges,88.17,215.79,
L-Spine 2V-3V,5661,CDM,320,RC,72100,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,257.17,
L-Spine Comp,5662,CDM,320,RC,72110,HCPCS,outpatient,,,367.93,275.95,,331.14,90,,,percent of total billed charges,90% of total billed charges,342.17,93,,,percent of total billed charges,93% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,312.74,85,,,percent of total billed charges,85% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,299.5,81.4,,,percent of total billed charges,81.4% of total billed charges,331.14,90,,,percent of total billed charges,90% of total billed charges,331.14,90,,,percent of total billed charges,90% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,139.81,38,,,percent of total billed charges,38% of total billed charges,275.95,75,,,percent of total billed charges,75% of total billed charges,312.74,85,,,percent of total billed charges,85% of total billed charges,139.81,342.17,
L-Spine 7V (Flex & Ext),5663,CDM,320,RC,72114,HCPCS,outpatient,,,434.73,326.05,,391.26,90,,,percent of total billed charges,90% of total billed charges,404.3,93,,,percent of total billed charges,93% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,369.52,85,,,percent of total billed charges,85% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,353.87,81.4,,,percent of total billed charges,81.4% of total billed charges,391.26,90,,,percent of total billed charges,90% of total billed charges,391.26,90,,,percent of total billed charges,90% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,165.2,38,,,percent of total billed charges,38% of total billed charges,326.05,75,,,percent of total billed charges,75% of total billed charges,369.52,85,,,percent of total billed charges,85% of total billed charges,165.2,404.3,
Pelvis,5664,CDM,320,RC,72170,HCPCS,outpatient,,,226.16,169.62,,203.54,90,,,percent of total billed charges,90% of total billed charges,210.33,93,,,percent of total billed charges,93% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,192.24,85,,,percent of total billed charges,85% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,184.09,81.4,,,percent of total billed charges,81.4% of total billed charges,203.54,90,,,percent of total billed charges,90% of total billed charges,203.54,90,,,percent of total billed charges,90% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,169.62,75,,,percent of total billed charges,75% of total billed charges,192.24,85,,,percent of total billed charges,85% of total billed charges,85.94,210.33,
Pelvis w/Cleaves Position (Baby),5665,CDM,320,RC,72190,HCPCS,outpatient,,,269.5,202.13,,242.55,90,,,percent of total billed charges,90% of total billed charges,250.64,93,,,percent of total billed charges,93% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,229.08,85,,,percent of total billed charges,85% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,219.37,81.4,,,percent of total billed charges,81.4% of total billed charges,242.55,90,,,percent of total billed charges,90% of total billed charges,242.55,90,,,percent of total billed charges,90% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,102.41,38,,,percent of total billed charges,38% of total billed charges,202.13,75,,,percent of total billed charges,75% of total billed charges,229.08,85,,,percent of total billed charges,85% of total billed charges,102.41,250.64,
XRAY SI JTS,5666,CDM,320,RC,72202,HCPCS,outpatient,,,270.67,203,,243.6,90,,,percent of total billed charges,90% of total billed charges,251.72,93,,,percent of total billed charges,93% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,230.07,85,,,percent of total billed charges,85% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,220.33,81.4,,,percent of total billed charges,81.4% of total billed charges,243.6,90,,,percent of total billed charges,90% of total billed charges,243.6,90,,,percent of total billed charges,90% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,102.85,38,,,percent of total billed charges,38% of total billed charges,203,75,,,percent of total billed charges,75% of total billed charges,230.07,85,,,percent of total billed charges,85% of total billed charges,102.85,251.72,
Sacrum/Coccyx,5667,CDM,320,RC,72220,HCPCS,outpatient,,,260.13,195.1,,234.12,90,,,percent of total billed charges,90% of total billed charges,241.92,93,,,percent of total billed charges,93% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,211.75,81.4,,,percent of total billed charges,81.4% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,195.1,75,,,percent of total billed charges,75% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,241.92,
Clavicle L/R,5668,CDM,320,RC,73000,HCPCS,outpatient,,,226.16,169.62,,203.54,90,,,percent of total billed charges,90% of total billed charges,210.33,93,,,percent of total billed charges,93% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,192.24,85,,,percent of total billed charges,85% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,184.09,81.4,,,percent of total billed charges,81.4% of total billed charges,203.54,90,,,percent of total billed charges,90% of total billed charges,203.54,90,,,percent of total billed charges,90% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,169.62,75,,,percent of total billed charges,75% of total billed charges,192.24,85,,,percent of total billed charges,85% of total billed charges,85.94,210.33,
Clavicle bi-lateral,5669,CDM,320,RC,73000,HCPCS,outpatient,,,452.3,339.23,,407.07,90,,,percent of total billed charges,90% of total billed charges,420.64,93,,,percent of total billed charges,93% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,368.17,81.4,,,percent of total billed charges,81.4% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,339.23,75,,,percent of total billed charges,75% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,420.64,
Clavicle bi-lateral,5670,CDM,320,RC,73000,HCPCS,outpatient,,,452.3,339.23,,407.07,90,,,percent of total billed charges,90% of total billed charges,420.64,93,,,percent of total billed charges,93% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,368.17,81.4,,,percent of total billed charges,81.4% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,339.23,75,,,percent of total billed charges,75% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,420.64,
Clavicle bi-lateral,5671,CDM,320,RC,73000,HCPCS,outpatient,,,452.3,339.23,,407.07,90,,,percent of total billed charges,90% of total billed charges,420.64,93,,,percent of total billed charges,93% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,368.17,81.4,,,percent of total billed charges,81.4% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,339.23,75,,,percent of total billed charges,75% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,420.64,
Scapula,5672,CDM,320,RC,73010,HCPCS,outpatient,,,213.26,159.95,,191.93,90,,,percent of total billed charges,90% of total billed charges,198.33,93,,,percent of total billed charges,93% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,181.27,85,,,percent of total billed charges,85% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,173.59,81.4,,,percent of total billed charges,81.4% of total billed charges,191.93,90,,,percent of total billed charges,90% of total billed charges,191.93,90,,,percent of total billed charges,90% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,81.04,38,,,percent of total billed charges,38% of total billed charges,159.95,75,,,percent of total billed charges,75% of total billed charges,181.27,85,,,percent of total billed charges,85% of total billed charges,81.04,198.33,
Scapula bi-lateral,5673,CDM,320,RC,73010,HCPCS,outpatient,,,426.54,319.91,,383.89,90,,,percent of total billed charges,90% of total billed charges,396.68,93,,,percent of total billed charges,93% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,362.56,85,,,percent of total billed charges,85% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,347.2,81.4,,,percent of total billed charges,81.4% of total billed charges,383.89,90,,,percent of total billed charges,90% of total billed charges,383.89,90,,,percent of total billed charges,90% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,319.91,75,,,percent of total billed charges,75% of total billed charges,362.56,85,,,percent of total billed charges,85% of total billed charges,162.09,396.68,
Scapula bi-lateral,5674,CDM,320,RC,73010,HCPCS,outpatient,,,426.54,319.91,,383.89,90,,,percent of total billed charges,90% of total billed charges,396.68,93,,,percent of total billed charges,93% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,362.56,85,,,percent of total billed charges,85% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,347.2,81.4,,,percent of total billed charges,81.4% of total billed charges,383.89,90,,,percent of total billed charges,90% of total billed charges,383.89,90,,,percent of total billed charges,90% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,319.91,75,,,percent of total billed charges,75% of total billed charges,362.56,85,,,percent of total billed charges,85% of total billed charges,162.09,396.68,
Scapula bi-lateral,5675,CDM,320,RC,73010,HCPCS,outpatient,,,426.54,319.91,,383.89,90,,,percent of total billed charges,90% of total billed charges,396.68,93,,,percent of total billed charges,93% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,362.56,85,,,percent of total billed charges,85% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,347.2,81.4,,,percent of total billed charges,81.4% of total billed charges,383.89,90,,,percent of total billed charges,90% of total billed charges,383.89,90,,,percent of total billed charges,90% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,162.09,38,,,percent of total billed charges,38% of total billed charges,319.91,75,,,percent of total billed charges,75% of total billed charges,362.56,85,,,percent of total billed charges,85% of total billed charges,162.09,396.68,
Shoulder 1 V L/R,5676,CDM,320,RC,73020,HCPCS,outpatient,,,166.39,124.79,,149.75,90,,,percent of total billed charges,90% of total billed charges,154.74,93,,,percent of total billed charges,93% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,141.43,85,,,percent of total billed charges,85% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,135.44,81.4,,,percent of total billed charges,81.4% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,124.79,75,,,percent of total billed charges,75% of total billed charges,141.43,85,,,percent of total billed charges,85% of total billed charges,63.23,154.74,
Shoulder bi-lateral 1V,5677,CDM,320,RC,73020,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,309.49,
Shoulder bi-lateral 1V,5678,CDM,320,RC,73020,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,309.49,
Shoulder bi-lateral 1V,5679,CDM,320,RC,73020,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,309.49,
Shoulder 2 V L/R,5680,CDM,320,RC,73030,HCPCS,outpatient,,,205.05,153.79,,184.55,90,,,percent of total billed charges,90% of total billed charges,190.7,93,,,percent of total billed charges,93% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,166.91,81.4,,,percent of total billed charges,81.4% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,153.79,75,,,percent of total billed charges,75% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,190.7,
Shoulder Comp,5681,CDM,320,RC,73030,HCPCS,outpatient,,,223.81,167.86,,201.43,90,,,percent of total billed charges,90% of total billed charges,208.14,93,,,percent of total billed charges,93% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,190.24,85,,,percent of total billed charges,85% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,182.18,81.4,,,percent of total billed charges,81.4% of total billed charges,201.43,90,,,percent of total billed charges,90% of total billed charges,201.43,90,,,percent of total billed charges,90% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,85.05,38,,,percent of total billed charges,38% of total billed charges,167.86,75,,,percent of total billed charges,75% of total billed charges,190.24,85,,,percent of total billed charges,85% of total billed charges,85.05,208.14,
Shoulder bi-lateral 2V,5682,CDM,320,RC,73030,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Shoulder bi-lateral 2V,5683,CDM,320,RC,73030,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Shoulder bi-lateral 2V,5684,CDM,320,RC,73030,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Shoulders Bi-lat complete,5685,CDM,320,RC,73030,HCPCS,outpatient,,,308.17,231.13,,277.35,90,,,percent of total billed charges,90% of total billed charges,286.6,93,,,percent of total billed charges,93% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,261.94,85,,,percent of total billed charges,85% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,250.85,81.4,,,percent of total billed charges,81.4% of total billed charges,277.35,90,,,percent of total billed charges,90% of total billed charges,277.35,90,,,percent of total billed charges,90% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,231.13,75,,,percent of total billed charges,75% of total billed charges,261.94,85,,,percent of total billed charges,85% of total billed charges,117.1,286.6,
Acromion/Clavicular Joints W/WO Wts,5686,CDM,320,RC,73050,HCPCS,outpatient,,,233.17,174.88,,209.85,90,,,percent of total billed charges,90% of total billed charges,216.85,93,,,percent of total billed charges,93% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,198.19,85,,,percent of total billed charges,85% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,189.8,81.4,,,percent of total billed charges,81.4% of total billed charges,209.85,90,,,percent of total billed charges,90% of total billed charges,209.85,90,,,percent of total billed charges,90% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,174.88,75,,,percent of total billed charges,75% of total billed charges,198.19,85,,,percent of total billed charges,85% of total billed charges,88.6,216.85,
Humerus L/R,5687,CDM,320,RC,73060,HCPCS,outpatient,,,230.85,173.14,,207.77,90,,,percent of total billed charges,90% of total billed charges,214.69,93,,,percent of total billed charges,93% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,196.22,85,,,percent of total billed charges,85% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,187.91,81.4,,,percent of total billed charges,81.4% of total billed charges,207.77,90,,,percent of total billed charges,90% of total billed charges,207.77,90,,,percent of total billed charges,90% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,87.72,38,,,percent of total billed charges,38% of total billed charges,173.14,75,,,percent of total billed charges,75% of total billed charges,196.22,85,,,percent of total billed charges,85% of total billed charges,87.72,214.69,
Humerus bi-lateral,5688,CDM,320,RC,73060,HCPCS,outpatient,,,461.68,346.26,,415.51,90,,,percent of total billed charges,90% of total billed charges,429.36,93,,,percent of total billed charges,93% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,392.43,85,,,percent of total billed charges,85% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,375.81,81.4,,,percent of total billed charges,81.4% of total billed charges,415.51,90,,,percent of total billed charges,90% of total billed charges,415.51,90,,,percent of total billed charges,90% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,346.26,75,,,percent of total billed charges,75% of total billed charges,392.43,85,,,percent of total billed charges,85% of total billed charges,175.44,429.36,
Humerus bi-lateral,5689,CDM,320,RC,73060,HCPCS,outpatient,,,461.68,346.26,,415.51,90,,,percent of total billed charges,90% of total billed charges,429.36,93,,,percent of total billed charges,93% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,392.43,85,,,percent of total billed charges,85% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,375.81,81.4,,,percent of total billed charges,81.4% of total billed charges,415.51,90,,,percent of total billed charges,90% of total billed charges,415.51,90,,,percent of total billed charges,90% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,346.26,75,,,percent of total billed charges,75% of total billed charges,392.43,85,,,percent of total billed charges,85% of total billed charges,175.44,429.36,
Humerus bi-lateral,5690,CDM,320,RC,73060,HCPCS,outpatient,,,461.68,346.26,,415.51,90,,,percent of total billed charges,90% of total billed charges,429.36,93,,,percent of total billed charges,93% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,392.43,85,,,percent of total billed charges,85% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,375.81,81.4,,,percent of total billed charges,81.4% of total billed charges,415.51,90,,,percent of total billed charges,90% of total billed charges,415.51,90,,,percent of total billed charges,90% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,175.44,38,,,percent of total billed charges,38% of total billed charges,346.26,75,,,percent of total billed charges,75% of total billed charges,392.43,85,,,percent of total billed charges,85% of total billed charges,175.44,429.36,
Elbow 2 V L/R,5691,CDM,320,RC,73070,HCPCS,outpatient,,,188.67,141.5,,169.8,90,,,percent of total billed charges,90% of total billed charges,175.46,93,,,percent of total billed charges,93% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,160.37,85,,,percent of total billed charges,85% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,153.58,81.4,,,percent of total billed charges,81.4% of total billed charges,169.8,90,,,percent of total billed charges,90% of total billed charges,169.8,90,,,percent of total billed charges,90% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,71.69,38,,,percent of total billed charges,38% of total billed charges,141.5,75,,,percent of total billed charges,75% of total billed charges,160.37,85,,,percent of total billed charges,85% of total billed charges,71.69,175.46,
Elbow bi-lateral 2V,5692,CDM,320,RC,73070,HCPCS,outpatient,,,377.3,282.98,,339.57,90,,,percent of total billed charges,90% of total billed charges,350.89,93,,,percent of total billed charges,93% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,307.12,81.4,,,percent of total billed charges,81.4% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,282.98,75,,,percent of total billed charges,75% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,350.89,
Elbow bi-lateral 2V,5693,CDM,320,RC,73070,HCPCS,outpatient,,,377.3,282.98,,339.57,90,,,percent of total billed charges,90% of total billed charges,350.89,93,,,percent of total billed charges,93% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,307.12,81.4,,,percent of total billed charges,81.4% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,282.98,75,,,percent of total billed charges,75% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,350.89,
Elbow bi-lateral 2V,5694,CDM,320,RC,73070,HCPCS,outpatient,,,377.3,282.98,,339.57,90,,,percent of total billed charges,90% of total billed charges,350.89,93,,,percent of total billed charges,93% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,307.12,81.4,,,percent of total billed charges,81.4% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,282.98,75,,,percent of total billed charges,75% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,350.89,
Elbow Comp L/R,5695,CDM,320,RC,73080,HCPCS,outpatient,,,205.05,153.79,,184.55,90,,,percent of total billed charges,90% of total billed charges,190.7,93,,,percent of total billed charges,93% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,166.91,81.4,,,percent of total billed charges,81.4% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,153.79,75,,,percent of total billed charges,75% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,190.7,
Elbow bi-lateral Comp,5696,CDM,320,RC,73080,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Elbow bi-lateral Comp,5697,CDM,320,RC,73080,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Elbow bi-lateral Comp,5698,CDM,320,RC,73080,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Forearm L/R,5699,CDM,320,RC,73090,HCPCS,outpatient,,,207.41,155.56,,186.67,90,,,percent of total billed charges,90% of total billed charges,192.89,93,,,percent of total billed charges,93% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,176.3,85,,,percent of total billed charges,85% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,168.83,81.4,,,percent of total billed charges,81.4% of total billed charges,186.67,90,,,percent of total billed charges,90% of total billed charges,186.67,90,,,percent of total billed charges,90% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,78.82,38,,,percent of total billed charges,38% of total billed charges,155.56,75,,,percent of total billed charges,75% of total billed charges,176.3,85,,,percent of total billed charges,85% of total billed charges,78.82,192.89,
Forearm bi-lateral,5700,CDM,320,RC,73090,HCPCS,outpatient,,,414.8,311.1,,373.32,90,,,percent of total billed charges,90% of total billed charges,385.76,93,,,percent of total billed charges,93% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,337.65,81.4,,,percent of total billed charges,81.4% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,311.1,75,,,percent of total billed charges,75% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,385.76,
Forearm bi-lateral,5701,CDM,320,RC,73090,HCPCS,outpatient,,,414.8,311.1,,373.32,90,,,percent of total billed charges,90% of total billed charges,385.76,93,,,percent of total billed charges,93% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,337.65,81.4,,,percent of total billed charges,81.4% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,311.1,75,,,percent of total billed charges,75% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,385.76,
Forearm bi-lateral,5702,CDM,320,RC,73090,HCPCS,outpatient,,,414.8,311.1,,373.32,90,,,percent of total billed charges,90% of total billed charges,385.76,93,,,percent of total billed charges,93% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,337.65,81.4,,,percent of total billed charges,81.4% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,311.1,75,,,percent of total billed charges,75% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,385.76,
Upper Extremity Infant,5703,CDM,320,RC,73092,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
Upper Extremity bi-lateral infant,5704,CDM,320,RC,73092,HCPCS,outpatient,,,210.93,158.2,,189.84,90,,,percent of total billed charges,90% of total billed charges,196.16,93,,,percent of total billed charges,93% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,179.29,85,,,percent of total billed charges,85% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,171.7,81.4,,,percent of total billed charges,81.4% of total billed charges,189.84,90,,,percent of total billed charges,90% of total billed charges,189.84,90,,,percent of total billed charges,90% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,158.2,75,,,percent of total billed charges,75% of total billed charges,179.29,85,,,percent of total billed charges,85% of total billed charges,80.15,196.16,
Upper Extremity bi-lateral infant,5705,CDM,320,RC,73092,HCPCS,outpatient,,,210.93,158.2,,189.84,90,,,percent of total billed charges,90% of total billed charges,196.16,93,,,percent of total billed charges,93% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,179.29,85,,,percent of total billed charges,85% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,171.7,81.4,,,percent of total billed charges,81.4% of total billed charges,189.84,90,,,percent of total billed charges,90% of total billed charges,189.84,90,,,percent of total billed charges,90% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,158.2,75,,,percent of total billed charges,75% of total billed charges,179.29,85,,,percent of total billed charges,85% of total billed charges,80.15,196.16,
Upper Extremity bi-lateral infant,5706,CDM,320,RC,73092,HCPCS,outpatient,,,210.93,158.2,,189.84,90,,,percent of total billed charges,90% of total billed charges,196.16,93,,,percent of total billed charges,93% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,179.29,85,,,percent of total billed charges,85% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,171.7,81.4,,,percent of total billed charges,81.4% of total billed charges,189.84,90,,,percent of total billed charges,90% of total billed charges,189.84,90,,,percent of total billed charges,90% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,80.15,38,,,percent of total billed charges,38% of total billed charges,158.2,75,,,percent of total billed charges,75% of total billed charges,179.29,85,,,percent of total billed charges,85% of total billed charges,80.15,196.16,
Wrist 2V L/R,5707,CDM,320,RC,73100,HCPCS,outpatient,,,191.01,143.26,,171.91,90,,,percent of total billed charges,90% of total billed charges,177.64,93,,,percent of total billed charges,93% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,162.36,85,,,percent of total billed charges,85% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,155.48,81.4,,,percent of total billed charges,81.4% of total billed charges,171.91,90,,,percent of total billed charges,90% of total billed charges,171.91,90,,,percent of total billed charges,90% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,72.58,38,,,percent of total billed charges,38% of total billed charges,143.26,75,,,percent of total billed charges,75% of total billed charges,162.36,85,,,percent of total billed charges,85% of total billed charges,72.58,177.64,
Wrist bi-lateral 2V,5708,CDM,320,RC,73100,HCPCS,outpatient,,,381.99,286.49,,343.79,90,,,percent of total billed charges,90% of total billed charges,355.25,93,,,percent of total billed charges,93% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,310.94,81.4,,,percent of total billed charges,81.4% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,286.49,75,,,percent of total billed charges,75% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,355.25,
Wrist bi-lateral 2V,5709,CDM,320,RC,73100,HCPCS,outpatient,,,381.99,286.49,,343.79,90,,,percent of total billed charges,90% of total billed charges,355.25,93,,,percent of total billed charges,93% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,310.94,81.4,,,percent of total billed charges,81.4% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,286.49,75,,,percent of total billed charges,75% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,355.25,
Wrist bi-lateral 2V,5710,CDM,320,RC,73100,HCPCS,outpatient,,,381.99,286.49,,343.79,90,,,percent of total billed charges,90% of total billed charges,355.25,93,,,percent of total billed charges,93% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,310.94,81.4,,,percent of total billed charges,81.4% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,286.49,75,,,percent of total billed charges,75% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,355.25,
Wrist Comp L/R,5711,CDM,320,RC,73110,HCPCS,outpatient,,,215.6,161.7,,194.04,90,,,percent of total billed charges,90% of total billed charges,200.51,93,,,percent of total billed charges,93% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,175.5,81.4,,,percent of total billed charges,81.4% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,161.7,75,,,percent of total billed charges,75% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,200.51,
Wrist bi-lateral complete,5712,CDM,320,RC,73110,HCPCS,outpatient,,,431.23,323.42,,388.11,90,,,percent of total billed charges,90% of total billed charges,401.04,93,,,percent of total billed charges,93% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,366.55,85,,,percent of total billed charges,85% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,351.02,81.4,,,percent of total billed charges,81.4% of total billed charges,388.11,90,,,percent of total billed charges,90% of total billed charges,388.11,90,,,percent of total billed charges,90% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,323.42,75,,,percent of total billed charges,75% of total billed charges,366.55,85,,,percent of total billed charges,85% of total billed charges,163.87,401.04,
Wrist bi-lateral complete,5713,CDM,320,RC,73110,HCPCS,outpatient,,,431.23,323.42,,388.11,90,,,percent of total billed charges,90% of total billed charges,401.04,93,,,percent of total billed charges,93% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,366.55,85,,,percent of total billed charges,85% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,351.02,81.4,,,percent of total billed charges,81.4% of total billed charges,388.11,90,,,percent of total billed charges,90% of total billed charges,388.11,90,,,percent of total billed charges,90% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,323.42,75,,,percent of total billed charges,75% of total billed charges,366.55,85,,,percent of total billed charges,85% of total billed charges,163.87,401.04,
Wrist bi-lateral complete,5714,CDM,320,RC,73110,HCPCS,outpatient,,,431.23,323.42,,388.11,90,,,percent of total billed charges,90% of total billed charges,401.04,93,,,percent of total billed charges,93% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,366.55,85,,,percent of total billed charges,85% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,351.02,81.4,,,percent of total billed charges,81.4% of total billed charges,388.11,90,,,percent of total billed charges,90% of total billed charges,388.11,90,,,percent of total billed charges,90% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,163.87,38,,,percent of total billed charges,38% of total billed charges,323.42,75,,,percent of total billed charges,75% of total billed charges,366.55,85,,,percent of total billed charges,85% of total billed charges,163.87,401.04,
Hand 2 V L/R,5715,CDM,320,RC,73120,HCPCS,outpatient,,,166.39,124.79,,149.75,90,,,percent of total billed charges,90% of total billed charges,154.74,93,,,percent of total billed charges,93% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,141.43,85,,,percent of total billed charges,85% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,135.44,81.4,,,percent of total billed charges,81.4% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,124.79,75,,,percent of total billed charges,75% of total billed charges,141.43,85,,,percent of total billed charges,85% of total billed charges,63.23,154.74,
Hand-bilateral 2 V,5716,CDM,320,RC,73120,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,309.49,
Hand-bilateral 2 V,5717,CDM,320,RC,73120,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,309.49,
Hand-bilateral 2 V,5718,CDM,320,RC,73120,HCPCS,outpatient,,,332.79,249.59,,299.51,90,,,percent of total billed charges,90% of total billed charges,309.49,93,,,percent of total billed charges,93% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,270.89,81.4,,,percent of total billed charges,81.4% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,299.51,90,,,percent of total billed charges,90% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,126.46,38,,,percent of total billed charges,38% of total billed charges,249.59,75,,,percent of total billed charges,75% of total billed charges,282.87,85,,,percent of total billed charges,85% of total billed charges,126.46,309.49,
Hand Complete  L/R,5719,CDM,320,RC,73130,HCPCS,outpatient,,,205.05,153.79,,184.55,90,,,percent of total billed charges,90% of total billed charges,190.7,93,,,percent of total billed charges,93% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,166.91,81.4,,,percent of total billed charges,81.4% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,153.79,75,,,percent of total billed charges,75% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,190.7,
Hand Complete bi-lateral,5720,CDM,320,RC,73130,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Hand Complete bi-lateral,5721,CDM,320,RC,73130,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Hand Complete bi-lateral,5722,CDM,320,RC,73130,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Finger,5723,CDM,320,RC,73140,HCPCS,outpatient,,,205.05,153.79,,184.55,90,,,percent of total billed charges,90% of total billed charges,190.7,93,,,percent of total billed charges,93% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,166.91,81.4,,,percent of total billed charges,81.4% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,153.79,75,,,percent of total billed charges,75% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,190.7,
Finger bi-lateral,5724,CDM,320,RC,73140,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Finger bi-lateral,5725,CDM,320,RC,73140,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Finger bi-lateral,5726,CDM,320,RC,73140,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
HIP Unilateral w pelvis 1 view,5727,CDM,320,RC,73501,HCPCS,outpatient,,,197.22,147.92,,177.5,90,,,percent of total billed charges,90% of total billed charges,183.41,93,,,percent of total billed charges,93% of total billed charges,74.94,38,,,percent of total billed charges,38% of total billed charges,74.94,38,,,percent of total billed charges,38% of total billed charges,167.64,85,,,percent of total billed charges,85% of total billed charges,74.94,38,,,percent of total billed charges,38% of total billed charges,160.54,81.4,,,percent of total billed charges,81.4% of total billed charges,177.5,90,,,percent of total billed charges,90% of total billed charges,177.5,90,,,percent of total billed charges,90% of total billed charges,74.94,38,,,percent of total billed charges,38% of total billed charges,74.94,38,,,percent of total billed charges,38% of total billed charges,74.94,38,,,percent of total billed charges,38% of total billed charges,147.92,75,,,percent of total billed charges,75% of total billed charges,167.64,85,,,percent of total billed charges,85% of total billed charges,74.94,183.41,
Hip Unilat 2 V w pelvis,5728,CDM,320,RC,73502,HCPCS,outpatient,,,253.12,189.84,,227.81,90,,,percent of total billed charges,90% of total billed charges,235.4,93,,,percent of total billed charges,93% of total billed charges,96.19,38,,,percent of total billed charges,38% of total billed charges,96.19,38,,,percent of total billed charges,38% of total billed charges,215.15,85,,,percent of total billed charges,85% of total billed charges,96.19,38,,,percent of total billed charges,38% of total billed charges,206.04,81.4,,,percent of total billed charges,81.4% of total billed charges,227.81,90,,,percent of total billed charges,90% of total billed charges,227.81,90,,,percent of total billed charges,90% of total billed charges,96.19,38,,,percent of total billed charges,38% of total billed charges,96.19,38,,,percent of total billed charges,38% of total billed charges,96.19,38,,,percent of total billed charges,38% of total billed charges,189.84,75,,,percent of total billed charges,75% of total billed charges,215.15,85,,,percent of total billed charges,85% of total billed charges,96.19,235.4,
Hip Bilat w pelvis  2 views,5729,CDM,320,RC,73521,HCPCS,outpatient,,,341.01,255.76,,306.91,90,,,percent of total billed charges,90% of total billed charges,317.14,93,,,percent of total billed charges,93% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,289.86,85,,,percent of total billed charges,85% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,277.58,81.4,,,percent of total billed charges,81.4% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,255.76,75,,,percent of total billed charges,75% of total billed charges,289.86,85,,,percent of total billed charges,85% of total billed charges,129.58,317.14,
Hips Bilat w pelvis 3-4 view,5730,CDM,320,RC,73522,HCPCS,outpatient,,,406.06,304.55,,365.45,90,,,percent of total billed charges,90% of total billed charges,377.64,93,,,percent of total billed charges,93% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,345.15,85,,,percent of total billed charges,85% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,330.53,81.4,,,percent of total billed charges,81.4% of total billed charges,365.45,90,,,percent of total billed charges,90% of total billed charges,365.45,90,,,percent of total billed charges,90% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,304.55,75,,,percent of total billed charges,75% of total billed charges,345.15,85,,,percent of total billed charges,85% of total billed charges,154.3,377.64,
Femur 1 view,5731,CDM,320,RC,73551,HCPCS,outpatient,,,162.41,121.81,,146.17,90,,,percent of total billed charges,90% of total billed charges,151.04,93,,,percent of total billed charges,93% of total billed charges,61.72,38,,,percent of total billed charges,38% of total billed charges,61.72,38,,,percent of total billed charges,38% of total billed charges,138.05,85,,,percent of total billed charges,85% of total billed charges,61.72,38,,,percent of total billed charges,38% of total billed charges,132.2,81.4,,,percent of total billed charges,81.4% of total billed charges,146.17,90,,,percent of total billed charges,90% of total billed charges,146.17,90,,,percent of total billed charges,90% of total billed charges,61.72,38,,,percent of total billed charges,38% of total billed charges,61.72,38,,,percent of total billed charges,38% of total billed charges,61.72,38,,,percent of total billed charges,38% of total billed charges,121.81,75,,,percent of total billed charges,75% of total billed charges,138.05,85,,,percent of total billed charges,85% of total billed charges,61.72,151.04,
Femur bi-lateral 1V,5732,CDM,320,RC,73551,HCPCS,outpatient,,,324.84,243.63,,292.36,90,,,percent of total billed charges,90% of total billed charges,302.1,93,,,percent of total billed charges,93% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,276.11,85,,,percent of total billed charges,85% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,264.42,81.4,,,percent of total billed charges,81.4% of total billed charges,292.36,90,,,percent of total billed charges,90% of total billed charges,292.36,90,,,percent of total billed charges,90% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,243.63,75,,,percent of total billed charges,75% of total billed charges,276.11,85,,,percent of total billed charges,85% of total billed charges,123.44,302.1,
Femur bi-lateral 1V,5733,CDM,320,RC,73551,HCPCS,outpatient,,,324.84,243.63,,292.36,90,,,percent of total billed charges,90% of total billed charges,302.1,93,,,percent of total billed charges,93% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,276.11,85,,,percent of total billed charges,85% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,264.42,81.4,,,percent of total billed charges,81.4% of total billed charges,292.36,90,,,percent of total billed charges,90% of total billed charges,292.36,90,,,percent of total billed charges,90% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,243.63,75,,,percent of total billed charges,75% of total billed charges,276.11,85,,,percent of total billed charges,85% of total billed charges,123.44,302.1,
Femur bi-lateral 1V,5734,CDM,320,RC,73551,HCPCS,outpatient,,,324.84,243.63,,292.36,90,,,percent of total billed charges,90% of total billed charges,302.1,93,,,percent of total billed charges,93% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,276.11,85,,,percent of total billed charges,85% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,264.42,81.4,,,percent of total billed charges,81.4% of total billed charges,292.36,90,,,percent of total billed charges,90% of total billed charges,292.36,90,,,percent of total billed charges,90% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,123.44,38,,,percent of total billed charges,38% of total billed charges,243.63,75,,,percent of total billed charges,75% of total billed charges,276.11,85,,,percent of total billed charges,85% of total billed charges,123.44,302.1,
Femur 2 view,5735,CDM,320,RC,73552,HCPCS,outpatient,,,225.08,168.81,,202.57,90,,,percent of total billed charges,90% of total billed charges,209.32,93,,,percent of total billed charges,93% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,191.32,85,,,percent of total billed charges,85% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,183.22,81.4,,,percent of total billed charges,81.4% of total billed charges,202.57,90,,,percent of total billed charges,90% of total billed charges,202.57,90,,,percent of total billed charges,90% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,85.53,38,,,percent of total billed charges,38% of total billed charges,168.81,75,,,percent of total billed charges,75% of total billed charges,191.32,85,,,percent of total billed charges,85% of total billed charges,85.53,209.32,
Femur bi-lateral 2V,5736,CDM,320,RC,73552,HCPCS,outpatient,,,450.14,337.61,,405.13,90,,,percent of total billed charges,90% of total billed charges,418.63,93,,,percent of total billed charges,93% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,382.62,85,,,percent of total billed charges,85% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,366.41,81.4,,,percent of total billed charges,81.4% of total billed charges,405.13,90,,,percent of total billed charges,90% of total billed charges,405.13,90,,,percent of total billed charges,90% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,337.61,75,,,percent of total billed charges,75% of total billed charges,382.62,85,,,percent of total billed charges,85% of total billed charges,171.05,418.63,
Femur bi-lateral 2V,5737,CDM,320,RC,73552,HCPCS,outpatient,,,450.14,337.61,,405.13,90,,,percent of total billed charges,90% of total billed charges,418.63,93,,,percent of total billed charges,93% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,382.62,85,,,percent of total billed charges,85% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,366.41,81.4,,,percent of total billed charges,81.4% of total billed charges,405.13,90,,,percent of total billed charges,90% of total billed charges,405.13,90,,,percent of total billed charges,90% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,337.61,75,,,percent of total billed charges,75% of total billed charges,382.62,85,,,percent of total billed charges,85% of total billed charges,171.05,418.63,
Femur bi-lateral 2V,5738,CDM,320,RC,73552,HCPCS,outpatient,,,450.14,337.61,,405.13,90,,,percent of total billed charges,90% of total billed charges,418.63,93,,,percent of total billed charges,93% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,382.62,85,,,percent of total billed charges,85% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,366.41,81.4,,,percent of total billed charges,81.4% of total billed charges,405.13,90,,,percent of total billed charges,90% of total billed charges,405.13,90,,,percent of total billed charges,90% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,171.05,38,,,percent of total billed charges,38% of total billed charges,337.61,75,,,percent of total billed charges,75% of total billed charges,382.62,85,,,percent of total billed charges,85% of total billed charges,171.05,418.63,
Knee 1V-2V L/R,5739,CDM,320,RC,73560,HCPCS,outpatient,,,205.05,153.79,,184.55,90,,,percent of total billed charges,90% of total billed charges,190.7,93,,,percent of total billed charges,93% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,166.91,81.4,,,percent of total billed charges,81.4% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,184.55,90,,,percent of total billed charges,90% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,77.92,38,,,percent of total billed charges,38% of total billed charges,153.79,75,,,percent of total billed charges,75% of total billed charges,174.29,85,,,percent of total billed charges,85% of total billed charges,77.92,190.7,
Knee bi-lateral 1V-2V,5740,CDM,320,RC,73560,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Knee bi-lateral 1V-2V,5741,CDM,320,RC,73560,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Knee bi-lateral 1V-2V,5742,CDM,320,RC,73560,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
Knee Comp,5743,CDM,320,RC,73564,HCPCS,outpatient,,,264.81,198.61,,238.33,90,,,percent of total billed charges,90% of total billed charges,246.27,93,,,percent of total billed charges,93% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,225.09,85,,,percent of total billed charges,85% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,215.56,81.4,,,percent of total billed charges,81.4% of total billed charges,238.33,90,,,percent of total billed charges,90% of total billed charges,238.33,90,,,percent of total billed charges,90% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,100.63,38,,,percent of total billed charges,38% of total billed charges,198.61,75,,,percent of total billed charges,75% of total billed charges,225.09,85,,,percent of total billed charges,85% of total billed charges,100.63,246.27,
Knee bi-lateral complete,5744,CDM,320,RC,73564,HCPCS,outpatient,,,529.65,397.24,,476.69,90,,,percent of total billed charges,90% of total billed charges,492.57,93,,,percent of total billed charges,93% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,450.2,85,,,percent of total billed charges,85% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,431.14,81.4,,,percent of total billed charges,81.4% of total billed charges,476.69,90,,,percent of total billed charges,90% of total billed charges,476.69,90,,,percent of total billed charges,90% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,397.24,75,,,percent of total billed charges,75% of total billed charges,450.2,85,,,percent of total billed charges,85% of total billed charges,201.27,492.57,
Knee bi-lateral complete,5745,CDM,320,RC,73564,HCPCS,outpatient,,,529.65,397.24,,476.69,90,,,percent of total billed charges,90% of total billed charges,492.57,93,,,percent of total billed charges,93% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,450.2,85,,,percent of total billed charges,85% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,431.14,81.4,,,percent of total billed charges,81.4% of total billed charges,476.69,90,,,percent of total billed charges,90% of total billed charges,476.69,90,,,percent of total billed charges,90% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,397.24,75,,,percent of total billed charges,75% of total billed charges,450.2,85,,,percent of total billed charges,85% of total billed charges,201.27,492.57,
Knee bi-lateral complete,5746,CDM,320,RC,73564,HCPCS,outpatient,,,529.65,397.24,,476.69,90,,,percent of total billed charges,90% of total billed charges,492.57,93,,,percent of total billed charges,93% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,450.2,85,,,percent of total billed charges,85% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,431.14,81.4,,,percent of total billed charges,81.4% of total billed charges,476.69,90,,,percent of total billed charges,90% of total billed charges,476.69,90,,,percent of total billed charges,90% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,201.27,38,,,percent of total billed charges,38% of total billed charges,397.24,75,,,percent of total billed charges,75% of total billed charges,450.2,85,,,percent of total billed charges,85% of total billed charges,201.27,492.57,
"Knee, Bilat Standing",5747,CDM,320,RC,73565,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,185.27,
Tibia-Fibula L/R,5748,CDM,320,RC,73590,HCPCS,outpatient,,,226.16,169.62,,203.54,90,,,percent of total billed charges,90% of total billed charges,210.33,93,,,percent of total billed charges,93% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,192.24,85,,,percent of total billed charges,85% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,184.09,81.4,,,percent of total billed charges,81.4% of total billed charges,203.54,90,,,percent of total billed charges,90% of total billed charges,203.54,90,,,percent of total billed charges,90% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,85.94,38,,,percent of total billed charges,38% of total billed charges,169.62,75,,,percent of total billed charges,75% of total billed charges,192.24,85,,,percent of total billed charges,85% of total billed charges,85.94,210.33,
Tibia-Fibula bi-lateral,5749,CDM,320,RC,73590,HCPCS,outpatient,,,452.3,339.23,,407.07,90,,,percent of total billed charges,90% of total billed charges,420.64,93,,,percent of total billed charges,93% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,368.17,81.4,,,percent of total billed charges,81.4% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,339.23,75,,,percent of total billed charges,75% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,420.64,
Tibia-Fibula bi-lateral,5750,CDM,320,RC,73590,HCPCS,outpatient,,,452.3,339.23,,407.07,90,,,percent of total billed charges,90% of total billed charges,420.64,93,,,percent of total billed charges,93% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,368.17,81.4,,,percent of total billed charges,81.4% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,339.23,75,,,percent of total billed charges,75% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,420.64,
Tibia-Fibula bi-lateral,5751,CDM,320,RC,73590,HCPCS,outpatient,,,452.3,339.23,,407.07,90,,,percent of total billed charges,90% of total billed charges,420.64,93,,,percent of total billed charges,93% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,368.17,81.4,,,percent of total billed charges,81.4% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,339.23,75,,,percent of total billed charges,75% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,420.64,
Lower Extremity Infant,5752,CDM,510,RC,73592,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
Lower Extremity bi-lateral infant,5753,CDM,320,RC,73592,HCPCS,outpatient,,,215.6,161.7,,194.04,90,,,percent of total billed charges,90% of total billed charges,200.51,93,,,percent of total billed charges,93% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,175.5,81.4,,,percent of total billed charges,81.4% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,161.7,75,,,percent of total billed charges,75% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,200.51,
Lower Extremity bi-lateral infant,5754,CDM,320,RC,73592,HCPCS,outpatient,,,215.6,161.7,,194.04,90,,,percent of total billed charges,90% of total billed charges,200.51,93,,,percent of total billed charges,93% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,175.5,81.4,,,percent of total billed charges,81.4% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,161.7,75,,,percent of total billed charges,75% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,200.51,
Lower Extremity bi-lateral infant,5755,CDM,320,RC,73592,HCPCS,outpatient,,,215.6,161.7,,194.04,90,,,percent of total billed charges,90% of total billed charges,200.51,93,,,percent of total billed charges,93% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,175.5,81.4,,,percent of total billed charges,81.4% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,194.04,90,,,percent of total billed charges,90% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,81.93,38,,,percent of total billed charges,38% of total billed charges,161.7,75,,,percent of total billed charges,75% of total billed charges,183.26,85,,,percent of total billed charges,85% of total billed charges,81.93,200.51,
Ankle 2V,5756,CDM,320,RC,73600,HCPCS,outpatient,,,151.15,113.36,,136.04,90,,,percent of total billed charges,90% of total billed charges,140.57,93,,,percent of total billed charges,93% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,123.04,81.4,,,percent of total billed charges,81.4% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,113.36,75,,,percent of total billed charges,75% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,140.57,
Ankle bi-lateral 2V,5757,CDM,320,RC,73600,HCPCS,outpatient,,,302.33,226.75,,272.1,90,,,percent of total billed charges,90% of total billed charges,281.17,93,,,percent of total billed charges,93% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,256.98,85,,,percent of total billed charges,85% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,246.1,81.4,,,percent of total billed charges,81.4% of total billed charges,272.1,90,,,percent of total billed charges,90% of total billed charges,272.1,90,,,percent of total billed charges,90% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,226.75,75,,,percent of total billed charges,75% of total billed charges,256.98,85,,,percent of total billed charges,85% of total billed charges,114.89,281.17,
Ankle bi-lateral 2V,5758,CDM,320,RC,73600,HCPCS,outpatient,,,302.33,226.75,,272.1,90,,,percent of total billed charges,90% of total billed charges,281.17,93,,,percent of total billed charges,93% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,256.98,85,,,percent of total billed charges,85% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,246.1,81.4,,,percent of total billed charges,81.4% of total billed charges,272.1,90,,,percent of total billed charges,90% of total billed charges,272.1,90,,,percent of total billed charges,90% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,226.75,75,,,percent of total billed charges,75% of total billed charges,256.98,85,,,percent of total billed charges,85% of total billed charges,114.89,281.17,
Ankle bi-lateral 2V,5759,CDM,320,RC,73600,HCPCS,outpatient,,,302.33,226.75,,272.1,90,,,percent of total billed charges,90% of total billed charges,281.17,93,,,percent of total billed charges,93% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,256.98,85,,,percent of total billed charges,85% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,246.1,81.4,,,percent of total billed charges,81.4% of total billed charges,272.1,90,,,percent of total billed charges,90% of total billed charges,272.1,90,,,percent of total billed charges,90% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,114.89,38,,,percent of total billed charges,38% of total billed charges,226.75,75,,,percent of total billed charges,75% of total billed charges,256.98,85,,,percent of total billed charges,85% of total billed charges,114.89,281.17,
Ankle Comp,5760,CDM,320,RC,73610,HCPCS,outpatient,,,227.33,170.5,,204.6,90,,,percent of total billed charges,90% of total billed charges,211.42,93,,,percent of total billed charges,93% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,193.23,85,,,percent of total billed charges,85% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,185.05,81.4,,,percent of total billed charges,81.4% of total billed charges,204.6,90,,,percent of total billed charges,90% of total billed charges,204.6,90,,,percent of total billed charges,90% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,170.5,75,,,percent of total billed charges,75% of total billed charges,193.23,85,,,percent of total billed charges,85% of total billed charges,86.39,211.42,
Ankle bi-lateral complete,5761,CDM,320,RC,73610,HCPCS,outpatient,,,454.65,340.99,,409.19,90,,,percent of total billed charges,90% of total billed charges,422.82,93,,,percent of total billed charges,93% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,386.45,85,,,percent of total billed charges,85% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,370.09,81.4,,,percent of total billed charges,81.4% of total billed charges,409.19,90,,,percent of total billed charges,90% of total billed charges,409.19,90,,,percent of total billed charges,90% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,340.99,75,,,percent of total billed charges,75% of total billed charges,386.45,85,,,percent of total billed charges,85% of total billed charges,172.77,422.82,
Ankle bi-lateral complete,5762,CDM,320,RC,73610,HCPCS,outpatient,,,454.65,340.99,,409.19,90,,,percent of total billed charges,90% of total billed charges,422.82,93,,,percent of total billed charges,93% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,386.45,85,,,percent of total billed charges,85% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,370.09,81.4,,,percent of total billed charges,81.4% of total billed charges,409.19,90,,,percent of total billed charges,90% of total billed charges,409.19,90,,,percent of total billed charges,90% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,340.99,75,,,percent of total billed charges,75% of total billed charges,386.45,85,,,percent of total billed charges,85% of total billed charges,172.77,422.82,
Ankle bi-lateral complete,5763,CDM,320,RC,73610,HCPCS,outpatient,,,454.65,340.99,,409.19,90,,,percent of total billed charges,90% of total billed charges,422.82,93,,,percent of total billed charges,93% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,386.45,85,,,percent of total billed charges,85% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,370.09,81.4,,,percent of total billed charges,81.4% of total billed charges,409.19,90,,,percent of total billed charges,90% of total billed charges,409.19,90,,,percent of total billed charges,90% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,172.77,38,,,percent of total billed charges,38% of total billed charges,340.99,75,,,percent of total billed charges,75% of total billed charges,386.45,85,,,percent of total billed charges,85% of total billed charges,172.77,422.82,
Foot 2V  L/R,5764,CDM,320,RC,73620,HCPCS,outpatient,,,193.34,145.01,,174.01,90,,,percent of total billed charges,90% of total billed charges,179.81,93,,,percent of total billed charges,93% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,164.34,85,,,percent of total billed charges,85% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,157.38,81.4,,,percent of total billed charges,81.4% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,145.01,75,,,percent of total billed charges,75% of total billed charges,164.34,85,,,percent of total billed charges,85% of total billed charges,73.47,179.81,
Foot bi-lateral 2V,5765,CDM,320,RC,73620,HCPCS,outpatient,,,386.67,290,,348,90,,,percent of total billed charges,90% of total billed charges,359.6,93,,,percent of total billed charges,93% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,328.67,85,,,percent of total billed charges,85% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,314.75,81.4,,,percent of total billed charges,81.4% of total billed charges,348,90,,,percent of total billed charges,90% of total billed charges,348,90,,,percent of total billed charges,90% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,290,75,,,percent of total billed charges,75% of total billed charges,328.67,85,,,percent of total billed charges,85% of total billed charges,146.93,359.6,
Foot bi-lateral 2V,5766,CDM,320,RC,73620,HCPCS,outpatient,,,386.67,290,,348,90,,,percent of total billed charges,90% of total billed charges,359.6,93,,,percent of total billed charges,93% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,328.67,85,,,percent of total billed charges,85% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,314.75,81.4,,,percent of total billed charges,81.4% of total billed charges,348,90,,,percent of total billed charges,90% of total billed charges,348,90,,,percent of total billed charges,90% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,290,75,,,percent of total billed charges,75% of total billed charges,328.67,85,,,percent of total billed charges,85% of total billed charges,146.93,359.6,
Foot bi-lateral 2V,5767,CDM,320,RC,73620,HCPCS,outpatient,,,386.67,290,,348,90,,,percent of total billed charges,90% of total billed charges,359.6,93,,,percent of total billed charges,93% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,328.67,85,,,percent of total billed charges,85% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,314.75,81.4,,,percent of total billed charges,81.4% of total billed charges,348,90,,,percent of total billed charges,90% of total billed charges,348,90,,,percent of total billed charges,90% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,290,75,,,percent of total billed charges,75% of total billed charges,328.67,85,,,percent of total billed charges,85% of total billed charges,146.93,359.6,
Foot Complete  L/R,5768,CDM,320,RC,73630,HCPCS,outpatient,,,225,168.75,,202.5,90,,,percent of total billed charges,90% of total billed charges,209.25,93,,,percent of total billed charges,93% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,183.15,81.4,,,percent of total billed charges,81.4% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,168.75,75,,,percent of total billed charges,75% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,209.25,
Foot bi-lateral complete,5769,CDM,320,RC,73630,HCPCS,outpatient,,,449.95,337.46,,404.96,90,,,percent of total billed charges,90% of total billed charges,418.45,93,,,percent of total billed charges,93% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,382.46,85,,,percent of total billed charges,85% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,366.26,81.4,,,percent of total billed charges,81.4% of total billed charges,404.96,90,,,percent of total billed charges,90% of total billed charges,404.96,90,,,percent of total billed charges,90% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,337.46,75,,,percent of total billed charges,75% of total billed charges,382.46,85,,,percent of total billed charges,85% of total billed charges,170.98,418.45,
Foot bi-lateral complete,5770,CDM,320,RC,73630,HCPCS,outpatient,,,449.95,337.46,,404.96,90,,,percent of total billed charges,90% of total billed charges,418.45,93,,,percent of total billed charges,93% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,382.46,85,,,percent of total billed charges,85% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,366.26,81.4,,,percent of total billed charges,81.4% of total billed charges,404.96,90,,,percent of total billed charges,90% of total billed charges,404.96,90,,,percent of total billed charges,90% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,337.46,75,,,percent of total billed charges,75% of total billed charges,382.46,85,,,percent of total billed charges,85% of total billed charges,170.98,418.45,
Foot bi-lateral complete,5771,CDM,320,RC,73630,HCPCS,outpatient,,,449.95,337.46,,404.96,90,,,percent of total billed charges,90% of total billed charges,418.45,93,,,percent of total billed charges,93% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,382.46,85,,,percent of total billed charges,85% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,366.26,81.4,,,percent of total billed charges,81.4% of total billed charges,404.96,90,,,percent of total billed charges,90% of total billed charges,404.96,90,,,percent of total billed charges,90% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,170.98,38,,,percent of total billed charges,38% of total billed charges,337.46,75,,,percent of total billed charges,75% of total billed charges,382.46,85,,,percent of total billed charges,85% of total billed charges,170.98,418.45,
Heel,5772,CDM,320,RC,73650,HCPCS,outpatient,,,79.68,59.76,,71.71,90,,,percent of total billed charges,90% of total billed charges,74.1,93,,,percent of total billed charges,93% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,67.73,85,,,percent of total billed charges,85% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,64.86,81.4,,,percent of total billed charges,81.4% of total billed charges,71.71,90,,,percent of total billed charges,90% of total billed charges,71.71,90,,,percent of total billed charges,90% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,59.76,75,,,percent of total billed charges,75% of total billed charges,67.73,85,,,percent of total billed charges,85% of total billed charges,30.28,74.1,
Heel bi-lateral,5773,CDM,320,RC,73650,HCPCS,outpatient,,,159.34,119.51,,143.41,90,,,percent of total billed charges,90% of total billed charges,148.19,93,,,percent of total billed charges,93% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,135.44,85,,,percent of total billed charges,85% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,129.7,81.4,,,percent of total billed charges,81.4% of total billed charges,143.41,90,,,percent of total billed charges,90% of total billed charges,143.41,90,,,percent of total billed charges,90% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,119.51,75,,,percent of total billed charges,75% of total billed charges,135.44,85,,,percent of total billed charges,85% of total billed charges,60.55,148.19,
Heel bi-lateral,5774,CDM,320,RC,73650,HCPCS,outpatient,,,159.34,119.51,,143.41,90,,,percent of total billed charges,90% of total billed charges,148.19,93,,,percent of total billed charges,93% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,135.44,85,,,percent of total billed charges,85% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,129.7,81.4,,,percent of total billed charges,81.4% of total billed charges,143.41,90,,,percent of total billed charges,90% of total billed charges,143.41,90,,,percent of total billed charges,90% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,119.51,75,,,percent of total billed charges,75% of total billed charges,135.44,85,,,percent of total billed charges,85% of total billed charges,60.55,148.19,
Heel bi-lateral,5775,CDM,320,RC,73650,HCPCS,outpatient,,,159.34,119.51,,143.41,90,,,percent of total billed charges,90% of total billed charges,148.19,93,,,percent of total billed charges,93% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,135.44,85,,,percent of total billed charges,85% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,129.7,81.4,,,percent of total billed charges,81.4% of total billed charges,143.41,90,,,percent of total billed charges,90% of total billed charges,143.41,90,,,percent of total billed charges,90% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,60.55,38,,,percent of total billed charges,38% of total billed charges,119.51,75,,,percent of total billed charges,75% of total billed charges,135.44,85,,,percent of total billed charges,85% of total billed charges,60.55,148.19,
Toes,5776,CDM,320,RC,73660,HCPCS,outpatient,,,182.8,137.1,,164.52,90,,,percent of total billed charges,90% of total billed charges,170,93,,,percent of total billed charges,93% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,148.8,81.4,,,percent of total billed charges,81.4% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,137.1,75,,,percent of total billed charges,75% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,170,
Abdomen 1 V(Upright),5777,CDM,320,RC,74018,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,185.27,
Abdomen 2 V,5778,CDM,320,RC,74019,HCPCS,outpatient,,,255.45,191.59,,229.91,90,,,percent of total billed charges,90% of total billed charges,237.57,93,,,percent of total billed charges,93% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,217.13,85,,,percent of total billed charges,85% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,207.94,81.4,,,percent of total billed charges,81.4% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,191.59,75,,,percent of total billed charges,75% of total billed charges,217.13,85,,,percent of total billed charges,85% of total billed charges,97.07,237.57,
Abdomen 3 V(Complete),5779,CDM,320,RC,74022,HCPCS,outpatient,,,344.51,258.38,,310.06,90,,,percent of total billed charges,90% of total billed charges,320.39,93,,,percent of total billed charges,93% of total billed charges,130.91,38,,,percent of total billed charges,38% of total billed charges,130.91,38,,,percent of total billed charges,38% of total billed charges,292.83,85,,,percent of total billed charges,85% of total billed charges,130.91,38,,,percent of total billed charges,38% of total billed charges,280.43,81.4,,,percent of total billed charges,81.4% of total billed charges,310.06,90,,,percent of total billed charges,90% of total billed charges,310.06,90,,,percent of total billed charges,90% of total billed charges,130.91,38,,,percent of total billed charges,38% of total billed charges,130.91,38,,,percent of total billed charges,38% of total billed charges,130.91,38,,,percent of total billed charges,38% of total billed charges,258.38,75,,,percent of total billed charges,75% of total billed charges,292.83,85,,,percent of total billed charges,85% of total billed charges,130.91,320.39,
Barium Swallow,5780,CDM,320,RC,74230,HCPCS,outpatient,,,459.35,344.51,,413.42,90,,,percent of total billed charges,90% of total billed charges,427.2,93,,,percent of total billed charges,93% of total billed charges,174.55,38,,,percent of total billed charges,38% of total billed charges,174.55,38,,,percent of total billed charges,38% of total billed charges,390.45,85,,,percent of total billed charges,85% of total billed charges,174.55,38,,,percent of total billed charges,38% of total billed charges,373.91,81.4,,,percent of total billed charges,81.4% of total billed charges,413.42,90,,,percent of total billed charges,90% of total billed charges,413.42,90,,,percent of total billed charges,90% of total billed charges,174.55,38,,,percent of total billed charges,38% of total billed charges,174.55,38,,,percent of total billed charges,38% of total billed charges,174.55,38,,,percent of total billed charges,38% of total billed charges,344.51,75,,,percent of total billed charges,75% of total billed charges,390.45,85,,,percent of total billed charges,85% of total billed charges,174.55,427.2,
Barium Swallow w/Ambulance,5781,CDM,320,RC,74230,HCPCS,outpatient,,,1921.71,1441.28,,1729.54,90,,,percent of total billed charges,90% of total billed charges,1787.19,93,,,percent of total billed charges,93% of total billed charges,730.25,38,,,percent of total billed charges,38% of total billed charges,730.25,38,,,percent of total billed charges,38% of total billed charges,1633.45,85,,,percent of total billed charges,85% of total billed charges,730.25,38,,,percent of total billed charges,38% of total billed charges,1564.27,81.4,,,percent of total billed charges,81.4% of total billed charges,1729.54,90,,,percent of total billed charges,90% of total billed charges,1729.54,90,,,percent of total billed charges,90% of total billed charges,730.25,38,,,percent of total billed charges,38% of total billed charges,730.25,38,,,percent of total billed charges,38% of total billed charges,730.25,38,,,percent of total billed charges,38% of total billed charges,1441.28,75,,,percent of total billed charges,75% of total billed charges,1633.45,85,,,percent of total billed charges,85% of total billed charges,730.25,1787.19,
I.V.P,5782,CDM,320,RC,74400,HCPCS,outpatient,,,416,312,,374.4,90,,,percent of total billed charges,90% of total billed charges,386.88,93,,,percent of total billed charges,93% of total billed charges,158.08,38,,,percent of total billed charges,38% of total billed charges,158.08,38,,,percent of total billed charges,38% of total billed charges,353.6,85,,,percent of total billed charges,85% of total billed charges,158.08,38,,,percent of total billed charges,38% of total billed charges,338.62,81.4,,,percent of total billed charges,81.4% of total billed charges,374.4,90,,,percent of total billed charges,90% of total billed charges,374.4,90,,,percent of total billed charges,90% of total billed charges,158.08,38,,,percent of total billed charges,38% of total billed charges,158.08,38,,,percent of total billed charges,38% of total billed charges,158.08,38,,,percent of total billed charges,38% of total billed charges,312,75,,,percent of total billed charges,75% of total billed charges,353.6,85,,,percent of total billed charges,85% of total billed charges,158.08,386.88,
CT Heart (Calcium Scores),5783,CDM,350,RC,75571,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,500,100,,,case rate,100% of case rate,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,1209,100,,,case rate,100% of UHC case rate,41.13,1209,
Bone Mineral Density(BMD) (HEEL),5784,CDM,402,RC,76977,HCPCS,outpatient,,,145.29,108.97,,130.76,90,,,percent of total billed charges,90% of total billed charges,135.12,93,,,percent of total billed charges,93% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,123.5,85,,,percent of total billed charges,85% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,118.27,81.4,,,percent of total billed charges,81.4% of total billed charges,130.76,90,,,percent of total billed charges,90% of total billed charges,130.76,90,,,percent of total billed charges,90% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,55.21,38,,,percent of total billed charges,38% of total billed charges,108.97,75,,,percent of total billed charges,75% of total billed charges,123.5,85,,,percent of total billed charges,85% of total billed charges,55.21,135.12,
Bone Survey Limited,5785,CDM,320,RC,77074,HCPCS,outpatient,,,371.45,278.59,,334.31,90,,,percent of total billed charges,90% of total billed charges,345.45,93,,,percent of total billed charges,93% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,315.73,85,,,percent of total billed charges,85% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,302.36,81.4,,,percent of total billed charges,81.4% of total billed charges,334.31,90,,,percent of total billed charges,90% of total billed charges,334.31,90,,,percent of total billed charges,90% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,141.15,38,,,percent of total billed charges,38% of total billed charges,278.59,75,,,percent of total billed charges,75% of total billed charges,315.73,85,,,percent of total billed charges,85% of total billed charges,141.15,345.45,
VQ Scan with ambulance to SLVH,5786,CDM,341,RC,78580,HCPCS,outpatient,,,4965.99,3724.49,,4469.39,90,,,percent of total billed charges,90% of total billed charges,4618.37,93,,,percent of total billed charges,93% of total billed charges,1887.08,38,,,percent of total billed charges,38% of total billed charges,1887.08,38,,,percent of total billed charges,38% of total billed charges,4221.09,85,,,percent of total billed charges,85% of total billed charges,1887.08,38,,,percent of total billed charges,38% of total billed charges,4042.32,81.4,,,percent of total billed charges,81.4% of total billed charges,4469.39,90,,,percent of total billed charges,90% of total billed charges,4469.39,90,,,percent of total billed charges,90% of total billed charges,1887.08,38,,,percent of total billed charges,38% of total billed charges,1887.08,38,,,percent of total billed charges,38% of total billed charges,1887.08,38,,,percent of total billed charges,38% of total billed charges,3724.49,75,,,percent of total billed charges,75% of total billed charges,4221.09,85,,,percent of total billed charges,85% of total billed charges,1887.08,4618.37,
VQ Scan - Alamosa,5787,CDM,341,RC,78582,HCPCS,outpatient,,,1577.1,1182.83,,1419.39,90,,,percent of total billed charges,90% of total billed charges,1466.7,93,,,percent of total billed charges,93% of total billed charges,599.3,38,,,percent of total billed charges,38% of total billed charges,599.3,38,,,percent of total billed charges,38% of total billed charges,1340.54,85,,,percent of total billed charges,85% of total billed charges,599.3,38,,,percent of total billed charges,38% of total billed charges,1283.76,81.4,,,percent of total billed charges,81.4% of total billed charges,1419.39,90,,,percent of total billed charges,90% of total billed charges,1419.39,90,,,percent of total billed charges,90% of total billed charges,599.3,38,,,percent of total billed charges,38% of total billed charges,599.3,38,,,percent of total billed charges,38% of total billed charges,599.3,38,,,percent of total billed charges,38% of total billed charges,1182.83,75,,,percent of total billed charges,75% of total billed charges,1340.54,85,,,percent of total billed charges,85% of total billed charges,599.3,1466.7,
Nuc Med Radiopharm,5788,CDM,343,RC,A9540,HCPCS,outpatient,,,221.9,166.43,,199.71,90,,,percent of total billed charges,90% of total billed charges,206.37,93,,,percent of total billed charges,93% of total billed charges,84.32,38,,,percent of total billed charges,38% of total billed charges,84.32,38,,,percent of total billed charges,38% of total billed charges,188.62,85,,,percent of total billed charges,85% of total billed charges,84.32,38,,,percent of total billed charges,38% of total billed charges,180.63,81.4,,,percent of total billed charges,81.4% of total billed charges,199.71,90,,,percent of total billed charges,90% of total billed charges,199.71,90,,,percent of total billed charges,90% of total billed charges,84.32,38,,,percent of total billed charges,38% of total billed charges,84.32,38,,,percent of total billed charges,38% of total billed charges,84.32,38,,,percent of total billed charges,38% of total billed charges,166.43,75,,,percent of total billed charges,75% of total billed charges,188.62,85,,,percent of total billed charges,85% of total billed charges,84.32,206.37,
OR FAC Recovery Room <60 min/min,5790,CDM,710,RC,30000,HCPCS,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
OR FAC Recovery room >60 min,5791,CDM,710,RC,30001,HCPCS,outpatient,,,517.93,388.45,,466.14,90,,,percent of total billed charges,90% of total billed charges,481.67,93,,,percent of total billed charges,93% of total billed charges,196.81,38,,,percent of total billed charges,38% of total billed charges,196.81,38,,,percent of total billed charges,38% of total billed charges,440.24,85,,,percent of total billed charges,85% of total billed charges,196.81,38,,,percent of total billed charges,38% of total billed charges,421.6,81.4,,,percent of total billed charges,81.4% of total billed charges,466.14,90,,,percent of total billed charges,90% of total billed charges,466.14,90,,,percent of total billed charges,90% of total billed charges,196.81,38,,,percent of total billed charges,38% of total billed charges,196.81,38,,,percent of total billed charges,38% of total billed charges,196.81,38,,,percent of total billed charges,38% of total billed charges,388.45,75,,,percent of total billed charges,75% of total billed charges,440.24,85,,,percent of total billed charges,85% of total billed charges,196.81,481.67,
(report) Oxygen Source- for ABG report,5792,CDM,410,RC,85805,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
RT-CPR Assist-Non,5793,CDM,469,RC,92950,HCPCS,outpatient,,,312.87,234.65,,281.58,90,,,percent of total billed charges,90% of total billed charges,290.97,93,,,percent of total billed charges,93% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,265.94,85,,,percent of total billed charges,85% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,254.68,81.4,,,percent of total billed charges,81.4% of total billed charges,281.58,90,,,percent of total billed charges,90% of total billed charges,281.58,90,,,percent of total billed charges,90% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,234.65,75,,,percent of total billed charges,75% of total billed charges,265.94,85,,,percent of total billed charges,85% of total billed charges,118.89,290.97,
Holter Monitor Analysis,5794,CDM,731,RC,93226,HCPCS,outpatient,,,386.67,290,,348,90,,,percent of total billed charges,90% of total billed charges,359.6,93,,,percent of total billed charges,93% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,328.67,85,,,percent of total billed charges,85% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,314.75,81.4,,,percent of total billed charges,81.4% of total billed charges,348,90,,,percent of total billed charges,90% of total billed charges,348,90,,,percent of total billed charges,90% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,146.93,38,,,percent of total billed charges,38% of total billed charges,290,75,,,percent of total billed charges,75% of total billed charges,328.67,85,,,percent of total billed charges,85% of total billed charges,146.93,359.6,
Ventilator Mech Initial,5795,CDM,410,RC,94002,HCPCS,outpatient,,,906.95,680.21,,816.26,90,,,percent of total billed charges,90% of total billed charges,843.46,93,,,percent of total billed charges,93% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,770.91,85,,,percent of total billed charges,85% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,738.26,81.4,,,percent of total billed charges,81.4% of total billed charges,816.26,90,,,percent of total billed charges,90% of total billed charges,816.26,90,,,percent of total billed charges,90% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,680.21,75,,,percent of total billed charges,75% of total billed charges,770.91,85,,,percent of total billed charges,85% of total billed charges,344.64,843.46,
Ventilator Mech - Subs,5796,CDM,410,RC,94003,HCPCS,outpatient,,,906.95,680.21,,816.26,90,,,percent of total billed charges,90% of total billed charges,843.46,93,,,percent of total billed charges,93% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,770.91,85,,,percent of total billed charges,85% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,738.26,81.4,,,percent of total billed charges,81.4% of total billed charges,816.26,90,,,percent of total billed charges,90% of total billed charges,816.26,90,,,percent of total billed charges,90% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,344.64,38,,,percent of total billed charges,38% of total billed charges,680.21,75,,,percent of total billed charges,75% of total billed charges,770.91,85,,,percent of total billed charges,85% of total billed charges,344.64,843.46,
PFT Simple/Incent Spiro - FAC,5797,CDM,460,RC,94010,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
PFT pre & post Technical,5798,CDM,460,RC,94060,HCPCS,outpatient,,,178.11,133.58,,160.3,90,,,percent of total billed charges,90% of total billed charges,165.64,93,,,percent of total billed charges,93% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,144.98,81.4,,,percent of total billed charges,81.4% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,133.58,75,,,percent of total billed charges,75% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,165.64,
6-minute walk test-PRO,5799,CDM,460,RC,94620,HCPCS,outpatient,,,145.03,108.77,,130.53,90,,,percent of total billed charges,90% of total billed charges,134.88,93,,,percent of total billed charges,93% of total billed charges,55.11,38,,,percent of total billed charges,38% of total billed charges,55.11,38,,,percent of total billed charges,38% of total billed charges,123.28,85,,,percent of total billed charges,85% of total billed charges,55.11,38,,,percent of total billed charges,38% of total billed charges,118.05,81.4,,,percent of total billed charges,81.4% of total billed charges,130.53,90,,,percent of total billed charges,90% of total billed charges,130.53,90,,,percent of total billed charges,90% of total billed charges,55.11,38,,,percent of total billed charges,38% of total billed charges,55.11,38,,,percent of total billed charges,38% of total billed charges,55.11,38,,,percent of total billed charges,38% of total billed charges,108.77,75,,,percent of total billed charges,75% of total billed charges,123.28,85,,,percent of total billed charges,85% of total billed charges,55.11,134.88,
Nebulizer Inhalation Initial Treatment,5800,CDM,410,RC,94640,HCPCS,outpatient,,,112.5,84.38,,101.25,90,,,percent of total billed charges,90% of total billed charges,104.63,93,,,percent of total billed charges,93% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,91.58,81.4,,,percent of total billed charges,81.4% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,84.38,75,,,percent of total billed charges,75% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,42.75,104.63,
Nebulizer Inhalation Initial Treatment,5801,CDM,410,RC,94640,HCPCS,outpatient,,,112.5,84.38,,101.25,90,,,percent of total billed charges,90% of total billed charges,104.63,93,,,percent of total billed charges,93% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,91.58,81.4,,,percent of total billed charges,81.4% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,84.38,75,,,percent of total billed charges,75% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,42.75,104.63,
Nebulizer Inhalation Initial Treatment,5802,CDM,410,RC,94640,HCPCS,outpatient,,,112.5,84.38,,101.25,90,,,percent of total billed charges,90% of total billed charges,104.63,93,,,percent of total billed charges,93% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,91.58,81.4,,,percent of total billed charges,81.4% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,42.75,38,,,percent of total billed charges,38% of total billed charges,84.38,75,,,percent of total billed charges,75% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,42.75,104.63,
Sputum Induction,5803,CDM,410,RC,94640,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Nebulizer Subsequent,5804,CDM,410,RC,94640,HCPCS,outpatient,,,87.88,65.91,,79.09,90,,,percent of total billed charges,90% of total billed charges,81.73,93,,,percent of total billed charges,93% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,74.7,85,,,percent of total billed charges,85% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,71.53,81.4,,,percent of total billed charges,81.4% of total billed charges,79.09,90,,,percent of total billed charges,90% of total billed charges,79.09,90,,,percent of total billed charges,90% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,65.91,75,,,percent of total billed charges,75% of total billed charges,74.7,85,,,percent of total billed charges,85% of total billed charges,33.39,81.73,
Nebulizer Subsequent - Drug 2,5805,CDM,410,RC,94640,HCPCS,outpatient,,,87.88,65.91,,79.09,90,,,percent of total billed charges,90% of total billed charges,81.73,93,,,percent of total billed charges,93% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,74.7,85,,,percent of total billed charges,85% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,71.53,81.4,,,percent of total billed charges,81.4% of total billed charges,79.09,90,,,percent of total billed charges,90% of total billed charges,79.09,90,,,percent of total billed charges,90% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,65.91,75,,,percent of total billed charges,75% of total billed charges,74.7,85,,,percent of total billed charges,85% of total billed charges,33.39,81.73,
Chest Percussion Initial,5806,CDM,410,RC,-9466,HCPCS,outpatient,,,100.78,75.59,,90.7,90,,,percent of total billed charges,90% of total billed charges,93.73,93,,,percent of total billed charges,93% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,85.66,85,,,percent of total billed charges,85% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,82.03,81.4,,,percent of total billed charges,81.4% of total billed charges,90.7,90,,,percent of total billed charges,90% of total billed charges,90.7,90,,,percent of total billed charges,90% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,38.3,38,,,percent of total billed charges,38% of total billed charges,75.59,75,,,percent of total billed charges,75% of total billed charges,85.66,85,,,percent of total billed charges,85% of total billed charges,38.3,93.73,
BIPAP/CPAP,5807,CDM,410,RC,94660,HCPCS,outpatient,,,644.49,483.37,,580.04,90,,,percent of total billed charges,90% of total billed charges,599.38,93,,,percent of total billed charges,93% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,547.82,85,,,percent of total billed charges,85% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,524.61,81.4,,,percent of total billed charges,81.4% of total billed charges,580.04,90,,,percent of total billed charges,90% of total billed charges,580.04,90,,,percent of total billed charges,90% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,244.91,38,,,percent of total billed charges,38% of total billed charges,483.37,75,,,percent of total billed charges,75% of total billed charges,547.82,85,,,percent of total billed charges,85% of total billed charges,244.91,599.38,
Eval/Demo Nebulizer,5808,CDM,410,RC,94664,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Manipulate Chest Subs,5809,CDM,410,RC,94668,HCPCS,outpatient,,,104.31,78.23,,93.88,90,,,percent of total billed charges,90% of total billed charges,97.01,93,,,percent of total billed charges,93% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,88.66,85,,,percent of total billed charges,85% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,84.91,81.4,,,percent of total billed charges,81.4% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,78.23,75,,,percent of total billed charges,75% of total billed charges,88.66,85,,,percent of total billed charges,85% of total billed charges,39.64,97.01,
PFT FRC by nitrogen washout,5810,CDM,410,RC,94727,HCPCS,outpatient,,,139.45,104.59,,125.51,90,,,percent of total billed charges,90% of total billed charges,129.69,93,,,percent of total billed charges,93% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,118.53,85,,,percent of total billed charges,85% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,113.51,81.4,,,percent of total billed charges,81.4% of total billed charges,125.51,90,,,percent of total billed charges,90% of total billed charges,125.51,90,,,percent of total billed charges,90% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,104.59,75,,,percent of total billed charges,75% of total billed charges,118.53,85,,,percent of total billed charges,85% of total billed charges,52.99,129.69,
PFT Co DIffusing capacity,5811,CDM,460,RC,94729,HCPCS,outpatient,,,151.15,113.36,,136.04,90,,,percent of total billed charges,90% of total billed charges,140.57,93,,,percent of total billed charges,93% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,123.04,81.4,,,percent of total billed charges,81.4% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,113.36,75,,,percent of total billed charges,75% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,140.57,
Pulse Oximetry Single,5812,CDM,460,RC,94760,HCPCS,outpatient,,,26.96,20.22,,24.26,90,,,percent of total billed charges,90% of total billed charges,25.07,93,,,percent of total billed charges,93% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,21.95,81.4,,,percent of total billed charges,81.4% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,20.22,75,,,percent of total billed charges,75% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,25.07,
Alcohol and/or subst abuse screening/brief intervention 15-30min MEDICARE,5813,CDM,521,RC,G0396,HCPCS,outpatient,,,61.22,45.92,,55.1,90,,,percent of total billed charges,90% of total billed charges,56.93,93,,,percent of total billed charges,93% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,52.04,85,,,percent of total billed charges,85% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,49.83,81.4,,,percent of total billed charges,81.4% of total billed charges,55.1,90,,,percent of total billed charges,90% of total billed charges,55.1,90,,,percent of total billed charges,90% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,23.26,38,,,percent of total billed charges,38% of total billed charges,45.92,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,23.26,56.93,
Incentive Spiro Training,5814,CDM,460,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
"PEAK FLOW on admission, before and after each neb",5815,CDM,410,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Debridement - Muscle or fascia <20cm[Package],5816,CDM,521,RC,11043,HCPCS,outpatient,,,912.19,684.14,,820.97,90,,,percent of total billed charges,90% of total billed charges,848.34,93,,,percent of total billed charges,93% of total billed charges,346.63,38,,,percent of total billed charges,38% of total billed charges,346.63,38,,,percent of total billed charges,38% of total billed charges,775.36,85,,,percent of total billed charges,85% of total billed charges,346.63,38,,,percent of total billed charges,38% of total billed charges,742.52,81.4,,,percent of total billed charges,81.4% of total billed charges,820.97,90,,,percent of total billed charges,90% of total billed charges,820.97,90,,,percent of total billed charges,90% of total billed charges,346.63,38,,,percent of total billed charges,38% of total billed charges,346.63,38,,,percent of total billed charges,38% of total billed charges,346.63,38,,,percent of total billed charges,38% of total billed charges,684.14,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,346.63,848.34,
Debridement  Bone <20cm[Package],5817,CDM,521,RC,11044,HCPCS,outpatient,,,1689.24,1266.93,,1520.32,90,,,percent of total billed charges,90% of total billed charges,1570.99,93,,,percent of total billed charges,93% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,1435.85,85,,,percent of total billed charges,85% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,1375.04,81.4,,,percent of total billed charges,81.4% of total billed charges,1520.32,90,,,percent of total billed charges,90% of total billed charges,1520.32,90,,,percent of total billed charges,90% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,641.91,38,,,percent of total billed charges,38% of total billed charges,1266.93,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,641.91,1570.99,
Exc/debride subq add 20sq c[Package],5818,CDM,521,RC,11045,HCPCS,outpatient,,,157.38,118.04,,141.64,90,,,percent of total billed charges,90% of total billed charges,146.36,93,,,percent of total billed charges,93% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,133.77,85,,,percent of total billed charges,85% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,128.11,81.4,,,percent of total billed charges,81.4% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,118.04,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,59.8,146.36,
Exc/debride subq add 20sq c[Package],5819,CDM,521,RC,11045,HCPCS,outpatient,,,157.38,118.04,,141.64,90,,,percent of total billed charges,90% of total billed charges,146.36,93,,,percent of total billed charges,93% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,133.77,85,,,percent of total billed charges,85% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,128.11,81.4,,,percent of total billed charges,81.4% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,118.04,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,59.8,146.36,
Exc/debride subq add 20sq c[Package],5820,CDM,521,RC,11045,HCPCS,outpatient,,,157.38,118.04,,141.64,90,,,percent of total billed charges,90% of total billed charges,146.36,93,,,percent of total billed charges,93% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,133.77,85,,,percent of total billed charges,85% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,128.11,81.4,,,percent of total billed charges,81.4% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,118.04,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,59.8,146.36,
Exc/debride subq add 20sq c[Package],5821,CDM,521,RC,11045,HCPCS,outpatient,,,157.38,118.04,,141.64,90,,,percent of total billed charges,90% of total billed charges,146.36,93,,,percent of total billed charges,93% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,133.77,85,,,percent of total billed charges,85% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,128.11,81.4,,,percent of total billed charges,81.4% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,118.04,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,59.8,146.36,
Debride- muscle/fascia add 20cm[Package],5822,CDM,521,RC,11046,HCPCS,outpatient,,,723.01,542.26,,650.71,90,,,percent of total billed charges,90% of total billed charges,672.4,93,,,percent of total billed charges,93% of total billed charges,274.74,38,,,percent of total billed charges,38% of total billed charges,274.74,38,,,percent of total billed charges,38% of total billed charges,614.56,85,,,percent of total billed charges,85% of total billed charges,274.74,38,,,percent of total billed charges,38% of total billed charges,588.53,81.4,,,percent of total billed charges,81.4% of total billed charges,650.71,90,,,percent of total billed charges,90% of total billed charges,650.71,90,,,percent of total billed charges,90% of total billed charges,274.74,38,,,percent of total billed charges,38% of total billed charges,274.74,38,,,percent of total billed charges,38% of total billed charges,274.74,38,,,percent of total billed charges,38% of total billed charges,542.26,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,274.74,672.4,
EXC - paring or cutting benign lesion -single[Package],5823,CDM,521,RC,11055,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,36.07,88.27,
EXC - paring or cutting benign lesion -single[Package],5824,CDM,521,RC,11055,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,36.07,88.27,
EXC - paring or cutting benign lesion -single[Package],5825,CDM,521,RC,11055,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,36.07,88.27,
BIOPSY-tangential (scrape)[Package],5826,CDM,521,RC,11102,HCPCS,outpatient,,,333.43,250.07,,300.09,90,,,percent of total billed charges,90% of total billed charges,310.09,93,,,percent of total billed charges,93% of total billed charges,126.7,38,,,percent of total billed charges,38% of total billed charges,126.7,38,,,percent of total billed charges,38% of total billed charges,283.42,85,,,percent of total billed charges,85% of total billed charges,126.7,38,,,percent of total billed charges,38% of total billed charges,271.41,81.4,,,percent of total billed charges,81.4% of total billed charges,300.09,90,,,percent of total billed charges,90% of total billed charges,300.09,90,,,percent of total billed charges,90% of total billed charges,126.7,38,,,percent of total billed charges,38% of total billed charges,126.7,38,,,percent of total billed charges,38% of total billed charges,126.7,38,,,percent of total billed charges,38% of total billed charges,250.07,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,126.7,310.09,
BIOPSY-tangential (scrape) FAC,5827,CDM,510,RC,11102,HCPCS,outpatient,,,220.81,165.61,,198.73,90,,,percent of total billed charges,90% of total billed charges,205.35,93,,,percent of total billed charges,93% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,83.91,38,,,percent of total billed charges,38% of total billed charges,179.74,81.4,,,percent of total billed charges,81.4% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,165.61,75,,,percent of total billed charges,75% of total billed charges,187.69,85,,,percent of total billed charges,85% of total billed charges,83.91,205.35,
BIOPSY-tangential (scrape) FAC,5828,CDM,510,RC,11102,HCPCS,outpatient,,,220.81,165.61,,198.73,90,,,percent of total billed charges,90% of total billed charges,205.35,93,,,percent of total billed charges,93% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,83.91,38,,,percent of total billed charges,38% of total billed charges,179.74,81.4,,,percent of total billed charges,81.4% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,165.61,75,,,percent of total billed charges,75% of total billed charges,187.69,85,,,percent of total billed charges,85% of total billed charges,83.91,205.35,
"Biopsy tangential, ea add[Package]",5829,CDM,521,RC,11103,HCPCS,outpatient,,,115.92,86.94,,104.33,90,,,percent of total billed charges,90% of total billed charges,107.81,93,,,percent of total billed charges,93% of total billed charges,44.05,38,,,percent of total billed charges,38% of total billed charges,44.05,38,,,percent of total billed charges,38% of total billed charges,98.53,85,,,percent of total billed charges,85% of total billed charges,44.05,38,,,percent of total billed charges,38% of total billed charges,94.36,81.4,,,percent of total billed charges,81.4% of total billed charges,104.33,90,,,percent of total billed charges,90% of total billed charges,104.33,90,,,percent of total billed charges,90% of total billed charges,44.05,38,,,percent of total billed charges,38% of total billed charges,44.05,38,,,percent of total billed charges,38% of total billed charges,44.05,38,,,percent of total billed charges,38% of total billed charges,86.94,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,44.05,107.81,
Biopsy -punch  ea add[Package],5830,CDM,521,RC,11105,HCPCS,outpatient,,,157.9,118.43,,142.11,90,,,percent of total billed charges,90% of total billed charges,146.85,93,,,percent of total billed charges,93% of total billed charges,60,38,,,percent of total billed charges,38% of total billed charges,60,38,,,percent of total billed charges,38% of total billed charges,134.22,85,,,percent of total billed charges,85% of total billed charges,60,38,,,percent of total billed charges,38% of total billed charges,128.53,81.4,,,percent of total billed charges,81.4% of total billed charges,142.11,90,,,percent of total billed charges,90% of total billed charges,142.11,90,,,percent of total billed charges,90% of total billed charges,60,38,,,percent of total billed charges,38% of total billed charges,60,38,,,percent of total billed charges,38% of total billed charges,60,38,,,percent of total billed charges,38% of total billed charges,118.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,60,146.85,
Biopsy incisional[Package],5831,CDM,521,RC,11106,HCPCS,outpatient,,,552.03,414.02,,496.83,90,,,percent of total billed charges,90% of total billed charges,513.39,93,,,percent of total billed charges,93% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,469.23,85,,,percent of total billed charges,85% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,449.35,81.4,,,percent of total billed charges,81.4% of total billed charges,496.83,90,,,percent of total billed charges,90% of total billed charges,496.83,90,,,percent of total billed charges,90% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,414.02,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,209.77,513.39,
"Exc Benigh(head,neck,ext, gen) 1.1-2cm[Package]",5832,CDM,521,RC,11422,HCPCS,outpatient,,,222.64,166.98,,200.38,90,,,percent of total billed charges,90% of total billed charges,207.06,93,,,percent of total billed charges,93% of total billed charges,84.6,38,,,percent of total billed charges,38% of total billed charges,84.6,38,,,percent of total billed charges,38% of total billed charges,189.24,85,,,percent of total billed charges,85% of total billed charges,84.6,38,,,percent of total billed charges,38% of total billed charges,181.23,81.4,,,percent of total billed charges,81.4% of total billed charges,200.38,90,,,percent of total billed charges,90% of total billed charges,200.38,90,,,percent of total billed charges,90% of total billed charges,84.6,38,,,percent of total billed charges,38% of total billed charges,84.6,38,,,percent of total billed charges,38% of total billed charges,84.6,38,,,percent of total billed charges,38% of total billed charges,166.98,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,84.6,207.06,
"Lesion rem Mal head,face 3.1-4.0cm[Package]",5833,CDM,521,RC,11644,HCPCS,outpatient,,,1183.5,887.63,,1065.15,90,,,percent of total billed charges,90% of total billed charges,1100.66,93,,,percent of total billed charges,93% of total billed charges,449.73,38,,,percent of total billed charges,38% of total billed charges,449.73,38,,,percent of total billed charges,38% of total billed charges,1005.98,85,,,percent of total billed charges,85% of total billed charges,449.73,38,,,percent of total billed charges,38% of total billed charges,963.37,81.4,,,percent of total billed charges,81.4% of total billed charges,1065.15,90,,,percent of total billed charges,90% of total billed charges,1065.15,90,,,percent of total billed charges,90% of total billed charges,449.73,38,,,percent of total billed charges,38% of total billed charges,449.73,38,,,percent of total billed charges,38% of total billed charges,449.73,38,,,percent of total billed charges,38% of total billed charges,887.63,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,449.73,1100.66,
Skin Graft app trnk/arm/leg up to 100sq cm[Package],5834,CDM,521,RC,15271,HCPCS,outpatient,,,3418.23,2563.67,,3076.41,90,,,percent of total billed charges,90% of total billed charges,3178.95,93,,,percent of total billed charges,93% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2905.5,85,,,percent of total billed charges,85% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2782.44,81.4,,,percent of total billed charges,81.4% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2563.67,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,1298.93,3178.95,
Skin Graft app trnk/arm/leg up to 100sq cm[Package],5835,CDM,521,RC,15271,HCPCS,outpatient,,,3418.23,2563.67,,3076.41,90,,,percent of total billed charges,90% of total billed charges,3178.95,93,,,percent of total billed charges,93% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2905.5,85,,,percent of total billed charges,85% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2782.44,81.4,,,percent of total billed charges,81.4% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2563.67,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,1298.93,3178.95,
Skin Graft app trnk/arm/leg up to 100sq cm[Package],5836,CDM,521,RC,15271,HCPCS,outpatient,,,3418.23,2563.67,,3076.41,90,,,percent of total billed charges,90% of total billed charges,3178.95,93,,,percent of total billed charges,93% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2905.5,85,,,percent of total billed charges,85% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2782.44,81.4,,,percent of total billed charges,81.4% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2563.67,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,1298.93,3178.95,
Skin Graft app trnk/arm/leg up to 100sq cm[Package],5837,CDM,521,RC,15271,HCPCS,outpatient,,,3418.23,2563.67,,3076.41,90,,,percent of total billed charges,90% of total billed charges,3178.95,93,,,percent of total billed charges,93% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2905.5,85,,,percent of total billed charges,85% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2782.44,81.4,,,percent of total billed charges,81.4% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2563.67,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,1298.93,3178.95,
WND APP OF SKIN SUBSTITUE GRAFT global,5838,CDM,521,RC,15275,HCPCS,outpatient,,,855.33,641.5,,769.8,90,,,percent of total billed charges,90% of total billed charges,795.46,93,,,percent of total billed charges,93% of total billed charges,325.03,38,,,percent of total billed charges,38% of total billed charges,325.03,38,,,percent of total billed charges,38% of total billed charges,727.03,85,,,percent of total billed charges,85% of total billed charges,325.03,38,,,percent of total billed charges,38% of total billed charges,696.24,81.4,,,percent of total billed charges,81.4% of total billed charges,769.8,90,,,percent of total billed charges,90% of total billed charges,769.8,90,,,percent of total billed charges,90% of total billed charges,325.03,38,,,percent of total billed charges,38% of total billed charges,325.03,38,,,percent of total billed charges,38% of total billed charges,325.03,38,,,percent of total billed charges,38% of total billed charges,641.5,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,325.03,795.46,
Burn Debride 5%-10% (med.)[Package],5839,CDM,521,RC,16025,HCPCS,outpatient,,,585.16,438.87,,526.64,90,,,percent of total billed charges,90% of total billed charges,544.2,93,,,percent of total billed charges,93% of total billed charges,222.36,38,,,percent of total billed charges,38% of total billed charges,222.36,38,,,percent of total billed charges,38% of total billed charges,497.39,85,,,percent of total billed charges,85% of total billed charges,222.36,38,,,percent of total billed charges,38% of total billed charges,476.32,81.4,,,percent of total billed charges,81.4% of total billed charges,526.64,90,,,percent of total billed charges,90% of total billed charges,526.64,90,,,percent of total billed charges,90% of total billed charges,222.36,38,,,percent of total billed charges,38% of total billed charges,222.36,38,,,percent of total billed charges,38% of total billed charges,222.36,38,,,percent of total billed charges,38% of total billed charges,438.87,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,222.36,544.2,
"Asp./Inj joint; BILATERAL  Inter.(w,el,an)",5840,CDM,521,RC,20605,HCPCS,outpatient,,,475.75,356.81,,428.18,90,,,percent of total billed charges,90% of total billed charges,442.45,93,,,percent of total billed charges,93% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,404.39,85,,,percent of total billed charges,85% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,387.26,81.4,,,percent of total billed charges,81.4% of total billed charges,428.18,90,,,percent of total billed charges,90% of total billed charges,428.18,90,,,percent of total billed charges,90% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,356.81,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,180.79,442.45,
"Asp./Inj joint; BILATERAL  Inter.(w,el,an)",5841,CDM,521,RC,20605,HCPCS,outpatient,,,475.75,356.81,,428.18,90,,,percent of total billed charges,90% of total billed charges,442.45,93,,,percent of total billed charges,93% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,404.39,85,,,percent of total billed charges,85% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,387.26,81.4,,,percent of total billed charges,81.4% of total billed charges,428.18,90,,,percent of total billed charges,90% of total billed charges,428.18,90,,,percent of total billed charges,90% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,356.81,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,180.79,442.45,
"Asp./Inj Joint; Major(s,h,k) BILATERAL",5842,CDM,521,RC,20610,HCPCS,outpatient,,,527.3,395.48,,474.57,90,,,percent of total billed charges,90% of total billed charges,490.39,93,,,percent of total billed charges,93% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,448.21,85,,,percent of total billed charges,85% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,429.22,81.4,,,percent of total billed charges,81.4% of total billed charges,474.57,90,,,percent of total billed charges,90% of total billed charges,474.57,90,,,percent of total billed charges,90% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,395.48,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,200.37,490.39,
"Asp./Inj Joint; Major(s,h,k) BILATERAL",5843,CDM,521,RC,20610,HCPCS,outpatient,,,527.3,395.48,,474.57,90,,,percent of total billed charges,90% of total billed charges,490.39,93,,,percent of total billed charges,93% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,448.21,85,,,percent of total billed charges,85% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,429.22,81.4,,,percent of total billed charges,81.4% of total billed charges,474.57,90,,,percent of total billed charges,90% of total billed charges,474.57,90,,,percent of total billed charges,90% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,200.37,38,,,percent of total billed charges,38% of total billed charges,395.48,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,200.37,490.39,
Dislocation-interphalangeal closed w anes-Pro,5844,CDM,982,RC,26775,HCPCS,outpatient,,,946.77,710.08,,449.41,130,,,fee schedule,130% of fee schedule,449.41,130,,,fee schedule,130% of fee schedule,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,432.65,119,,,fee schedule,119% of fee schedule,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,100% of fee schedule,852.09,90,,,percent of total billed charges,90% of total billed charges,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,375.98,100,,,fee schedule,100% of fee schedule,86.23,852.09,
Dislocation-interphalangeal closed w anes-Facility,5845,CDM,510,RC,26775,HCPCS,outpatient,,,591.74,443.81,,532.57,90,,,percent of total billed charges,90% of total billed charges,550.32,93,,,percent of total billed charges,93% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,224.86,38,,,percent of total billed charges,38% of total billed charges,481.68,81.4,,,percent of total billed charges,81.4% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,443.81,75,,,percent of total billed charges,75% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,550.32,
Application of Finger splint[Package],5846,CDM,521,RC,29130,HCPCS,outpatient,,,151.15,113.36,,136.04,90,,,percent of total billed charges,90% of total billed charges,140.57,93,,,percent of total billed charges,93% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,123.04,81.4,,,percent of total billed charges,81.4% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,113.36,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,57.44,140.57,
Strapping - Hand or finger[Package],5847,CDM,521,RC,29280,HCPCS,outpatient,,,142.42,106.82,,128.18,90,,,percent of total billed charges,90% of total billed charges,132.45,93,,,percent of total billed charges,93% of total billed charges,54.12,38,,,percent of total billed charges,38% of total billed charges,54.12,38,,,percent of total billed charges,38% of total billed charges,121.06,85,,,percent of total billed charges,85% of total billed charges,54.12,38,,,percent of total billed charges,38% of total billed charges,115.93,81.4,,,percent of total billed charges,81.4% of total billed charges,128.18,90,,,percent of total billed charges,90% of total billed charges,128.18,90,,,percent of total billed charges,90% of total billed charges,54.12,38,,,percent of total billed charges,38% of total billed charges,54.12,38,,,percent of total billed charges,38% of total billed charges,54.12,38,,,percent of total billed charges,38% of total billed charges,106.82,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,54.12,132.45,
Apply rigid leg (TCC)[Package],5848,CDM,521,RC,29445,HCPCS,outpatient,,,697.77,523.33,,627.99,90,,,percent of total billed charges,90% of total billed charges,648.93,93,,,percent of total billed charges,93% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,593.1,85,,,percent of total billed charges,85% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,567.98,81.4,,,percent of total billed charges,81.4% of total billed charges,627.99,90,,,percent of total billed charges,90% of total billed charges,627.99,90,,,percent of total billed charges,90% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,523.33,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,265.15,648.93,
Apply rigid leg (TCC)[Package],5849,CDM,521,RC,29445,HCPCS,outpatient,,,697.77,523.33,,627.99,90,,,percent of total billed charges,90% of total billed charges,648.93,93,,,percent of total billed charges,93% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,593.1,85,,,percent of total billed charges,85% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,567.98,81.4,,,percent of total billed charges,81.4% of total billed charges,627.99,90,,,percent of total billed charges,90% of total billed charges,627.99,90,,,percent of total billed charges,90% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,523.33,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,265.15,648.93,
Apply rigid leg (TCC)[Package],5850,CDM,521,RC,29445,HCPCS,outpatient,,,697.77,523.33,,627.99,90,,,percent of total billed charges,90% of total billed charges,648.93,93,,,percent of total billed charges,93% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,593.1,85,,,percent of total billed charges,85% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,567.98,81.4,,,percent of total billed charges,81.4% of total billed charges,627.99,90,,,percent of total billed charges,90% of total billed charges,627.99,90,,,percent of total billed charges,90% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,523.33,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,265.15,648.93,
Strapping UNA boot,5851,CDM,521,RC,29580,HCPCS,outpatient,,,168.92,126.69,,152.03,90,,,percent of total billed charges,90% of total billed charges,157.1,93,,,percent of total billed charges,93% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,143.58,85,,,percent of total billed charges,85% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,137.5,81.4,,,percent of total billed charges,81.4% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,152.03,90,,,percent of total billed charges,90% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,64.19,38,,,percent of total billed charges,38% of total billed charges,126.69,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,64.19,157.1,
Apply strapping lower ext multi-layer cast[Package],5852,CDM,521,RC,29581,HCPCS,outpatient,,,250.27,187.7,,225.24,90,,,percent of total billed charges,90% of total billed charges,232.75,93,,,percent of total billed charges,93% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,212.73,85,,,percent of total billed charges,85% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,203.72,81.4,,,percent of total billed charges,81.4% of total billed charges,225.24,90,,,percent of total billed charges,90% of total billed charges,225.24,90,,,percent of total billed charges,90% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,187.7,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,95.1,232.75,
Apply strapping lower ext multi-layer cast[Package],5853,CDM,521,RC,29581,HCPCS,outpatient,,,250.27,187.7,,225.24,90,,,percent of total billed charges,90% of total billed charges,232.75,93,,,percent of total billed charges,93% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,212.73,85,,,percent of total billed charges,85% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,203.72,81.4,,,percent of total billed charges,81.4% of total billed charges,225.24,90,,,percent of total billed charges,90% of total billed charges,225.24,90,,,percent of total billed charges,90% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,95.1,38,,,percent of total billed charges,38% of total billed charges,187.7,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,95.1,232.75,
dentoalveolar block-PRO,5854,CDM,521,RC,64400,HCPCS,outpatient,,,344.6,258.45,,310.14,90,,,percent of total billed charges,90% of total billed charges,320.48,93,,,percent of total billed charges,93% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,280.5,81.4,,,percent of total billed charges,81.4% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,258.45,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,130.95,320.48,
dentoalveolar block-PRO,5855,CDM,521,RC,64400,HCPCS,outpatient,,,344.6,258.45,,310.14,90,,,percent of total billed charges,90% of total billed charges,320.48,93,,,percent of total billed charges,93% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,280.5,81.4,,,percent of total billed charges,81.4% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,130.95,38,,,percent of total billed charges,38% of total billed charges,258.45,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,130.95,320.48,
Myositis profile-PL-12 autoab,5856,CDM,300,RC,83516,HCPCS,outpatient,,,128.28,96.21,,115.45,90,,,percent of total billed charges,90% of total billed charges,119.3,93,,,percent of total billed charges,93% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,104.42,81.4,,,percent of total billed charges,81.4% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,115.45,90,,,percent of total billed charges,90% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,48.75,38,,,percent of total billed charges,38% of total billed charges,96.21,75,,,percent of total billed charges,75% of total billed charges,109.04,85,,,percent of total billed charges,85% of total billed charges,48.75,119.3,
VFC Vaccine adm additional,5857,CDM,771,RC,90472,HCPCS,outpatient,,,22.12,16.59,,19.91,90,,,percent of total billed charges,90% of total billed charges,20.57,93,,,percent of total billed charges,93% of total billed charges,8.41,38,,,percent of total billed charges,38% of total billed charges,8.41,38,,,percent of total billed charges,38% of total billed charges,18.8,85,,,percent of total billed charges,85% of total billed charges,8.41,38,,,percent of total billed charges,38% of total billed charges,18.01,81.4,,,percent of total billed charges,81.4% of total billed charges,19.91,90,,,percent of total billed charges,90% of total billed charges,19.91,90,,,percent of total billed charges,90% of total billed charges,8.41,38,,,percent of total billed charges,38% of total billed charges,8.41,38,,,percent of total billed charges,38% of total billed charges,8.41,38,,,percent of total billed charges,38% of total billed charges,16.59,75,,,percent of total billed charges,75% of total billed charges,18.8,85,,,percent of total billed charges,85% of total billed charges,8.41,20.57,
CLINIC COVID vaccine admin,5858,CDM,771,RC,90480,HCPCS,outpatient,,,35.7,26.78,,32.13,90,,,percent of total billed charges,90% of total billed charges,33.2,93,,,percent of total billed charges,93% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,29.06,81.4,,,percent of total billed charges,81.4% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,26.78,75,,,percent of total billed charges,75% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,33.2,
Clinic 23 COVID vaccination moderna 12 &up,5859,CDM,636,RC,91322,HCPCS,both,,,137.7,103.28,,123.93,90,,,percent of total billed charges,90% of total billed charges,128.06,93,,,percent of total billed charges,93% of total billed charges,52.33,38,,,percent of total billed charges,38% of total billed charges,52.33,38,,,percent of total billed charges,38% of total billed charges,117.05,85,,,percent of total billed charges,85% of total billed charges,52.33,38,,,percent of total billed charges,38% of total billed charges,112.09,81.4,,,percent of total billed charges,81.4% of total billed charges,123.93,90,,,percent of total billed charges,90% of total billed charges,123.93,90,,,percent of total billed charges,90% of total billed charges,52.33,38,,,percent of total billed charges,38% of total billed charges,52.33,38,,,percent of total billed charges,38% of total billed charges,52.33,38,,,percent of total billed charges,38% of total billed charges,103.28,75,,,percent of total billed charges,75% of total billed charges,117.05,85,,,percent of total billed charges,85% of total billed charges,52.33,128.06,
Clinic Spirometry,5860,CDM,460,RC,94010,HCPCS,outpatient,,,110.4,82.8,,99.36,90,,,percent of total billed charges,90% of total billed charges,102.67,93,,,percent of total billed charges,93% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,89.87,81.4,,,percent of total billed charges,81.4% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,82.8,75,,,percent of total billed charges,75% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,102.67,
Clinic Spirometry,5861,CDM,460,RC,94010,HCPCS,outpatient,,,110.4,82.8,,99.36,90,,,percent of total billed charges,90% of total billed charges,102.67,93,,,percent of total billed charges,93% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,89.87,81.4,,,percent of total billed charges,81.4% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,82.8,75,,,percent of total billed charges,75% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,102.67,
Clinic Pre and Post PFT,5862,CDM,460,RC,94060,HCPCS,outpatient,,,176.65,132.49,,158.99,90,,,percent of total billed charges,90% of total billed charges,164.28,93,,,percent of total billed charges,93% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,150.15,85,,,percent of total billed charges,85% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,143.79,81.4,,,percent of total billed charges,81.4% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,132.49,75,,,percent of total billed charges,75% of total billed charges,150.15,85,,,percent of total billed charges,85% of total billed charges,67.13,164.28,
Clinic Pre and Post PFT,5863,CDM,460,RC,94060,HCPCS,outpatient,,,176.65,132.49,,158.99,90,,,percent of total billed charges,90% of total billed charges,164.28,93,,,percent of total billed charges,93% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,150.15,85,,,percent of total billed charges,85% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,143.79,81.4,,,percent of total billed charges,81.4% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,132.49,75,,,percent of total billed charges,75% of total billed charges,150.15,85,,,percent of total billed charges,85% of total billed charges,67.13,164.28,
Diagnostic screening w symptoms,5864,CDM,521,RC,96127,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
Diagnostic screening w symptoms,5865,CDM,521,RC,96127,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
Administration of patient-focused health risk assessment instrument,5866,CDM,983,RC,96160,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.6,100,,,fee schedule,100% of fee schedule,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,100% of fee schedule,2.6,36.72,
Administration of patient-focused health risk assessment instrument,5867,CDM,983,RC,96160,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.6,100,,,fee schedule,100% of fee schedule,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,100% of fee schedule,2.6,36.72,
Administration of patient-focused health risk assessment instrument,5868,CDM,983,RC,96160,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.6,100,,,fee schedule,100% of fee schedule,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,100% of fee schedule,2.6,36.72,
Administration of caregiver-focused health risk assessment instrument,5869,CDM,983,RC,96161,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.6,100,,,fee schedule,100% of fee schedule,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,100% of fee schedule,2.6,36.72,
Administration of caregiver-focused health risk assessment instrument,5870,CDM,983,RC,96161,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.6,100,,,fee schedule,100% of fee schedule,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,100% of fee schedule,2.6,36.72,
Administration of caregiver-focused health risk assessment instrument,5871,CDM,983,RC,96161,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.6,100,,,fee schedule,100% of fee schedule,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,2.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.84,100,,,fee schedule,100% of fee schedule,2.6,36.72,
Home Visit Est pt minor-15 min,5872,CDM,522,RC,99347,HCPCS,outpatient,,,125.87,94.4,,113.28,90,,,percent of total billed charges,90% of total billed charges,117.06,93,,,percent of total billed charges,93% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,106.99,85,,,percent of total billed charges,85% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,102.46,81.4,,,percent of total billed charges,81.4% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,113.28,90,,,percent of total billed charges,90% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,47.83,38,,,percent of total billed charges,38% of total billed charges,94.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,47.83,117.06,
Home visit Est pt low to mod probl 25 min,5873,CDM,522,RC,99348,HCPCS,outpatient,,,176.65,132.49,,158.99,90,,,percent of total billed charges,90% of total billed charges,164.28,93,,,percent of total billed charges,93% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,150.15,85,,,percent of total billed charges,85% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,143.79,81.4,,,percent of total billed charges,81.4% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,158.99,90,,,percent of total billed charges,90% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,67.13,38,,,percent of total billed charges,38% of total billed charges,132.49,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,67.13,164.28,
Positive AUDIT Screen with brief intervention 10 to 30 minutes,5874,CDM,521,RC,99408,HCPCS,outpatient,,,69.52,52.14,,62.57,90,,,percent of total billed charges,90% of total billed charges,64.65,93,,,percent of total billed charges,93% of total billed charges,26.42,38,,,percent of total billed charges,38% of total billed charges,26.42,38,,,percent of total billed charges,38% of total billed charges,59.09,85,,,percent of total billed charges,85% of total billed charges,26.42,38,,,percent of total billed charges,38% of total billed charges,56.59,81.4,,,percent of total billed charges,81.4% of total billed charges,62.57,90,,,percent of total billed charges,90% of total billed charges,62.57,90,,,percent of total billed charges,90% of total billed charges,26.42,38,,,percent of total billed charges,38% of total billed charges,26.42,38,,,percent of total billed charges,38% of total billed charges,26.42,38,,,percent of total billed charges,38% of total billed charges,52.14,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,26.42,64.65,
Positive AUDIT Screen with brief intervention greater than 30 minutes,5875,CDM,521,RC,99409,HCPCS,outpatient,,,136.31,102.23,,122.68,90,,,percent of total billed charges,90% of total billed charges,126.77,93,,,percent of total billed charges,93% of total billed charges,51.8,38,,,percent of total billed charges,38% of total billed charges,51.8,38,,,percent of total billed charges,38% of total billed charges,115.86,85,,,percent of total billed charges,85% of total billed charges,51.8,38,,,percent of total billed charges,38% of total billed charges,110.96,81.4,,,percent of total billed charges,81.4% of total billed charges,122.68,90,,,percent of total billed charges,90% of total billed charges,122.68,90,,,percent of total billed charges,90% of total billed charges,51.8,38,,,percent of total billed charges,38% of total billed charges,51.8,38,,,percent of total billed charges,38% of total billed charges,51.8,38,,,percent of total billed charges,38% of total billed charges,102.23,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,51.8,126.77,
Chronic Care Mgt ea add 20 min/mo,5876,CDM,521,RC,99439,HCPCS,outpatient,,,80.65,60.49,,72.59,90,,,percent of total billed charges,90% of total billed charges,75,93,,,percent of total billed charges,93% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,68.55,85,,,percent of total billed charges,85% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,65.65,81.4,,,percent of total billed charges,81.4% of total billed charges,72.59,90,,,percent of total billed charges,90% of total billed charges,72.59,90,,,percent of total billed charges,90% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,30.65,38,,,percent of total billed charges,38% of total billed charges,60.49,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,30.65,75,
Chronic care mgt -20 min/mo,5877,CDM,521,RC,99490,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,20.98,51.34,
Chronic care mgt -20 min/mo,5878,CDM,521,RC,99490,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,20.98,51.34,
Chronic care mgt -20 min/mo,5879,CDM,521,RC,99490,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,20.98,51.34,
Chronic care mgt-30 min/mo,5880,CDM,521,RC,99491,HCPCS,outpatient,,,99.37,74.53,,89.43,90,,,percent of total billed charges,90% of total billed charges,92.41,93,,,percent of total billed charges,93% of total billed charges,37.76,38,,,percent of total billed charges,38% of total billed charges,37.76,38,,,percent of total billed charges,38% of total billed charges,84.46,85,,,percent of total billed charges,85% of total billed charges,37.76,38,,,percent of total billed charges,38% of total billed charges,80.89,81.4,,,percent of total billed charges,81.4% of total billed charges,89.43,90,,,percent of total billed charges,90% of total billed charges,89.43,90,,,percent of total billed charges,90% of total billed charges,37.76,38,,,percent of total billed charges,38% of total billed charges,37.76,38,,,percent of total billed charges,38% of total billed charges,37.76,38,,,percent of total billed charges,38% of total billed charges,74.53,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,37.76,92.41,
Alcohol and/or subst abuse screening/brief intervention >30 mins MEDICARE,5881,CDM,521,RC,G0397,HCPCS,outpatient,,,120.04,90.03,,108.04,90,,,percent of total billed charges,90% of total billed charges,111.64,93,,,percent of total billed charges,93% of total billed charges,45.62,38,,,percent of total billed charges,38% of total billed charges,45.62,38,,,percent of total billed charges,38% of total billed charges,102.03,85,,,percent of total billed charges,85% of total billed charges,45.62,38,,,percent of total billed charges,38% of total billed charges,97.71,81.4,,,percent of total billed charges,81.4% of total billed charges,108.04,90,,,percent of total billed charges,90% of total billed charges,108.04,90,,,percent of total billed charges,90% of total billed charges,45.62,38,,,percent of total billed charges,38% of total billed charges,45.62,38,,,percent of total billed charges,38% of total billed charges,45.62,38,,,percent of total billed charges,38% of total billed charges,90.03,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,45.62,111.64,
Comprehensive Assessment,5882,CDM,521,RC,G0506,HCPCS,outpatient,,,71.77,53.83,,64.59,90,,,percent of total billed charges,90% of total billed charges,66.75,93,,,percent of total billed charges,93% of total billed charges,27.27,38,,,percent of total billed charges,38% of total billed charges,27.27,38,,,percent of total billed charges,38% of total billed charges,61,85,,,percent of total billed charges,85% of total billed charges,27.27,38,,,percent of total billed charges,38% of total billed charges,58.42,81.4,,,percent of total billed charges,81.4% of total billed charges,64.59,90,,,percent of total billed charges,90% of total billed charges,64.59,90,,,percent of total billed charges,90% of total billed charges,27.27,38,,,percent of total billed charges,38% of total billed charges,27.27,38,,,percent of total billed charges,38% of total billed charges,27.27,38,,,percent of total billed charges,38% of total billed charges,53.83,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,27.27,66.75,
"Depression screening, pos w plan  Medicaid",5883,CDM,983,RC,G8431,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,36.72,
"Depression screening, pos w plan  Medicaid",5884,CDM,983,RC,G8431,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,36.72,
"Depression screening, pos w plan  Medicaid",5885,CDM,983,RC,G8431,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,36.72,
"Depression screening-neg, no FU Medicaid",5886,CDM,521,RC,G851-,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
"Depression screening-neg, no FU Medicaid",5887,CDM,521,RC,G851-,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
Depression screening neg,5888,CDM,983,RC,G8510,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,36.72,
Depression screening neg,5889,CDM,983,RC,G8510,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,36.72,
Depression screening neg,5890,CDM,983,RC,G8510,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,36.72,
Alcohol and/or drug screening Negative Result MEDICAID ONLY,5891,CDM,521,RC,H0049,HCPCS,outpatient,,,49.94,37.46,,44.95,90,,,percent of total billed charges,90% of total billed charges,46.44,93,,,percent of total billed charges,93% of total billed charges,18.98,38,,,percent of total billed charges,38% of total billed charges,18.98,38,,,percent of total billed charges,38% of total billed charges,42.45,85,,,percent of total billed charges,85% of total billed charges,18.98,38,,,percent of total billed charges,38% of total billed charges,40.65,81.4,,,percent of total billed charges,81.4% of total billed charges,44.95,90,,,percent of total billed charges,90% of total billed charges,44.95,90,,,percent of total billed charges,90% of total billed charges,18.98,38,,,percent of total billed charges,38% of total billed charges,18.98,38,,,percent of total billed charges,38% of total billed charges,18.98,38,,,percent of total billed charges,38% of total billed charges,37.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,18.98,46.44,
"Alcohol and/or drug screening, brief intervention, per 15 minutes MEDICAID",5892,CDM,521,RC,H0050,HCPCS,outpatient,,,99.88,74.91,,89.89,90,,,percent of total billed charges,90% of total billed charges,92.89,93,,,percent of total billed charges,93% of total billed charges,37.95,38,,,percent of total billed charges,38% of total billed charges,37.95,38,,,percent of total billed charges,38% of total billed charges,84.9,85,,,percent of total billed charges,85% of total billed charges,37.95,38,,,percent of total billed charges,38% of total billed charges,81.3,81.4,,,percent of total billed charges,81.4% of total billed charges,89.89,90,,,percent of total billed charges,90% of total billed charges,89.89,90,,,percent of total billed charges,90% of total billed charges,37.95,38,,,percent of total billed charges,38% of total billed charges,37.95,38,,,percent of total billed charges,38% of total billed charges,37.95,38,,,percent of total billed charges,38% of total billed charges,74.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,37.95,92.89,
DO NOT USE Debridement - bone <20cm[Package],5893,CDM,521,RC,,,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Polysomnography baseline facility,5894,CDM,740,RC,95810,HCPCS,outpatient,,,2413.86,1810.4,,2172.47,90,,,percent of total billed charges,90% of total billed charges,2244.89,93,,,percent of total billed charges,93% of total billed charges,917.27,38,,,percent of total billed charges,38% of total billed charges,917.27,38,,,percent of total billed charges,38% of total billed charges,2051.78,85,,,percent of total billed charges,85% of total billed charges,917.27,38,,,percent of total billed charges,38% of total billed charges,1964.88,81.4,,,percent of total billed charges,81.4% of total billed charges,2172.47,90,,,percent of total billed charges,90% of total billed charges,2172.47,90,,,percent of total billed charges,90% of total billed charges,917.27,38,,,percent of total billed charges,38% of total billed charges,917.27,38,,,percent of total billed charges,38% of total billed charges,917.27,38,,,percent of total billed charges,38% of total billed charges,1810.4,75,,,percent of total billed charges,75% of total billed charges,2051.78,85,,,percent of total billed charges,85% of total billed charges,917.27,2244.89,
Polysomnography sleep staging-facility,5895,CDM,740,RC,95811,HCPCS,outpatient,,,3051.31,2288.48,,2746.18,90,,,percent of total billed charges,90% of total billed charges,2837.72,93,,,percent of total billed charges,93% of total billed charges,1159.5,38,,,percent of total billed charges,38% of total billed charges,1159.5,38,,,percent of total billed charges,38% of total billed charges,2593.61,85,,,percent of total billed charges,85% of total billed charges,1159.5,38,,,percent of total billed charges,38% of total billed charges,2483.77,81.4,,,percent of total billed charges,81.4% of total billed charges,2746.18,90,,,percent of total billed charges,90% of total billed charges,2746.18,90,,,percent of total billed charges,90% of total billed charges,1159.5,38,,,percent of total billed charges,38% of total billed charges,1159.5,38,,,percent of total billed charges,38% of total billed charges,1159.5,38,,,percent of total billed charges,38% of total billed charges,2288.48,75,,,percent of total billed charges,75% of total billed charges,2593.61,85,,,percent of total billed charges,85% of total billed charges,1159.5,2837.72,
ST Treatment Language Voice,5896,CDM,440,RC,92507,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,185.27,
ST Treatment Language Voice,5897,CDM,440,RC,92507,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,185.27,
Speech Therapy eval.speech/sound/language,5898,CDM,444,RC,92523,HCPCS,outpatient,,,424.48,318.36,,382.03,90,,,percent of total billed charges,90% of total billed charges,394.77,93,,,percent of total billed charges,93% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,345.53,81.4,,,percent of total billed charges,81.4% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,382.03,90,,,percent of total billed charges,90% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,161.3,38,,,percent of total billed charges,38% of total billed charges,318.36,75,,,percent of total billed charges,75% of total billed charges,360.81,85,,,percent of total billed charges,85% of total billed charges,161.3,394.77,
ST Treatment Dysphagia,5899,CDM,440,RC,92526,HCPCS,outpatient,,,257.79,193.34,,232.01,90,,,percent of total billed charges,90% of total billed charges,239.74,93,,,percent of total billed charges,93% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,209.84,81.4,,,percent of total billed charges,81.4% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,193.34,75,,,percent of total billed charges,75% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,239.74,
ST Treatment Dysphagia,5900,CDM,440,RC,92526,HCPCS,outpatient,,,257.79,193.34,,232.01,90,,,percent of total billed charges,90% of total billed charges,239.74,93,,,percent of total billed charges,93% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,209.84,81.4,,,percent of total billed charges,81.4% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,193.34,75,,,percent of total billed charges,75% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,239.74,
ST Dysphagia  Eval,5901,CDM,440,RC,92610,HCPCS,outpatient,,,394.88,296.16,,355.39,90,,,percent of total billed charges,90% of total billed charges,367.24,93,,,percent of total billed charges,93% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,335.65,85,,,percent of total billed charges,85% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,321.43,81.4,,,percent of total billed charges,81.4% of total billed charges,355.39,90,,,percent of total billed charges,90% of total billed charges,355.39,90,,,percent of total billed charges,90% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,296.16,75,,,percent of total billed charges,75% of total billed charges,335.65,85,,,percent of total billed charges,85% of total billed charges,150.05,367.24,
ST Dysphagia  Eval,5902,CDM,440,RC,92610,HCPCS,outpatient,,,394.88,296.16,,355.39,90,,,percent of total billed charges,90% of total billed charges,367.24,93,,,percent of total billed charges,93% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,335.65,85,,,percent of total billed charges,85% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,321.43,81.4,,,percent of total billed charges,81.4% of total billed charges,355.39,90,,,percent of total billed charges,90% of total billed charges,355.39,90,,,percent of total billed charges,90% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,150.05,38,,,percent of total billed charges,38% of total billed charges,296.16,75,,,percent of total billed charges,75% of total billed charges,335.65,85,,,percent of total billed charges,85% of total billed charges,150.05,367.24,
ST Treatment,5903,CDM,120,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Anesthesia Vitroretinal Surgery,5904,CDM,964,RC,145,HCPCS,outpatient,,,118.24,88.68,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,106.42,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,106.42,106.42,
Anesthesia Vitroretinal Surgery,5905,CDM,964,RC,145,HCPCS,outpatient,,,118.24,88.68,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,106.42,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,106.42,106.42,
Anesthesia Vitroretinal Surgery,5906,CDM,964,RC,145,HCPCS,outpatient,,,118.24,88.68,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,106.42,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,106.42,106.42,
"OR SI joint arthrodesis -perc, bone allo BILAT",5907,CDM,360,RC,0775T,HCPCS,outpatient,,,42840,32130,,38556,90,,,percent of total billed charges,90% of total billed charges,39841.2,93,,,percent of total billed charges,93% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,36414,85,,,percent of total billed charges,85% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,34871.76,81.4,,,percent of total billed charges,81.4% of total billed charges,38556,90,,,percent of total billed charges,90% of total billed charges,38556,90,,,percent of total billed charges,90% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,32130,75,,,percent of total billed charges,75% of total billed charges,36414,85,,,percent of total billed charges,85% of total billed charges,16279.2,39841.2,
"OR SI joint arthrodesis -perc, bone allo BILAT",5908,CDM,360,RC,0775T,HCPCS,outpatient,,,42840,32130,,38556,90,,,percent of total billed charges,90% of total billed charges,39841.2,93,,,percent of total billed charges,93% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,36414,85,,,percent of total billed charges,85% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,34871.76,81.4,,,percent of total billed charges,81.4% of total billed charges,38556,90,,,percent of total billed charges,90% of total billed charges,38556,90,,,percent of total billed charges,90% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,16279.2,38,,,percent of total billed charges,38% of total billed charges,32130,75,,,percent of total billed charges,75% of total billed charges,36414,85,,,percent of total billed charges,85% of total billed charges,16279.2,39841.2,
OR-insert drug del to imp,5910,CDM,360,RC,11981,HCPCS,outpatient,,,395.1,296.33,,355.59,90,,,percent of total billed charges,90% of total billed charges,367.44,93,,,percent of total billed charges,93% of total billed charges,150.14,38,,,percent of total billed charges,38% of total billed charges,150.14,38,,,percent of total billed charges,38% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,150.14,38,,,percent of total billed charges,38% of total billed charges,321.61,81.4,,,percent of total billed charges,81.4% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,150.14,38,,,percent of total billed charges,38% of total billed charges,150.14,38,,,percent of total billed charges,38% of total billed charges,150.14,38,,,percent of total billed charges,38% of total billed charges,296.33,75,,,percent of total billed charges,75% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,150.14,367.44,
OR Lac Repair FAC Supf Nonface less than 2.5 cm,5911,CDM,360,RC,12001,HCPCS,outpatient,,,394.16,295.62,,354.74,90,,,percent of total billed charges,90% of total billed charges,366.57,93,,,percent of total billed charges,93% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,335.04,85,,,percent of total billed charges,85% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,320.85,81.4,,,percent of total billed charges,81.4% of total billed charges,354.74,90,,,percent of total billed charges,90% of total billed charges,354.74,90,,,percent of total billed charges,90% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,149.78,38,,,percent of total billed charges,38% of total billed charges,295.62,75,,,percent of total billed charges,75% of total billed charges,335.04,85,,,percent of total billed charges,85% of total billed charges,149.78,366.57,
FAC Lac Complex Hand 5cm,5912,CDM,360,RC,13133,HCPCS,outpatient,,,294.11,220.58,,264.7,90,,,percent of total billed charges,90% of total billed charges,273.52,93,,,percent of total billed charges,93% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,249.99,85,,,percent of total billed charges,85% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,239.41,81.4,,,percent of total billed charges,81.4% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,220.58,75,,,percent of total billed charges,75% of total billed charges,249.99,85,,,percent of total billed charges,85% of total billed charges,111.76,273.52,
FAC Lac Complex Hand 5cm,5913,CDM,360,RC,13133,HCPCS,outpatient,,,294.11,220.58,,264.7,90,,,percent of total billed charges,90% of total billed charges,273.52,93,,,percent of total billed charges,93% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,249.99,85,,,percent of total billed charges,85% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,239.41,81.4,,,percent of total billed charges,81.4% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,220.58,75,,,percent of total billed charges,75% of total billed charges,249.99,85,,,percent of total billed charges,85% of total billed charges,111.76,273.52,
Secondary (add) wound closure-PRO,5914,CDM,975,RC,13160,HCPCS,outpatient,,,1840.14,1380.11,,1077.21,130,,,fee schedule,130% of fee schedule,1077.21,130,,,fee schedule,130% of fee schedule,809.12,100,,,fee schedule,Pays 100% Medicare OPPS,809.12,100,,,fee schedule,Pays 100% Medicare OPPS,991.53,119,,,fee schedule,119% of fee schedule,809.12,100,,,fee schedule,Pays 100% Medicare OPPS,809.12,100,,,fee schedule,100% of fee schedule,1656.13,90,,,percent of total billed charges,90% of total billed charges,809.12,100,,,fee schedule,Pays 100% Medicare OPPS,809.12,100,,,fee schedule,Pays 100% Medicare OPPS,809.12,100,,,fee schedule,Pays 100% Medicare OPPS,809.12,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,809.12,100,,,fee schedule,100% of fee schedule,809.12,1656.13,
Secondary (add) wound closure,5915,CDM,360,RC,13160,HCPCS,outpatient,,,2328.9,1746.68,,2096.01,90,,,percent of total billed charges,90% of total billed charges,2165.88,93,,,percent of total billed charges,93% of total billed charges,884.98,38,,,percent of total billed charges,38% of total billed charges,884.98,38,,,percent of total billed charges,38% of total billed charges,1979.57,85,,,percent of total billed charges,85% of total billed charges,884.98,38,,,percent of total billed charges,38% of total billed charges,1895.72,81.4,,,percent of total billed charges,81.4% of total billed charges,2096.01,90,,,percent of total billed charges,90% of total billed charges,2096.01,90,,,percent of total billed charges,90% of total billed charges,884.98,38,,,percent of total billed charges,38% of total billed charges,884.98,38,,,percent of total billed charges,38% of total billed charges,884.98,38,,,percent of total billed charges,38% of total billed charges,1746.68,75,,,percent of total billed charges,75% of total billed charges,1979.57,85,,,percent of total billed charges,85% of total billed charges,884.98,2165.88,
"OR FAC Adjacent tissue transfer, eyelids, nose, etc",5916,CDM,360,RC,14060,HCPCS,outpatient,,,2613.06,1959.8,,2351.75,90,,,percent of total billed charges,90% of total billed charges,2430.15,93,,,percent of total billed charges,93% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,2221.1,85,,,percent of total billed charges,85% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,2127.03,81.4,,,percent of total billed charges,81.4% of total billed charges,2351.75,90,,,percent of total billed charges,90% of total billed charges,2351.75,90,,,percent of total billed charges,90% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,1959.8,75,,,percent of total billed charges,75% of total billed charges,2221.1,85,,,percent of total billed charges,85% of total billed charges,992.96,2430.15,
OR FAC Pinch graft minimal 0-2cm,5917,CDM,360,RC,15050,HCPCS,outpatient,,,897.58,673.19,,807.82,90,,,percent of total billed charges,90% of total billed charges,834.75,93,,,percent of total billed charges,93% of total billed charges,341.08,38,,,percent of total billed charges,38% of total billed charges,341.08,38,,,percent of total billed charges,38% of total billed charges,762.94,85,,,percent of total billed charges,85% of total billed charges,341.08,38,,,percent of total billed charges,38% of total billed charges,730.63,81.4,,,percent of total billed charges,81.4% of total billed charges,807.82,90,,,percent of total billed charges,90% of total billed charges,807.82,90,,,percent of total billed charges,90% of total billed charges,341.08,38,,,percent of total billed charges,38% of total billed charges,341.08,38,,,percent of total billed charges,38% of total billed charges,341.08,38,,,percent of total billed charges,38% of total billed charges,673.19,75,,,percent of total billed charges,75% of total billed charges,762.94,85,,,percent of total billed charges,85% of total billed charges,341.08,834.75,
OR FAC Full Thickness Graft,5918,CDM,360,RC,15240,HCPCS,outpatient,,,2690.39,2017.79,,2421.35,90,,,percent of total billed charges,90% of total billed charges,2502.06,93,,,percent of total billed charges,93% of total billed charges,1022.35,38,,,percent of total billed charges,38% of total billed charges,1022.35,38,,,percent of total billed charges,38% of total billed charges,2286.83,85,,,percent of total billed charges,85% of total billed charges,1022.35,38,,,percent of total billed charges,38% of total billed charges,2189.98,81.4,,,percent of total billed charges,81.4% of total billed charges,2421.35,90,,,percent of total billed charges,90% of total billed charges,2421.35,90,,,percent of total billed charges,90% of total billed charges,1022.35,38,,,percent of total billed charges,38% of total billed charges,1022.35,38,,,percent of total billed charges,38% of total billed charges,1022.35,38,,,percent of total billed charges,38% of total billed charges,2017.79,75,,,percent of total billed charges,75% of total billed charges,2286.83,85,,,percent of total billed charges,85% of total billed charges,1022.35,2502.06,
"OR FAC Full thickness skin graft eyelids, nose, etc",5919,CDM,360,RC,15260,HCPCS,outpatient,,,2613.06,1959.8,,2351.75,90,,,percent of total billed charges,90% of total billed charges,2430.15,93,,,percent of total billed charges,93% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,2221.1,85,,,percent of total billed charges,85% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,2127.03,81.4,,,percent of total billed charges,81.4% of total billed charges,2351.75,90,,,percent of total billed charges,90% of total billed charges,2351.75,90,,,percent of total billed charges,90% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,992.96,38,,,percent of total billed charges,38% of total billed charges,1959.8,75,,,percent of total billed charges,75% of total billed charges,2221.1,85,,,percent of total billed charges,85% of total billed charges,992.96,2430.15,
"OR FAC Blepharoplasty, lower eyelid",5920,CDM,360,RC,15820,HCPCS,outpatient,,,2224.03,1668.02,,2001.63,90,,,percent of total billed charges,90% of total billed charges,2068.35,93,,,percent of total billed charges,93% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,1890.43,85,,,percent of total billed charges,85% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,1810.36,81.4,,,percent of total billed charges,81.4% of total billed charges,2001.63,90,,,percent of total billed charges,90% of total billed charges,2001.63,90,,,percent of total billed charges,90% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,1668.02,75,,,percent of total billed charges,75% of total billed charges,1890.43,85,,,percent of total billed charges,85% of total billed charges,845.13,2068.35,
"OR FAC Blepharoplasty, upper eyelid",5921,CDM,360,RC,15823,HCPCS,outpatient,,,2263.88,1697.91,,2037.49,90,,,percent of total billed charges,90% of total billed charges,2105.41,93,,,percent of total billed charges,93% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,1924.3,85,,,percent of total billed charges,85% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,1842.8,81.4,,,percent of total billed charges,81.4% of total billed charges,2037.49,90,,,percent of total billed charges,90% of total billed charges,2037.49,90,,,percent of total billed charges,90% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,1697.91,75,,,percent of total billed charges,75% of total billed charges,1924.3,85,,,percent of total billed charges,85% of total billed charges,860.27,2105.41,
"OR FAC Blepharoplasty, upper eyelid",5922,CDM,360,RC,15823,HCPCS,outpatient,,,2263.88,1697.91,,2037.49,90,,,percent of total billed charges,90% of total billed charges,2105.41,93,,,percent of total billed charges,93% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,1924.3,85,,,percent of total billed charges,85% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,1842.8,81.4,,,percent of total billed charges,81.4% of total billed charges,2037.49,90,,,percent of total billed charges,90% of total billed charges,2037.49,90,,,percent of total billed charges,90% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,860.27,38,,,percent of total billed charges,38% of total billed charges,1697.91,75,,,percent of total billed charges,75% of total billed charges,1924.3,85,,,percent of total billed charges,85% of total billed charges,860.27,2105.41,
Incision-Breast mastotomy with drainage,5923,CDM,360,RC,19020,HCPCS,outpatient,,,1992.01,1494.01,,1792.81,90,,,percent of total billed charges,90% of total billed charges,1852.57,93,,,percent of total billed charges,93% of total billed charges,756.96,38,,,percent of total billed charges,38% of total billed charges,756.96,38,,,percent of total billed charges,38% of total billed charges,1693.21,85,,,percent of total billed charges,85% of total billed charges,756.96,38,,,percent of total billed charges,38% of total billed charges,1621.5,81.4,,,percent of total billed charges,81.4% of total billed charges,1792.81,90,,,percent of total billed charges,90% of total billed charges,1792.81,90,,,percent of total billed charges,90% of total billed charges,756.96,38,,,percent of total billed charges,38% of total billed charges,756.96,38,,,percent of total billed charges,38% of total billed charges,756.96,38,,,percent of total billed charges,38% of total billed charges,1494.01,75,,,percent of total billed charges,75% of total billed charges,1693.21,85,,,percent of total billed charges,85% of total billed charges,756.96,1852.57,
OR FAC Tisseel (fibrin sealant),5924,CDM,270,RC,20300,HCPCS,outpatient,,,312.87,234.65,,281.58,90,,,percent of total billed charges,90% of total billed charges,290.97,93,,,percent of total billed charges,93% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,265.94,85,,,percent of total billed charges,85% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,254.68,81.4,,,percent of total billed charges,81.4% of total billed charges,281.58,90,,,percent of total billed charges,90% of total billed charges,281.58,90,,,percent of total billed charges,90% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,118.89,38,,,percent of total billed charges,38% of total billed charges,234.65,75,,,percent of total billed charges,75% of total billed charges,265.94,85,,,percent of total billed charges,85% of total billed charges,118.89,290.97,
OR Inj/Asp Major joint,5925,CDM,360,RC,20610,HCPCS,outpatient,,,204,153,,183.6,90,,,percent of total billed charges,90% of total billed charges,189.72,93,,,percent of total billed charges,93% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,173.4,85,,,percent of total billed charges,85% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,166.06,81.4,,,percent of total billed charges,81.4% of total billed charges,183.6,90,,,percent of total billed charges,90% of total billed charges,183.6,90,,,percent of total billed charges,90% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,77.52,38,,,percent of total billed charges,38% of total billed charges,153,75,,,percent of total billed charges,75% of total billed charges,173.4,85,,,percent of total billed charges,85% of total billed charges,77.52,189.72,
Pin removal - distal plalanx-facility,5926,CDM,360,RC,20670,HCPCS,outpatient,,,2986.58,2239.94,,2687.92,90,,,percent of total billed charges,90% of total billed charges,2777.52,93,,,percent of total billed charges,93% of total billed charges,1134.9,38,,,percent of total billed charges,38% of total billed charges,1134.9,38,,,percent of total billed charges,38% of total billed charges,2538.59,85,,,percent of total billed charges,85% of total billed charges,1134.9,38,,,percent of total billed charges,38% of total billed charges,2431.08,81.4,,,percent of total billed charges,81.4% of total billed charges,2687.92,90,,,percent of total billed charges,90% of total billed charges,2687.92,90,,,percent of total billed charges,90% of total billed charges,1134.9,38,,,percent of total billed charges,38% of total billed charges,1134.9,38,,,percent of total billed charges,38% of total billed charges,1134.9,38,,,percent of total billed charges,38% of total billed charges,2239.94,75,,,percent of total billed charges,75% of total billed charges,2538.59,85,,,percent of total billed charges,85% of total billed charges,1134.9,2777.52,
OR PRO Removal hardware,5927,CDM,975,RC,20680,HCPCS,outpatient,,,894.08,670.56,,566.61,130,,,fee schedule,130% of fee schedule,566.61,130,,,fee schedule,130% of fee schedule,429.07,100,,,fee schedule,Pays 100% Medicare OPPS,429.07,100,,,fee schedule,Pays 100% Medicare OPPS,524.18,119,,,fee schedule,119% of fee schedule,429.07,100,,,fee schedule,Pays 100% Medicare OPPS,429.07,100,,,fee schedule,100% of fee schedule,804.67,90,,,percent of total billed charges,90% of total billed charges,429.07,100,,,fee schedule,Pays 100% Medicare OPPS,429.07,100,,,fee schedule,Pays 100% Medicare OPPS,429.07,100,,,fee schedule,Pays 100% Medicare OPPS,429.07,100,,,fee schedule,Pays 100% Medicare OPPS,258.7,100,,,fee schedule,100% of fee schedule,429.07,100,,,fee schedule,100% of fee schedule,258.7,804.67,
OR FAC Removal Hardware,5928,CDM,360,RC,20680,HCPCS,outpatient,,,2970.43,2227.82,,2673.39,90,,,percent of total billed charges,90% of total billed charges,2762.5,93,,,percent of total billed charges,93% of total billed charges,1128.76,38,,,percent of total billed charges,38% of total billed charges,1128.76,38,,,percent of total billed charges,38% of total billed charges,2524.87,85,,,percent of total billed charges,85% of total billed charges,1128.76,38,,,percent of total billed charges,38% of total billed charges,2417.93,81.4,,,percent of total billed charges,81.4% of total billed charges,2673.39,90,,,percent of total billed charges,90% of total billed charges,2673.39,90,,,percent of total billed charges,90% of total billed charges,1128.76,38,,,percent of total billed charges,38% of total billed charges,1128.76,38,,,percent of total billed charges,38% of total billed charges,1128.76,38,,,percent of total billed charges,38% of total billed charges,2227.82,75,,,percent of total billed charges,75% of total billed charges,2524.87,85,,,percent of total billed charges,85% of total billed charges,1128.76,2762.5,
Blades 2108 2 set,5929,CDM,272,RC,2108,HCPCS,outpatient,,,191.84,143.88,,172.66,90,,,percent of total billed charges,90% of total billed charges,178.41,93,,,percent of total billed charges,93% of total billed charges,72.9,38,,,percent of total billed charges,38% of total billed charges,72.9,38,,,percent of total billed charges,38% of total billed charges,163.06,85,,,percent of total billed charges,85% of total billed charges,72.9,38,,,percent of total billed charges,38% of total billed charges,156.16,81.4,,,percent of total billed charges,81.4% of total billed charges,172.66,90,,,percent of total billed charges,90% of total billed charges,172.66,90,,,percent of total billed charges,90% of total billed charges,72.9,38,,,percent of total billed charges,38% of total billed charges,72.9,38,,,percent of total billed charges,38% of total billed charges,72.9,38,,,percent of total billed charges,38% of total billed charges,143.88,75,,,percent of total billed charges,75% of total billed charges,163.06,85,,,percent of total billed charges,85% of total billed charges,72.9,178.41,
OR FAC Exc. Malignant Lesion 4cm,5930,CDM,360,RC,21626,HCPCS,outpatient,,,1940.46,1455.35,,1746.41,90,,,percent of total billed charges,90% of total billed charges,1804.63,93,,,percent of total billed charges,93% of total billed charges,737.37,38,,,percent of total billed charges,38% of total billed charges,737.37,38,,,percent of total billed charges,38% of total billed charges,1649.39,85,,,percent of total billed charges,85% of total billed charges,737.37,38,,,percent of total billed charges,38% of total billed charges,1579.53,81.4,,,percent of total billed charges,81.4% of total billed charges,1746.41,90,,,percent of total billed charges,90% of total billed charges,1746.41,90,,,percent of total billed charges,90% of total billed charges,737.37,38,,,percent of total billed charges,38% of total billed charges,737.37,38,,,percent of total billed charges,38% of total billed charges,737.37,38,,,percent of total billed charges,38% of total billed charges,1455.35,75,,,percent of total billed charges,75% of total billed charges,1649.39,85,,,percent of total billed charges,85% of total billed charges,737.37,1804.63,
OR FAC Excision tumor soft tissue shoulder-3cm,5931,CDM,360,RC,23071,HCPCS,outpatient,,,3974.66,2981,,3577.19,90,,,percent of total billed charges,90% of total billed charges,3696.43,93,,,percent of total billed charges,93% of total billed charges,1510.37,38,,,percent of total billed charges,38% of total billed charges,1510.37,38,,,percent of total billed charges,38% of total billed charges,3378.46,85,,,percent of total billed charges,85% of total billed charges,1510.37,38,,,percent of total billed charges,38% of total billed charges,3235.37,81.4,,,percent of total billed charges,81.4% of total billed charges,3577.19,90,,,percent of total billed charges,90% of total billed charges,3577.19,90,,,percent of total billed charges,90% of total billed charges,1510.37,38,,,percent of total billed charges,38% of total billed charges,1510.37,38,,,percent of total billed charges,38% of total billed charges,1510.37,38,,,percent of total billed charges,38% of total billed charges,2981,75,,,percent of total billed charges,75% of total billed charges,3378.46,85,,,percent of total billed charges,85% of total billed charges,1510.37,3696.43,
Excise Oleocranon bursa-FAC,5932,CDM,360,RC,24105,HCPCS,outpatient,,,5630.81,4223.11,,5067.73,90,,,percent of total billed charges,90% of total billed charges,5236.65,93,,,percent of total billed charges,93% of total billed charges,2139.71,38,,,percent of total billed charges,38% of total billed charges,2139.71,38,,,percent of total billed charges,38% of total billed charges,4786.19,85,,,percent of total billed charges,85% of total billed charges,2139.71,38,,,percent of total billed charges,38% of total billed charges,4583.48,81.4,,,percent of total billed charges,81.4% of total billed charges,5067.73,90,,,percent of total billed charges,90% of total billed charges,5067.73,90,,,percent of total billed charges,90% of total billed charges,2139.71,38,,,percent of total billed charges,38% of total billed charges,2139.71,38,,,percent of total billed charges,38% of total billed charges,2139.71,38,,,percent of total billed charges,38% of total billed charges,4223.11,75,,,percent of total billed charges,75% of total billed charges,4786.19,85,,,percent of total billed charges,85% of total billed charges,2139.71,5236.65,
OR FAC Arthrotomy elbow with debridement,5933,CDM,360,RC,24358,HCPCS,outpatient,,,5513.19,4134.89,,4961.87,90,,,percent of total billed charges,90% of total billed charges,5127.27,93,,,percent of total billed charges,93% of total billed charges,2095.01,38,,,percent of total billed charges,38% of total billed charges,2095.01,38,,,percent of total billed charges,38% of total billed charges,4686.21,85,,,percent of total billed charges,85% of total billed charges,2095.01,38,,,percent of total billed charges,38% of total billed charges,4487.74,81.4,,,percent of total billed charges,81.4% of total billed charges,4961.87,90,,,percent of total billed charges,90% of total billed charges,4961.87,90,,,percent of total billed charges,90% of total billed charges,2095.01,38,,,percent of total billed charges,38% of total billed charges,2095.01,38,,,percent of total billed charges,38% of total billed charges,2095.01,38,,,percent of total billed charges,38% of total billed charges,4134.89,75,,,percent of total billed charges,75% of total billed charges,4686.21,85,,,percent of total billed charges,85% of total billed charges,2095.01,5127.27,
OR FAC Fasciotomy Lower Arm,5934,CDM,360,RC,24495,HCPCS,outpatient,,,5121.84,3841.38,,4609.66,90,,,percent of total billed charges,90% of total billed charges,4763.31,93,,,percent of total billed charges,93% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,4353.56,85,,,percent of total billed charges,85% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,4169.18,81.4,,,percent of total billed charges,81.4% of total billed charges,4609.66,90,,,percent of total billed charges,90% of total billed charges,4609.66,90,,,percent of total billed charges,90% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,3841.38,75,,,percent of total billed charges,75% of total billed charges,4353.56,85,,,percent of total billed charges,85% of total billed charges,1946.3,4763.31,
OR FAC Inc. Extensor Tendon Sheath,5935,CDM,360,RC,25000,HCPCS,outpatient,,,3621.95,2716.46,,3259.76,90,,,percent of total billed charges,90% of total billed charges,3368.41,93,,,percent of total billed charges,93% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,3078.66,85,,,percent of total billed charges,85% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,2948.27,81.4,,,percent of total billed charges,81.4% of total billed charges,3259.76,90,,,percent of total billed charges,90% of total billed charges,3259.76,90,,,percent of total billed charges,90% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,2716.46,75,,,percent of total billed charges,75% of total billed charges,3078.66,85,,,percent of total billed charges,85% of total billed charges,1376.34,3368.41,
OR FAC Exc. Ganglion wrist,5936,CDM,360,RC,25111,HCPCS,outpatient,,,3798.9,2849.18,,3419.01,90,,,percent of total billed charges,90% of total billed charges,3532.98,93,,,percent of total billed charges,93% of total billed charges,1443.58,38,,,percent of total billed charges,38% of total billed charges,1443.58,38,,,percent of total billed charges,38% of total billed charges,3229.07,85,,,percent of total billed charges,85% of total billed charges,1443.58,38,,,percent of total billed charges,38% of total billed charges,3092.3,81.4,,,percent of total billed charges,81.4% of total billed charges,3419.01,90,,,percent of total billed charges,90% of total billed charges,3419.01,90,,,percent of total billed charges,90% of total billed charges,1443.58,38,,,percent of total billed charges,38% of total billed charges,1443.58,38,,,percent of total billed charges,38% of total billed charges,1443.58,38,,,percent of total billed charges,38% of total billed charges,2849.18,75,,,percent of total billed charges,75% of total billed charges,3229.07,85,,,percent of total billed charges,85% of total billed charges,1443.58,3532.98,
OR Excise Wrist Tendon sheath w/o anes Facility,5937,CDM,360,RC,25118,HCPCS,outpatient,,,2208.17,1656.13,,1987.35,90,,,percent of total billed charges,90% of total billed charges,2053.6,93,,,percent of total billed charges,93% of total billed charges,839.1,38,,,percent of total billed charges,38% of total billed charges,839.1,38,,,percent of total billed charges,38% of total billed charges,1876.94,85,,,percent of total billed charges,85% of total billed charges,839.1,38,,,percent of total billed charges,38% of total billed charges,1797.45,81.4,,,percent of total billed charges,81.4% of total billed charges,1987.35,90,,,percent of total billed charges,90% of total billed charges,1987.35,90,,,percent of total billed charges,90% of total billed charges,839.1,38,,,percent of total billed charges,38% of total billed charges,839.1,38,,,percent of total billed charges,38% of total billed charges,839.1,38,,,percent of total billed charges,38% of total billed charges,1656.13,75,,,percent of total billed charges,75% of total billed charges,1876.94,85,,,percent of total billed charges,85% of total billed charges,839.1,2053.6,
OR FAC Open Red Internal Fixation-Radius,5938,CDM,360,RC,25574,HCPCS,outpatient,,,3621.95,2716.46,,3259.76,90,,,percent of total billed charges,90% of total billed charges,3368.41,93,,,percent of total billed charges,93% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,3078.66,85,,,percent of total billed charges,85% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,2948.27,81.4,,,percent of total billed charges,81.4% of total billed charges,3259.76,90,,,percent of total billed charges,90% of total billed charges,3259.76,90,,,percent of total billed charges,90% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,1376.34,38,,,percent of total billed charges,38% of total billed charges,2716.46,75,,,percent of total billed charges,75% of total billed charges,3078.66,85,,,percent of total billed charges,85% of total billed charges,1376.34,3368.41,
OR FAC Decompress Fasciotomy Hand,5939,CDM,360,RC,26037,HCPCS,outpatient,,,2854.44,2140.83,,2569,90,,,percent of total billed charges,90% of total billed charges,2654.63,93,,,percent of total billed charges,93% of total billed charges,1084.69,38,,,percent of total billed charges,38% of total billed charges,1084.69,38,,,percent of total billed charges,38% of total billed charges,2426.27,85,,,percent of total billed charges,85% of total billed charges,1084.69,38,,,percent of total billed charges,38% of total billed charges,2323.51,81.4,,,percent of total billed charges,81.4% of total billed charges,2569,90,,,percent of total billed charges,90% of total billed charges,2569,90,,,percent of total billed charges,90% of total billed charges,1084.69,38,,,percent of total billed charges,38% of total billed charges,1084.69,38,,,percent of total billed charges,38% of total billed charges,1084.69,38,,,percent of total billed charges,38% of total billed charges,2140.83,75,,,percent of total billed charges,75% of total billed charges,2426.27,85,,,percent of total billed charges,85% of total billed charges,1084.69,2654.63,
OR FAC Tenovaginotomy Finger,5940,CDM,360,RC,26055,HCPCS,outpatient,,,2181.84,1636.38,,1963.66,90,,,percent of total billed charges,90% of total billed charges,2029.11,93,,,percent of total billed charges,93% of total billed charges,829.1,38,,,percent of total billed charges,38% of total billed charges,829.1,38,,,percent of total billed charges,38% of total billed charges,1854.56,85,,,percent of total billed charges,85% of total billed charges,829.1,38,,,percent of total billed charges,38% of total billed charges,1776.02,81.4,,,percent of total billed charges,81.4% of total billed charges,1963.66,90,,,percent of total billed charges,90% of total billed charges,1963.66,90,,,percent of total billed charges,90% of total billed charges,829.1,38,,,percent of total billed charges,38% of total billed charges,829.1,38,,,percent of total billed charges,38% of total billed charges,829.1,38,,,percent of total billed charges,38% of total billed charges,1636.38,75,,,percent of total billed charges,75% of total billed charges,1854.56,85,,,percent of total billed charges,85% of total billed charges,829.1,2029.11,
OR FAC Lesion Exc,5941,CDM,360,RC,26113,HCPCS,outpatient,,,2896.62,2172.47,,2606.96,90,,,percent of total billed charges,90% of total billed charges,2693.86,93,,,percent of total billed charges,93% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,2462.13,85,,,percent of total billed charges,85% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,2357.85,81.4,,,percent of total billed charges,81.4% of total billed charges,2606.96,90,,,percent of total billed charges,90% of total billed charges,2606.96,90,,,percent of total billed charges,90% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,2172.47,75,,,percent of total billed charges,75% of total billed charges,2462.13,85,,,percent of total billed charges,85% of total billed charges,1100.72,2693.86,
"OR fac Exc. tumor, mal, soft hand <1.5cm",5942,CDM,360,RC,26115,HCPCS,outpatient,,,2655.24,1991.43,,2389.72,90,,,percent of total billed charges,90% of total billed charges,2469.37,93,,,percent of total billed charges,93% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,2256.95,85,,,percent of total billed charges,85% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,2161.37,81.4,,,percent of total billed charges,81.4% of total billed charges,2389.72,90,,,percent of total billed charges,90% of total billed charges,2389.72,90,,,percent of total billed charges,90% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,1991.43,75,,,percent of total billed charges,75% of total billed charges,2256.95,85,,,percent of total billed charges,85% of total billed charges,1008.99,2469.37,
OR FAC Exc. Lesion Tendon Sheath/joint  Hand/finger,5943,CDM,360,RC,26160,HCPCS,outpatient,,,2815.4,2111.55,,2533.86,90,,,percent of total billed charges,90% of total billed charges,2618.32,93,,,percent of total billed charges,93% of total billed charges,1069.85,38,,,percent of total billed charges,38% of total billed charges,1069.85,38,,,percent of total billed charges,38% of total billed charges,2393.09,85,,,percent of total billed charges,85% of total billed charges,1069.85,38,,,percent of total billed charges,38% of total billed charges,2291.74,81.4,,,percent of total billed charges,81.4% of total billed charges,2533.86,90,,,percent of total billed charges,90% of total billed charges,2533.86,90,,,percent of total billed charges,90% of total billed charges,1069.85,38,,,percent of total billed charges,38% of total billed charges,1069.85,38,,,percent of total billed charges,38% of total billed charges,1069.85,38,,,percent of total billed charges,38% of total billed charges,2111.55,75,,,percent of total billed charges,75% of total billed charges,2393.09,85,,,percent of total billed charges,85% of total billed charges,1069.85,2618.32,
OR Removal -finger lesion FAC,5944,CDM,360,RC,26210,HCPCS,outpatient,,,2080.8,1560.6,,1872.72,90,,,percent of total billed charges,90% of total billed charges,1935.14,93,,,percent of total billed charges,93% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,1768.68,85,,,percent of total billed charges,85% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,1693.77,81.4,,,percent of total billed charges,81.4% of total billed charges,1872.72,90,,,percent of total billed charges,90% of total billed charges,1872.72,90,,,percent of total billed charges,90% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,1560.6,75,,,percent of total billed charges,75% of total billed charges,1768.68,85,,,percent of total billed charges,85% of total billed charges,790.7,1935.14,
Repair Extensor Tendon-Hand-FAC,5945,CDM,360,RC,26410,HCPCS,outpatient,,,2450.17,1837.63,,2205.15,90,,,percent of total billed charges,90% of total billed charges,2278.66,93,,,percent of total billed charges,93% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,2082.64,85,,,percent of total billed charges,85% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,1994.44,81.4,,,percent of total billed charges,81.4% of total billed charges,2205.15,90,,,percent of total billed charges,90% of total billed charges,2205.15,90,,,percent of total billed charges,90% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,1837.63,75,,,percent of total billed charges,75% of total billed charges,2082.64,85,,,percent of total billed charges,85% of total billed charges,931.06,2278.66,
Repair Extensor Tendon-Hand-FAC,5946,CDM,360,RC,26410,HCPCS,outpatient,,,2450.17,1837.63,,2205.15,90,,,percent of total billed charges,90% of total billed charges,2278.66,93,,,percent of total billed charges,93% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,2082.64,85,,,percent of total billed charges,85% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,1994.44,81.4,,,percent of total billed charges,81.4% of total billed charges,2205.15,90,,,percent of total billed charges,90% of total billed charges,2205.15,90,,,percent of total billed charges,90% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,1837.63,75,,,percent of total billed charges,75% of total billed charges,2082.64,85,,,percent of total billed charges,85% of total billed charges,931.06,2278.66,
FAC Tendon Rep Ext Fing,5947,CDM,360,RC,26418,HCPCS,outpatient,,,2444.33,1833.25,,2199.9,90,,,percent of total billed charges,90% of total billed charges,2273.23,93,,,percent of total billed charges,93% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,2077.68,85,,,percent of total billed charges,85% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,1989.68,81.4,,,percent of total billed charges,81.4% of total billed charges,2199.9,90,,,percent of total billed charges,90% of total billed charges,2199.9,90,,,percent of total billed charges,90% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,1833.25,75,,,percent of total billed charges,75% of total billed charges,2077.68,85,,,percent of total billed charges,85% of total billed charges,928.85,2273.23,
FAC Tendon Rep Ext Fing,5948,CDM,360,RC,26418,HCPCS,outpatient,,,2444.33,1833.25,,2199.9,90,,,percent of total billed charges,90% of total billed charges,2273.23,93,,,percent of total billed charges,93% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,2077.68,85,,,percent of total billed charges,85% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,1989.68,81.4,,,percent of total billed charges,81.4% of total billed charges,2199.9,90,,,percent of total billed charges,90% of total billed charges,2199.9,90,,,percent of total billed charges,90% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,1833.25,75,,,percent of total billed charges,75% of total billed charges,2077.68,85,,,percent of total billed charges,85% of total billed charges,928.85,2273.23,
OR FAC Repair Extensor Tendon-insertion,5949,CDM,360,RC,26433,HCPCS,outpatient,,,2827.48,2120.61,,2544.73,90,,,percent of total billed charges,90% of total billed charges,2629.56,93,,,percent of total billed charges,93% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,2403.36,85,,,percent of total billed charges,85% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,2301.57,81.4,,,percent of total billed charges,81.4% of total billed charges,2544.73,90,,,percent of total billed charges,90% of total billed charges,2544.73,90,,,percent of total billed charges,90% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,2120.61,75,,,percent of total billed charges,75% of total billed charges,2403.36,85,,,percent of total billed charges,85% of total billed charges,1074.44,2629.56,
OR FAC ORIF Metacarpal dislocation,5950,CDM,360,RC,26715,HCPCS,outpatient,,,4302.75,3227.06,,3872.48,90,,,percent of total billed charges,90% of total billed charges,4001.56,93,,,percent of total billed charges,93% of total billed charges,1635.05,38,,,percent of total billed charges,38% of total billed charges,1635.05,38,,,percent of total billed charges,38% of total billed charges,3657.34,85,,,percent of total billed charges,85% of total billed charges,1635.05,38,,,percent of total billed charges,38% of total billed charges,3502.44,81.4,,,percent of total billed charges,81.4% of total billed charges,3872.48,90,,,percent of total billed charges,90% of total billed charges,3872.48,90,,,percent of total billed charges,90% of total billed charges,1635.05,38,,,percent of total billed charges,38% of total billed charges,1635.05,38,,,percent of total billed charges,38% of total billed charges,1635.05,38,,,percent of total billed charges,38% of total billed charges,3227.06,75,,,percent of total billed charges,75% of total billed charges,3657.34,85,,,percent of total billed charges,85% of total billed charges,1635.05,4001.56,
OR FAC Amputation Finger / DI CL,5951,CDM,360,RC,26951,HCPCS,outpatient,,,1476.45,1107.34,,1328.81,90,,,percent of total billed charges,90% of total billed charges,1373.1,93,,,percent of total billed charges,93% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,1254.98,85,,,percent of total billed charges,85% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,1201.83,81.4,,,percent of total billed charges,81.4% of total billed charges,1328.81,90,,,percent of total billed charges,90% of total billed charges,1328.81,90,,,percent of total billed charges,90% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,561.05,38,,,percent of total billed charges,38% of total billed charges,1107.34,75,,,percent of total billed charges,75% of total billed charges,1254.98,85,,,percent of total billed charges,85% of total billed charges,561.05,1373.1,
OR SI Joint injection - Fac,5952,CDM,360,RC,27096,HCPCS,outpatient,,,816,612,,734.4,90,,,percent of total billed charges,90% of total billed charges,758.88,93,,,percent of total billed charges,93% of total billed charges,310.08,38,,,percent of total billed charges,38% of total billed charges,310.08,38,,,percent of total billed charges,38% of total billed charges,693.6,85,,,percent of total billed charges,85% of total billed charges,310.08,38,,,percent of total billed charges,38% of total billed charges,664.22,81.4,,,percent of total billed charges,81.4% of total billed charges,734.4,90,,,percent of total billed charges,90% of total billed charges,734.4,90,,,percent of total billed charges,90% of total billed charges,310.08,38,,,percent of total billed charges,38% of total billed charges,310.08,38,,,percent of total billed charges,38% of total billed charges,310.08,38,,,percent of total billed charges,38% of total billed charges,612,75,,,percent of total billed charges,75% of total billed charges,693.6,85,,,percent of total billed charges,85% of total billed charges,310.08,758.88,
OR EXC thigh/knee les SQ<3c FAC,5953,CDM,360,RC,27327,HCPCS,outpatient,,,2080.8,1560.6,,1872.72,90,,,percent of total billed charges,90% of total billed charges,1935.14,93,,,percent of total billed charges,93% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,1768.68,85,,,percent of total billed charges,85% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,1693.77,81.4,,,percent of total billed charges,81.4% of total billed charges,1872.72,90,,,percent of total billed charges,90% of total billed charges,1872.72,90,,,percent of total billed charges,90% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,1560.6,75,,,percent of total billed charges,75% of total billed charges,1768.68,85,,,percent of total billed charges,85% of total billed charges,790.7,1935.14,
OR Removal kneecap bursa - pro,5954,CDM,975,RC,27340,HCPCS,outpatient,,,1872.72,1404.54,,487.19,130,,,fee schedule,130% of fee schedule,487.19,130,,,fee schedule,130% of fee schedule,391.04,100,,,fee schedule,Pays 100% Medicare OPPS,391.04,100,,,fee schedule,Pays 100% Medicare OPPS,463.9,119,,,fee schedule,119% of fee schedule,391.04,100,,,fee schedule,Pays 100% Medicare OPPS,391.04,100,,,fee schedule,100% of fee schedule,1685.45,90,,,percent of total billed charges,90% of total billed charges,391.04,100,,,fee schedule,Pays 100% Medicare OPPS,391.04,100,,,fee schedule,Pays 100% Medicare OPPS,391.04,100,,,fee schedule,Pays 100% Medicare OPPS,391.04,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,391.04,100,,,fee schedule,100% of fee schedule,359.3,1685.45,
OR removal kneecap bursa-T,5955,CDM,360,RC,27340,HCPCS,outpatient,,,4681.8,3511.35,,4213.62,90,,,percent of total billed charges,90% of total billed charges,4354.07,93,,,percent of total billed charges,93% of total billed charges,1779.08,38,,,percent of total billed charges,38% of total billed charges,1779.08,38,,,percent of total billed charges,38% of total billed charges,3979.53,85,,,percent of total billed charges,85% of total billed charges,1779.08,38,,,percent of total billed charges,38% of total billed charges,3810.99,81.4,,,percent of total billed charges,81.4% of total billed charges,4213.62,90,,,percent of total billed charges,90% of total billed charges,4213.62,90,,,percent of total billed charges,90% of total billed charges,1779.08,38,,,percent of total billed charges,38% of total billed charges,1779.08,38,,,percent of total billed charges,38% of total billed charges,1779.08,38,,,percent of total billed charges,38% of total billed charges,3511.35,75,,,percent of total billed charges,75% of total billed charges,3979.53,85,,,percent of total billed charges,85% of total billed charges,1779.08,4354.07,
Knee Arthroplasty UNI- 1st assist PRO,5956,CDM,975,RC,27446,HCPCS,outpatient,,,4437.97,3328.48,,1467.65,130,,,fee schedule,130% of fee schedule,1467.65,130,,,fee schedule,130% of fee schedule,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1442.05,119,,,fee schedule,119% of fee schedule,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,100% of fee schedule,3994.17,90,,,percent of total billed charges,90% of total billed charges,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1580.92,100,,,fee schedule,100% of fee schedule,1166.15,100,,,fee schedule,100% of fee schedule,1166.15,3994.17,
Knee Arthroplasty UNI- 1st assist PRO,5957,CDM,975,RC,27446,HCPCS,outpatient,,,4437.97,3328.48,,1467.65,130,,,fee schedule,130% of fee schedule,1467.65,130,,,fee schedule,130% of fee schedule,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1442.05,119,,,fee schedule,119% of fee schedule,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,100% of fee schedule,3994.17,90,,,percent of total billed charges,90% of total billed charges,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1166.15,100,,,fee schedule,Pays 100% Medicare OPPS,1580.92,100,,,fee schedule,100% of fee schedule,1166.15,100,,,fee schedule,100% of fee schedule,1166.15,3994.17,
Knee Arthroplasty -uni fac,5958,CDM,360,RC,27446,HCPCS,outpatient,,,4504.65,3378.49,,4054.19,90,,,percent of total billed charges,90% of total billed charges,4189.32,93,,,percent of total billed charges,93% of total billed charges,1711.77,38,,,percent of total billed charges,38% of total billed charges,1711.77,38,,,percent of total billed charges,38% of total billed charges,3828.95,85,,,percent of total billed charges,85% of total billed charges,1711.77,38,,,percent of total billed charges,38% of total billed charges,3666.79,81.4,,,percent of total billed charges,81.4% of total billed charges,4054.19,90,,,percent of total billed charges,90% of total billed charges,4054.19,90,,,percent of total billed charges,90% of total billed charges,1711.77,38,,,percent of total billed charges,38% of total billed charges,1711.77,38,,,percent of total billed charges,38% of total billed charges,1711.77,38,,,percent of total billed charges,38% of total billed charges,3378.49,75,,,percent of total billed charges,75% of total billed charges,3828.95,85,,,percent of total billed charges,85% of total billed charges,1711.77,4189.32,
Total Knee arthroplasty,5959,CDM,360,RC,27447,HCPCS,outpatient,,,7320.06,5490.05,,6588.05,90,,,percent of total billed charges,90% of total billed charges,6807.66,93,,,percent of total billed charges,93% of total billed charges,2781.62,38,,,percent of total billed charges,38% of total billed charges,2781.62,38,,,percent of total billed charges,38% of total billed charges,6222.05,85,,,percent of total billed charges,85% of total billed charges,2781.62,38,,,percent of total billed charges,38% of total billed charges,5958.53,81.4,,,percent of total billed charges,81.4% of total billed charges,6588.05,90,,,percent of total billed charges,90% of total billed charges,6588.05,90,,,percent of total billed charges,90% of total billed charges,2781.62,38,,,percent of total billed charges,38% of total billed charges,2781.62,38,,,percent of total billed charges,38% of total billed charges,2781.62,38,,,percent of total billed charges,38% of total billed charges,5490.05,75,,,percent of total billed charges,75% of total billed charges,6222.05,85,,,percent of total billed charges,85% of total billed charges,2781.62,6807.66,
OR-Remove Knee prosth inc spacer-fac,5960,CDM,360,RC,27488,HCPCS,outpatient,,,8659.45,6494.59,,7793.51,90,,,percent of total billed charges,90% of total billed charges,8053.29,93,,,percent of total billed charges,93% of total billed charges,3290.59,38,,,percent of total billed charges,38% of total billed charges,3290.59,38,,,percent of total billed charges,38% of total billed charges,7360.53,85,,,percent of total billed charges,85% of total billed charges,3290.59,38,,,percent of total billed charges,38% of total billed charges,7048.79,81.4,,,percent of total billed charges,81.4% of total billed charges,7793.51,90,,,percent of total billed charges,90% of total billed charges,7793.51,90,,,percent of total billed charges,90% of total billed charges,3290.59,38,,,percent of total billed charges,38% of total billed charges,3290.59,38,,,percent of total billed charges,38% of total billed charges,3290.59,38,,,percent of total billed charges,38% of total billed charges,6494.59,75,,,percent of total billed charges,75% of total billed charges,7360.53,85,,,percent of total billed charges,85% of total billed charges,3290.59,8053.29,
OR FAC Exc. Lesion Leg,5961,CDM,360,RC,27618,HCPCS,outpatient,,,2574.39,1930.79,,2316.95,90,,,percent of total billed charges,90% of total billed charges,2394.18,93,,,percent of total billed charges,93% of total billed charges,978.27,38,,,percent of total billed charges,38% of total billed charges,978.27,38,,,percent of total billed charges,38% of total billed charges,2188.23,85,,,percent of total billed charges,85% of total billed charges,978.27,38,,,percent of total billed charges,38% of total billed charges,2095.55,81.4,,,percent of total billed charges,81.4% of total billed charges,2316.95,90,,,percent of total billed charges,90% of total billed charges,2316.95,90,,,percent of total billed charges,90% of total billed charges,978.27,38,,,percent of total billed charges,38% of total billed charges,978.27,38,,,percent of total billed charges,38% of total billed charges,978.27,38,,,percent of total billed charges,38% of total billed charges,1930.79,75,,,percent of total billed charges,75% of total billed charges,2188.23,85,,,percent of total billed charges,85% of total billed charges,978.27,2394.18,
OR FAC Plantar Fascia Fasciectomy,5962,CDM,360,RC,28060,HCPCS,outpatient,,,3784.83,2838.62,,3406.35,90,,,percent of total billed charges,90% of total billed charges,3519.89,93,,,percent of total billed charges,93% of total billed charges,1438.24,38,,,percent of total billed charges,38% of total billed charges,1438.24,38,,,percent of total billed charges,38% of total billed charges,3217.11,85,,,percent of total billed charges,85% of total billed charges,1438.24,38,,,percent of total billed charges,38% of total billed charges,3080.85,81.4,,,percent of total billed charges,81.4% of total billed charges,3406.35,90,,,percent of total billed charges,90% of total billed charges,3406.35,90,,,percent of total billed charges,90% of total billed charges,1438.24,38,,,percent of total billed charges,38% of total billed charges,1438.24,38,,,percent of total billed charges,38% of total billed charges,1438.24,38,,,percent of total billed charges,38% of total billed charges,2838.62,75,,,percent of total billed charges,75% of total billed charges,3217.11,85,,,percent of total billed charges,85% of total billed charges,1438.24,3519.89,
OR FAC Exc. Morton's Neuroma,5963,CDM,360,RC,28080,HCPCS,outpatient,,,2822.8,2117.1,,2540.52,90,,,percent of total billed charges,90% of total billed charges,2625.2,93,,,percent of total billed charges,93% of total billed charges,1072.66,38,,,percent of total billed charges,38% of total billed charges,1072.66,38,,,percent of total billed charges,38% of total billed charges,2399.38,85,,,percent of total billed charges,85% of total billed charges,1072.66,38,,,percent of total billed charges,38% of total billed charges,2297.76,81.4,,,percent of total billed charges,81.4% of total billed charges,2540.52,90,,,percent of total billed charges,90% of total billed charges,2540.52,90,,,percent of total billed charges,90% of total billed charges,1072.66,38,,,percent of total billed charges,38% of total billed charges,1072.66,38,,,percent of total billed charges,38% of total billed charges,1072.66,38,,,percent of total billed charges,38% of total billed charges,2117.1,75,,,percent of total billed charges,75% of total billed charges,2399.38,85,,,percent of total billed charges,85% of total billed charges,1072.66,2625.2,
OR FAC Exc. Bone Cyst or Tumor,5964,CDM,360,RC,28104,HCPCS,outpatient,,,3749.67,2812.25,,3374.7,90,,,percent of total billed charges,90% of total billed charges,3487.19,93,,,percent of total billed charges,93% of total billed charges,1424.87,38,,,percent of total billed charges,38% of total billed charges,1424.87,38,,,percent of total billed charges,38% of total billed charges,3187.22,85,,,percent of total billed charges,85% of total billed charges,1424.87,38,,,percent of total billed charges,38% of total billed charges,3052.23,81.4,,,percent of total billed charges,81.4% of total billed charges,3374.7,90,,,percent of total billed charges,90% of total billed charges,3374.7,90,,,percent of total billed charges,90% of total billed charges,1424.87,38,,,percent of total billed charges,38% of total billed charges,1424.87,38,,,percent of total billed charges,38% of total billed charges,1424.87,38,,,percent of total billed charges,38% of total billed charges,2812.25,75,,,percent of total billed charges,75% of total billed charges,3187.22,85,,,percent of total billed charges,85% of total billed charges,1424.87,3487.19,
OR FAC Osteotomy Calcaneous,5965,CDM,360,RC,28118,HCPCS,outpatient,,,2869.65,2152.24,,2582.69,90,,,percent of total billed charges,90% of total billed charges,2668.77,93,,,percent of total billed charges,93% of total billed charges,1090.47,38,,,percent of total billed charges,38% of total billed charges,1090.47,38,,,percent of total billed charges,38% of total billed charges,2439.2,85,,,percent of total billed charges,85% of total billed charges,1090.47,38,,,percent of total billed charges,38% of total billed charges,2335.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2582.69,90,,,percent of total billed charges,90% of total billed charges,2582.69,90,,,percent of total billed charges,90% of total billed charges,1090.47,38,,,percent of total billed charges,38% of total billed charges,1090.47,38,,,percent of total billed charges,38% of total billed charges,1090.47,38,,,percent of total billed charges,38% of total billed charges,2152.24,75,,,percent of total billed charges,75% of total billed charges,2439.2,85,,,percent of total billed charges,85% of total billed charges,1090.47,2668.77,
OR FAC Hemiphalenectomy,5966,CDM,360,RC,28160,HCPCS,outpatient,,,3913.73,2935.3,,3522.36,90,,,percent of total billed charges,90% of total billed charges,3639.77,93,,,percent of total billed charges,93% of total billed charges,1487.22,38,,,percent of total billed charges,38% of total billed charges,1487.22,38,,,percent of total billed charges,38% of total billed charges,3326.67,85,,,percent of total billed charges,85% of total billed charges,1487.22,38,,,percent of total billed charges,38% of total billed charges,3185.78,81.4,,,percent of total billed charges,81.4% of total billed charges,3522.36,90,,,percent of total billed charges,90% of total billed charges,3522.36,90,,,percent of total billed charges,90% of total billed charges,1487.22,38,,,percent of total billed charges,38% of total billed charges,1487.22,38,,,percent of total billed charges,38% of total billed charges,1487.22,38,,,percent of total billed charges,38% of total billed charges,2935.3,75,,,percent of total billed charges,75% of total billed charges,3326.67,85,,,percent of total billed charges,85% of total billed charges,1487.22,3639.77,
OR FAC Capsulotomy Toe,5967,CDM,360,RC,28270,HCPCS,outpatient,,,3330.17,2497.63,,2997.15,90,,,percent of total billed charges,90% of total billed charges,3097.06,93,,,percent of total billed charges,93% of total billed charges,1265.46,38,,,percent of total billed charges,38% of total billed charges,1265.46,38,,,percent of total billed charges,38% of total billed charges,2830.64,85,,,percent of total billed charges,85% of total billed charges,1265.46,38,,,percent of total billed charges,38% of total billed charges,2710.76,81.4,,,percent of total billed charges,81.4% of total billed charges,2997.15,90,,,percent of total billed charges,90% of total billed charges,2997.15,90,,,percent of total billed charges,90% of total billed charges,1265.46,38,,,percent of total billed charges,38% of total billed charges,1265.46,38,,,percent of total billed charges,38% of total billed charges,1265.46,38,,,percent of total billed charges,38% of total billed charges,2497.63,75,,,percent of total billed charges,75% of total billed charges,2830.64,85,,,percent of total billed charges,85% of total billed charges,1265.46,3097.06,
OR FAC Syndactilization Toe,5968,CDM,360,RC,28280,HCPCS,outpatient,,,3650.07,2737.55,,3285.06,90,,,percent of total billed charges,90% of total billed charges,3394.57,93,,,percent of total billed charges,93% of total billed charges,1387.03,38,,,percent of total billed charges,38% of total billed charges,1387.03,38,,,percent of total billed charges,38% of total billed charges,3102.56,85,,,percent of total billed charges,85% of total billed charges,1387.03,38,,,percent of total billed charges,38% of total billed charges,2971.16,81.4,,,percent of total billed charges,81.4% of total billed charges,3285.06,90,,,percent of total billed charges,90% of total billed charges,3285.06,90,,,percent of total billed charges,90% of total billed charges,1387.03,38,,,percent of total billed charges,38% of total billed charges,1387.03,38,,,percent of total billed charges,38% of total billed charges,1387.03,38,,,percent of total billed charges,38% of total billed charges,2737.55,75,,,percent of total billed charges,75% of total billed charges,3102.56,85,,,percent of total billed charges,85% of total billed charges,1387.03,3394.57,
OR FAC Hammer Toe correction,5969,CDM,360,RC,28285,HCPCS,outpatient,,,3393.45,2545.09,,3054.11,90,,,percent of total billed charges,90% of total billed charges,3155.91,93,,,percent of total billed charges,93% of total billed charges,1289.51,38,,,percent of total billed charges,38% of total billed charges,1289.51,38,,,percent of total billed charges,38% of total billed charges,2884.43,85,,,percent of total billed charges,85% of total billed charges,1289.51,38,,,percent of total billed charges,38% of total billed charges,2762.27,81.4,,,percent of total billed charges,81.4% of total billed charges,3054.11,90,,,percent of total billed charges,90% of total billed charges,3054.11,90,,,percent of total billed charges,90% of total billed charges,1289.51,38,,,percent of total billed charges,38% of total billed charges,1289.51,38,,,percent of total billed charges,38% of total billed charges,1289.51,38,,,percent of total billed charges,38% of total billed charges,2545.09,75,,,percent of total billed charges,75% of total billed charges,2884.43,85,,,percent of total billed charges,85% of total billed charges,1289.51,3155.91,
"OR Fac Open tx, talotarsal joint",5970,CDM,360,RC,28585,HCPCS,outpatient,,,1396.76,1047.57,,1257.08,90,,,percent of total billed charges,90% of total billed charges,1298.99,93,,,percent of total billed charges,93% of total billed charges,530.77,38,,,percent of total billed charges,38% of total billed charges,530.77,38,,,percent of total billed charges,38% of total billed charges,1187.25,85,,,percent of total billed charges,85% of total billed charges,530.77,38,,,percent of total billed charges,38% of total billed charges,1136.96,81.4,,,percent of total billed charges,81.4% of total billed charges,1257.08,90,,,percent of total billed charges,90% of total billed charges,1257.08,90,,,percent of total billed charges,90% of total billed charges,530.77,38,,,percent of total billed charges,38% of total billed charges,530.77,38,,,percent of total billed charges,38% of total billed charges,530.77,38,,,percent of total billed charges,38% of total billed charges,1047.57,75,,,percent of total billed charges,75% of total billed charges,1187.25,85,,,percent of total billed charges,85% of total billed charges,530.77,1298.99,
OR FAC ORIF DIP Joint Toe,5971,CDM,360,RC,28675,HCPCS,outpatient,,,5121.84,3841.38,,4609.66,90,,,percent of total billed charges,90% of total billed charges,4763.31,93,,,percent of total billed charges,93% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,4353.56,85,,,percent of total billed charges,85% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,4169.18,81.4,,,percent of total billed charges,81.4% of total billed charges,4609.66,90,,,percent of total billed charges,90% of total billed charges,4609.66,90,,,percent of total billed charges,90% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,1946.3,38,,,percent of total billed charges,38% of total billed charges,3841.38,75,,,percent of total billed charges,75% of total billed charges,4353.56,85,,,percent of total billed charges,85% of total billed charges,1946.3,4763.31,
OR ARTHRO Diagnostic FAC,5972,CDM,360,RC,29870,HCPCS,outpatient,,,4161.6,3121.2,,3745.44,90,,,percent of total billed charges,90% of total billed charges,3870.29,93,,,percent of total billed charges,93% of total billed charges,1581.41,38,,,percent of total billed charges,38% of total billed charges,1581.41,38,,,percent of total billed charges,38% of total billed charges,3537.36,85,,,percent of total billed charges,85% of total billed charges,1581.41,38,,,percent of total billed charges,38% of total billed charges,3387.54,81.4,,,percent of total billed charges,81.4% of total billed charges,3745.44,90,,,percent of total billed charges,90% of total billed charges,3745.44,90,,,percent of total billed charges,90% of total billed charges,1581.41,38,,,percent of total billed charges,38% of total billed charges,1581.41,38,,,percent of total billed charges,38% of total billed charges,1581.41,38,,,percent of total billed charges,38% of total billed charges,3121.2,75,,,percent of total billed charges,75% of total billed charges,3537.36,85,,,percent of total billed charges,85% of total billed charges,1581.41,3870.29,
OR Chondroplasty - Facility,5973,CDM,360,RC,29877,HCPCS,outpatient,,,6892.12,5169.09,,6202.91,90,,,percent of total billed charges,90% of total billed charges,6409.67,93,,,percent of total billed charges,93% of total billed charges,2619.01,38,,,percent of total billed charges,38% of total billed charges,2619.01,38,,,percent of total billed charges,38% of total billed charges,5858.3,85,,,percent of total billed charges,85% of total billed charges,2619.01,38,,,percent of total billed charges,38% of total billed charges,5610.19,81.4,,,percent of total billed charges,81.4% of total billed charges,6202.91,90,,,percent of total billed charges,90% of total billed charges,6202.91,90,,,percent of total billed charges,90% of total billed charges,2619.01,38,,,percent of total billed charges,38% of total billed charges,2619.01,38,,,percent of total billed charges,38% of total billed charges,2619.01,38,,,percent of total billed charges,38% of total billed charges,5169.09,75,,,percent of total billed charges,75% of total billed charges,5858.3,85,,,percent of total billed charges,85% of total billed charges,2619.01,6409.67,
Arthroscopy- lat-med meniscctomy -Facility,5974,CDM,360,RC,29880,HCPCS,outpatient,,,5743.43,4307.57,,5169.09,90,,,percent of total billed charges,90% of total billed charges,5341.39,93,,,percent of total billed charges,93% of total billed charges,2182.5,38,,,percent of total billed charges,38% of total billed charges,2182.5,38,,,percent of total billed charges,38% of total billed charges,4881.92,85,,,percent of total billed charges,85% of total billed charges,2182.5,38,,,percent of total billed charges,38% of total billed charges,4675.15,81.4,,,percent of total billed charges,81.4% of total billed charges,5169.09,90,,,percent of total billed charges,90% of total billed charges,5169.09,90,,,percent of total billed charges,90% of total billed charges,2182.5,38,,,percent of total billed charges,38% of total billed charges,2182.5,38,,,percent of total billed charges,38% of total billed charges,2182.5,38,,,percent of total billed charges,38% of total billed charges,4307.57,75,,,percent of total billed charges,75% of total billed charges,4881.92,85,,,percent of total billed charges,85% of total billed charges,2182.5,5341.39,
OR Arthro w meniscectomy-FAC,5975,CDM,360,RC,29881,HCPCS,outpatient,,,7466.46,5599.85,,6719.81,90,,,percent of total billed charges,90% of total billed charges,6943.81,93,,,percent of total billed charges,93% of total billed charges,2837.25,38,,,percent of total billed charges,38% of total billed charges,2837.25,38,,,percent of total billed charges,38% of total billed charges,6346.49,85,,,percent of total billed charges,85% of total billed charges,2837.25,38,,,percent of total billed charges,38% of total billed charges,6077.7,81.4,,,percent of total billed charges,81.4% of total billed charges,6719.81,90,,,percent of total billed charges,90% of total billed charges,6719.81,90,,,percent of total billed charges,90% of total billed charges,2837.25,38,,,percent of total billed charges,38% of total billed charges,2837.25,38,,,percent of total billed charges,38% of total billed charges,2837.25,38,,,percent of total billed charges,38% of total billed charges,5599.85,75,,,percent of total billed charges,75% of total billed charges,6346.49,85,,,percent of total billed charges,85% of total billed charges,2837.25,6943.81,
OR FAC Bronch flex w/biopsy,5976,CDM,360,RC,31628,HCPCS,outpatient,,,1745.95,1309.46,,1571.36,90,,,percent of total billed charges,90% of total billed charges,1623.73,93,,,percent of total billed charges,93% of total billed charges,663.46,38,,,percent of total billed charges,38% of total billed charges,663.46,38,,,percent of total billed charges,38% of total billed charges,1484.06,85,,,percent of total billed charges,85% of total billed charges,663.46,38,,,percent of total billed charges,38% of total billed charges,1421.2,81.4,,,percent of total billed charges,81.4% of total billed charges,1571.36,90,,,percent of total billed charges,90% of total billed charges,1571.36,90,,,percent of total billed charges,90% of total billed charges,663.46,38,,,percent of total billed charges,38% of total billed charges,663.46,38,,,percent of total billed charges,38% of total billed charges,663.46,38,,,percent of total billed charges,38% of total billed charges,1309.46,75,,,percent of total billed charges,75% of total billed charges,1484.06,85,,,percent of total billed charges,85% of total billed charges,663.46,1623.73,
OR FAC EGD-Diagnostic,5977,CDM,360,RC,43235,HCPCS,outpatient,,,1895.32,1421.49,,1705.79,90,,,percent of total billed charges,90% of total billed charges,1762.65,93,,,percent of total billed charges,93% of total billed charges,720.22,38,,,percent of total billed charges,38% of total billed charges,720.22,38,,,percent of total billed charges,38% of total billed charges,1611.02,85,,,percent of total billed charges,85% of total billed charges,720.22,38,,,percent of total billed charges,38% of total billed charges,1542.79,81.4,,,percent of total billed charges,81.4% of total billed charges,1705.79,90,,,percent of total billed charges,90% of total billed charges,1705.79,90,,,percent of total billed charges,90% of total billed charges,720.22,38,,,percent of total billed charges,38% of total billed charges,720.22,38,,,percent of total billed charges,38% of total billed charges,720.22,38,,,percent of total billed charges,38% of total billed charges,1421.49,75,,,percent of total billed charges,75% of total billed charges,1611.02,85,,,percent of total billed charges,85% of total billed charges,720.22,1762.65,
OR FAC EGD-Diagnostic w/biopsy,5978,CDM,360,RC,43239,HCPCS,outpatient,,,2011.94,1508.96,,1810.75,90,,,percent of total billed charges,90% of total billed charges,1871.1,93,,,percent of total billed charges,93% of total billed charges,764.54,38,,,percent of total billed charges,38% of total billed charges,764.54,38,,,percent of total billed charges,38% of total billed charges,1710.15,85,,,percent of total billed charges,85% of total billed charges,764.54,38,,,percent of total billed charges,38% of total billed charges,1637.72,81.4,,,percent of total billed charges,81.4% of total billed charges,1810.75,90,,,percent of total billed charges,90% of total billed charges,1810.75,90,,,percent of total billed charges,90% of total billed charges,764.54,38,,,percent of total billed charges,38% of total billed charges,764.54,38,,,percent of total billed charges,38% of total billed charges,764.54,38,,,percent of total billed charges,38% of total billed charges,1508.96,75,,,percent of total billed charges,75% of total billed charges,1710.15,85,,,percent of total billed charges,85% of total billed charges,764.54,1871.1,
OR FAC EGD-w/band ligation,5979,CDM,360,RC,43244,HCPCS,outpatient,,,2300.2,1725.15,,2070.18,90,,,percent of total billed charges,90% of total billed charges,2139.19,93,,,percent of total billed charges,93% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,1955.17,85,,,percent of total billed charges,85% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,1872.36,81.4,,,percent of total billed charges,81.4% of total billed charges,2070.18,90,,,percent of total billed charges,90% of total billed charges,2070.18,90,,,percent of total billed charges,90% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,1725.15,75,,,percent of total billed charges,75% of total billed charges,1955.17,85,,,percent of total billed charges,85% of total billed charges,874.08,2139.19,
OR FAC EGD-w/hot forceps or cautery,5980,CDM,360,RC,43250,HCPCS,outpatient,,,2300.2,1725.15,,2070.18,90,,,percent of total billed charges,90% of total billed charges,2139.19,93,,,percent of total billed charges,93% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,1955.17,85,,,percent of total billed charges,85% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,1872.36,81.4,,,percent of total billed charges,81.4% of total billed charges,2070.18,90,,,percent of total billed charges,90% of total billed charges,2070.18,90,,,percent of total billed charges,90% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,1725.15,75,,,percent of total billed charges,75% of total billed charges,1955.17,85,,,percent of total billed charges,85% of total billed charges,874.08,2139.19,
OR FAC EGD-w/snare,5981,CDM,360,RC,43251,HCPCS,outpatient,,,2300.2,1725.15,,2070.18,90,,,percent of total billed charges,90% of total billed charges,2139.19,93,,,percent of total billed charges,93% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,1955.17,85,,,percent of total billed charges,85% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,1872.36,81.4,,,percent of total billed charges,81.4% of total billed charges,2070.18,90,,,percent of total billed charges,90% of total billed charges,2070.18,90,,,percent of total billed charges,90% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,874.08,38,,,percent of total billed charges,38% of total billed charges,1725.15,75,,,percent of total billed charges,75% of total billed charges,1955.17,85,,,percent of total billed charges,85% of total billed charges,874.08,2139.19,
OR Sigmoidoscopy w biopsy-fac,5982,CDM,360,RC,45331,HCPCS,outpatient,,,1104.08,828.06,,993.67,90,,,percent of total billed charges,90% of total billed charges,1026.79,93,,,percent of total billed charges,93% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,938.47,85,,,percent of total billed charges,85% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,898.72,81.4,,,percent of total billed charges,81.4% of total billed charges,993.67,90,,,percent of total billed charges,90% of total billed charges,993.67,90,,,percent of total billed charges,90% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,419.55,38,,,percent of total billed charges,38% of total billed charges,828.06,75,,,percent of total billed charges,75% of total billed charges,938.47,85,,,percent of total billed charges,85% of total billed charges,419.55,1026.79,
OR FAC Colonoscopy-Diagnostic,5983,CDM,360,RC,45378,HCPCS,outpatient,,,1742.43,1306.82,,1568.19,90,,,percent of total billed charges,90% of total billed charges,1620.46,93,,,percent of total billed charges,93% of total billed charges,662.12,38,,,percent of total billed charges,38% of total billed charges,662.12,38,,,percent of total billed charges,38% of total billed charges,1481.07,85,,,percent of total billed charges,85% of total billed charges,662.12,38,,,percent of total billed charges,38% of total billed charges,1418.34,81.4,,,percent of total billed charges,81.4% of total billed charges,1568.19,90,,,percent of total billed charges,90% of total billed charges,1568.19,90,,,percent of total billed charges,90% of total billed charges,662.12,38,,,percent of total billed charges,38% of total billed charges,662.12,38,,,percent of total billed charges,38% of total billed charges,662.12,38,,,percent of total billed charges,38% of total billed charges,1306.82,75,,,percent of total billed charges,75% of total billed charges,1481.07,85,,,percent of total billed charges,85% of total billed charges,662.12,1620.46,
OR FAC Colonoscopy-w/biopsy,5984,CDM,360,RC,45380,HCPCS,outpatient,,,2279.1,1709.33,,2051.19,90,,,percent of total billed charges,90% of total billed charges,2119.56,93,,,percent of total billed charges,93% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,1937.24,85,,,percent of total billed charges,85% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,1855.19,81.4,,,percent of total billed charges,81.4% of total billed charges,2051.19,90,,,percent of total billed charges,90% of total billed charges,2051.19,90,,,percent of total billed charges,90% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,1709.33,75,,,percent of total billed charges,75% of total billed charges,1937.24,85,,,percent of total billed charges,85% of total billed charges,866.06,2119.56,
"OR FAC Colonoscopy-w/biopsy, hot forceps/cautery",5985,CDM,360,RC,45384,HCPCS,outpatient,,,2098.65,1573.99,,1888.79,90,,,percent of total billed charges,90% of total billed charges,1951.74,93,,,percent of total billed charges,93% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,1783.85,85,,,percent of total billed charges,85% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,1708.3,81.4,,,percent of total billed charges,81.4% of total billed charges,1888.79,90,,,percent of total billed charges,90% of total billed charges,1888.79,90,,,percent of total billed charges,90% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,1573.99,75,,,percent of total billed charges,75% of total billed charges,1783.85,85,,,percent of total billed charges,85% of total billed charges,797.49,1951.74,
"OR FAC Colonoscopy-w/biopsy, snare",5986,CDM,360,RC,45385,HCPCS,outpatient,,,2279.1,1709.33,,2051.19,90,,,percent of total billed charges,90% of total billed charges,2119.56,93,,,percent of total billed charges,93% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,1937.24,85,,,percent of total billed charges,85% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,1855.19,81.4,,,percent of total billed charges,81.4% of total billed charges,2051.19,90,,,percent of total billed charges,90% of total billed charges,2051.19,90,,,percent of total billed charges,90% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,866.06,38,,,percent of total billed charges,38% of total billed charges,1709.33,75,,,percent of total billed charges,75% of total billed charges,1937.24,85,,,percent of total billed charges,85% of total billed charges,866.06,2119.56,
"OR FAC Herniorrhaphy, inguinal (initial)",5987,CDM,360,RC,49505,HCPCS,outpatient,,,4937.85,3703.39,,4444.07,90,,,percent of total billed charges,90% of total billed charges,4592.2,93,,,percent of total billed charges,93% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,4197.17,85,,,percent of total billed charges,85% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,4019.41,81.4,,,percent of total billed charges,81.4% of total billed charges,4444.07,90,,,percent of total billed charges,90% of total billed charges,4444.07,90,,,percent of total billed charges,90% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,3703.39,75,,,percent of total billed charges,75% of total billed charges,4197.17,85,,,percent of total billed charges,85% of total billed charges,1876.38,4592.2,
"OR FAC Herniorraphy, inguinal (recurrent)",5988,CDM,360,RC,49520,HCPCS,outpatient,,,4937.85,3703.39,,4444.07,90,,,percent of total billed charges,90% of total billed charges,4592.2,93,,,percent of total billed charges,93% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,4197.17,85,,,percent of total billed charges,85% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,4019.41,81.4,,,percent of total billed charges,81.4% of total billed charges,4444.07,90,,,percent of total billed charges,90% of total billed charges,4444.07,90,,,percent of total billed charges,90% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,3703.39,75,,,percent of total billed charges,75% of total billed charges,4197.17,85,,,percent of total billed charges,85% of total billed charges,1876.38,4592.2,
"OR FAC Herniorrhaphy, inguinal (sliding)",5989,CDM,360,RC,49525,HCPCS,outpatient,,,4937.85,3703.39,,4444.07,90,,,percent of total billed charges,90% of total billed charges,4592.2,93,,,percent of total billed charges,93% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,4197.17,85,,,percent of total billed charges,85% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,4019.41,81.4,,,percent of total billed charges,81.4% of total billed charges,4444.07,90,,,percent of total billed charges,90% of total billed charges,4444.07,90,,,percent of total billed charges,90% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,1876.38,38,,,percent of total billed charges,38% of total billed charges,3703.39,75,,,percent of total billed charges,75% of total billed charges,4197.17,85,,,percent of total billed charges,85% of total billed charges,1876.38,4592.2,
OR FAC Lithotripsy,5990,CDM,360,RC,50590,HCPCS,outpatient,,,6588.88,4941.66,,5929.99,90,,,percent of total billed charges,90% of total billed charges,6127.66,93,,,percent of total billed charges,93% of total billed charges,2503.77,38,,,percent of total billed charges,38% of total billed charges,2503.77,38,,,percent of total billed charges,38% of total billed charges,5600.55,85,,,percent of total billed charges,85% of total billed charges,2503.77,38,,,percent of total billed charges,38% of total billed charges,5363.35,81.4,,,percent of total billed charges,81.4% of total billed charges,5929.99,90,,,percent of total billed charges,90% of total billed charges,5929.99,90,,,percent of total billed charges,90% of total billed charges,2503.77,38,,,percent of total billed charges,38% of total billed charges,2503.77,38,,,percent of total billed charges,38% of total billed charges,2503.77,38,,,percent of total billed charges,38% of total billed charges,4941.66,75,,,percent of total billed charges,75% of total billed charges,5600.55,85,,,percent of total billed charges,85% of total billed charges,2503.77,6127.66,
OR FAC Suprapubic Cath Insertion,5991,CDM,360,RC,51040,HCPCS,outpatient,,,1141.31,855.98,,1027.18,90,,,percent of total billed charges,90% of total billed charges,1061.42,93,,,percent of total billed charges,93% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,970.11,85,,,percent of total billed charges,85% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,929.03,81.4,,,percent of total billed charges,81.4% of total billed charges,1027.18,90,,,percent of total billed charges,90% of total billed charges,1027.18,90,,,percent of total billed charges,90% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,433.7,38,,,percent of total billed charges,38% of total billed charges,855.98,75,,,percent of total billed charges,75% of total billed charges,970.11,85,,,percent of total billed charges,85% of total billed charges,433.7,1061.42,
OR FAC Cystourethroscopy,5992,CDM,360,RC,52000,HCPCS,outpatient,,,628.07,471.05,,565.26,90,,,percent of total billed charges,90% of total billed charges,584.11,93,,,percent of total billed charges,93% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,533.86,85,,,percent of total billed charges,85% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,511.25,81.4,,,percent of total billed charges,81.4% of total billed charges,565.26,90,,,percent of total billed charges,90% of total billed charges,565.26,90,,,percent of total billed charges,90% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,238.67,38,,,percent of total billed charges,38% of total billed charges,471.05,75,,,percent of total billed charges,75% of total billed charges,533.86,85,,,percent of total billed charges,85% of total billed charges,238.67,584.11,
OR FAC Cystourethroscopy w/biopsy,5993,CDM,360,RC,52204,HCPCS,outpatient,,,2819.29,2114.47,,2537.36,90,,,percent of total billed charges,90% of total billed charges,2621.94,93,,,percent of total billed charges,93% of total billed charges,1071.33,38,,,percent of total billed charges,38% of total billed charges,1071.33,38,,,percent of total billed charges,38% of total billed charges,2396.4,85,,,percent of total billed charges,85% of total billed charges,1071.33,38,,,percent of total billed charges,38% of total billed charges,2294.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2537.36,90,,,percent of total billed charges,90% of total billed charges,2537.36,90,,,percent of total billed charges,90% of total billed charges,1071.33,38,,,percent of total billed charges,38% of total billed charges,1071.33,38,,,percent of total billed charges,38% of total billed charges,1071.33,38,,,percent of total billed charges,38% of total billed charges,2114.47,75,,,percent of total billed charges,75% of total billed charges,2396.4,85,,,percent of total billed charges,85% of total billed charges,1071.33,2621.94,
OR FAC Cystourethroscopy Bladder Dilation,5994,CDM,360,RC,52260,HCPCS,outpatient,,,2655.24,1991.43,,2389.72,90,,,percent of total billed charges,90% of total billed charges,2469.37,93,,,percent of total billed charges,93% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,2256.95,85,,,percent of total billed charges,85% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,2161.37,81.4,,,percent of total billed charges,81.4% of total billed charges,2389.72,90,,,percent of total billed charges,90% of total billed charges,2389.72,90,,,percent of total billed charges,90% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,1008.99,38,,,percent of total billed charges,38% of total billed charges,1991.43,75,,,percent of total billed charges,75% of total billed charges,2256.95,85,,,percent of total billed charges,85% of total billed charges,1008.99,2469.37,
OR FAC Cysto w/Calibration,5995,CDM,360,RC,52281,HCPCS,outpatient,,,2827.48,2120.61,,2544.73,90,,,percent of total billed charges,90% of total billed charges,2629.56,93,,,percent of total billed charges,93% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,2403.36,85,,,percent of total billed charges,85% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,2301.57,81.4,,,percent of total billed charges,81.4% of total billed charges,2544.73,90,,,percent of total billed charges,90% of total billed charges,2544.73,90,,,percent of total billed charges,90% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,1074.44,38,,,percent of total billed charges,38% of total billed charges,2120.61,75,,,percent of total billed charges,75% of total billed charges,2403.36,85,,,percent of total billed charges,85% of total billed charges,1074.44,2629.56,
Cystoscopy with stent removal,5996,CDM,360,RC,52310,HCPCS,outpatient,,,2835.68,2126.76,,2552.11,90,,,percent of total billed charges,90% of total billed charges,2637.18,93,,,percent of total billed charges,93% of total billed charges,1077.56,38,,,percent of total billed charges,38% of total billed charges,1077.56,38,,,percent of total billed charges,38% of total billed charges,2410.33,85,,,percent of total billed charges,85% of total billed charges,1077.56,38,,,percent of total billed charges,38% of total billed charges,2308.24,81.4,,,percent of total billed charges,81.4% of total billed charges,2552.11,90,,,percent of total billed charges,90% of total billed charges,2552.11,90,,,percent of total billed charges,90% of total billed charges,1077.56,38,,,percent of total billed charges,38% of total billed charges,1077.56,38,,,percent of total billed charges,38% of total billed charges,1077.56,38,,,percent of total billed charges,38% of total billed charges,2126.76,75,,,percent of total billed charges,75% of total billed charges,2410.33,85,,,percent of total billed charges,85% of total billed charges,1077.56,2637.18,
OR FAC Cysto Ureteral Stent,5997,CDM,360,RC,52310,HCPCS,outpatient,,,2896.62,2172.47,,2606.96,90,,,percent of total billed charges,90% of total billed charges,2693.86,93,,,percent of total billed charges,93% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,2462.13,85,,,percent of total billed charges,85% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,2357.85,81.4,,,percent of total billed charges,81.4% of total billed charges,2606.96,90,,,percent of total billed charges,90% of total billed charges,2606.96,90,,,percent of total billed charges,90% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,1100.72,38,,,percent of total billed charges,38% of total billed charges,2172.47,75,,,percent of total billed charges,75% of total billed charges,2462.13,85,,,percent of total billed charges,85% of total billed charges,1100.72,2693.86,
"OR FAC Transurethral Resection, Bladder Neck",5998,CDM,360,RC,52500,HCPCS,outpatient,,,2350.59,1762.94,,2115.53,90,,,percent of total billed charges,90% of total billed charges,2186.05,93,,,percent of total billed charges,93% of total billed charges,893.22,38,,,percent of total billed charges,38% of total billed charges,893.22,38,,,percent of total billed charges,38% of total billed charges,1998,85,,,percent of total billed charges,85% of total billed charges,893.22,38,,,percent of total billed charges,38% of total billed charges,1913.38,81.4,,,percent of total billed charges,81.4% of total billed charges,2115.53,90,,,percent of total billed charges,90% of total billed charges,2115.53,90,,,percent of total billed charges,90% of total billed charges,893.22,38,,,percent of total billed charges,38% of total billed charges,893.22,38,,,percent of total billed charges,38% of total billed charges,893.22,38,,,percent of total billed charges,38% of total billed charges,1762.94,75,,,percent of total billed charges,75% of total billed charges,1998,85,,,percent of total billed charges,85% of total billed charges,893.22,2186.05,
OR FAC PVP,5999,CDM,360,RC,52648,HCPCS,outpatient,,,7842.69,5882.02,,7058.42,90,,,percent of total billed charges,90% of total billed charges,7293.7,93,,,percent of total billed charges,93% of total billed charges,2980.22,38,,,percent of total billed charges,38% of total billed charges,2980.22,38,,,percent of total billed charges,38% of total billed charges,6666.29,85,,,percent of total billed charges,85% of total billed charges,2980.22,38,,,percent of total billed charges,38% of total billed charges,6383.95,81.4,,,percent of total billed charges,81.4% of total billed charges,7058.42,90,,,percent of total billed charges,90% of total billed charges,7058.42,90,,,percent of total billed charges,90% of total billed charges,2980.22,38,,,percent of total billed charges,38% of total billed charges,2980.22,38,,,percent of total billed charges,38% of total billed charges,2980.22,38,,,percent of total billed charges,38% of total billed charges,5882.02,75,,,percent of total billed charges,75% of total billed charges,6666.29,85,,,percent of total billed charges,85% of total billed charges,2980.22,7293.7,
OR FAC Meatotomy,6000,CDM,360,RC,53020,HCPCS,outpatient,,,2075.2,1556.4,,1867.68,90,,,percent of total billed charges,90% of total billed charges,1929.94,93,,,percent of total billed charges,93% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1763.92,85,,,percent of total billed charges,85% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1689.21,81.4,,,percent of total billed charges,81.4% of total billed charges,1867.68,90,,,percent of total billed charges,90% of total billed charges,1867.68,90,,,percent of total billed charges,90% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1556.4,75,,,percent of total billed charges,75% of total billed charges,1763.92,85,,,percent of total billed charges,85% of total billed charges,788.58,1929.94,
OR FAC Urethral Biopsy,6001,CDM,360,RC,53200,HCPCS,outpatient,,,2075.2,1556.4,,1867.68,90,,,percent of total billed charges,90% of total billed charges,1929.94,93,,,percent of total billed charges,93% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1763.92,85,,,percent of total billed charges,85% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1689.21,81.4,,,percent of total billed charges,81.4% of total billed charges,1867.68,90,,,percent of total billed charges,90% of total billed charges,1867.68,90,,,percent of total billed charges,90% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1556.4,75,,,percent of total billed charges,75% of total billed charges,1763.92,85,,,percent of total billed charges,85% of total billed charges,788.58,1929.94,
OR FAC Urethromeatoplasty,6002,CDM,360,RC,53540,HCPCS,outpatient,,,2765.39,2074.04,,2488.85,90,,,percent of total billed charges,90% of total billed charges,2571.81,93,,,percent of total billed charges,93% of total billed charges,1050.85,38,,,percent of total billed charges,38% of total billed charges,1050.85,38,,,percent of total billed charges,38% of total billed charges,2350.58,85,,,percent of total billed charges,85% of total billed charges,1050.85,38,,,percent of total billed charges,38% of total billed charges,2251.03,81.4,,,percent of total billed charges,81.4% of total billed charges,2488.85,90,,,percent of total billed charges,90% of total billed charges,2488.85,90,,,percent of total billed charges,90% of total billed charges,1050.85,38,,,percent of total billed charges,38% of total billed charges,1050.85,38,,,percent of total billed charges,38% of total billed charges,1050.85,38,,,percent of total billed charges,38% of total billed charges,2074.04,75,,,percent of total billed charges,75% of total billed charges,2350.58,85,,,percent of total billed charges,85% of total billed charges,1050.85,2571.81,
OR FAC Dorsal slit of Prepuce,6003,CDM,360,RC,54001,HCPCS,outpatient,,,3777.53,2833.15,,3399.78,90,,,percent of total billed charges,90% of total billed charges,3513.1,93,,,percent of total billed charges,93% of total billed charges,1435.46,38,,,percent of total billed charges,38% of total billed charges,1435.46,38,,,percent of total billed charges,38% of total billed charges,3210.9,85,,,percent of total billed charges,85% of total billed charges,1435.46,38,,,percent of total billed charges,38% of total billed charges,3074.91,81.4,,,percent of total billed charges,81.4% of total billed charges,3399.78,90,,,percent of total billed charges,90% of total billed charges,3399.78,90,,,percent of total billed charges,90% of total billed charges,1435.46,38,,,percent of total billed charges,38% of total billed charges,1435.46,38,,,percent of total billed charges,38% of total billed charges,1435.46,38,,,percent of total billed charges,38% of total billed charges,2833.15,75,,,percent of total billed charges,75% of total billed charges,3210.9,85,,,percent of total billed charges,85% of total billed charges,1435.46,3513.1,
OR FAC Exc. lesions penis,6004,CDM,360,RC,54055,HCPCS,outpatient,,,1093.27,819.95,,983.94,90,,,percent of total billed charges,90% of total billed charges,1016.74,93,,,percent of total billed charges,93% of total billed charges,415.44,38,,,percent of total billed charges,38% of total billed charges,415.44,38,,,percent of total billed charges,38% of total billed charges,929.28,85,,,percent of total billed charges,85% of total billed charges,415.44,38,,,percent of total billed charges,38% of total billed charges,889.92,81.4,,,percent of total billed charges,81.4% of total billed charges,983.94,90,,,percent of total billed charges,90% of total billed charges,983.94,90,,,percent of total billed charges,90% of total billed charges,415.44,38,,,percent of total billed charges,38% of total billed charges,415.44,38,,,percent of total billed charges,38% of total billed charges,415.44,38,,,percent of total billed charges,38% of total billed charges,819.95,75,,,percent of total billed charges,75% of total billed charges,929.28,85,,,percent of total billed charges,85% of total billed charges,415.44,1016.74,
OR FAC Penis - destr. of lesions,6005,CDM,360,RC,54060,HCPCS,outpatient,,,1934.6,1450.95,,1741.14,90,,,percent of total billed charges,90% of total billed charges,1799.18,93,,,percent of total billed charges,93% of total billed charges,735.15,38,,,percent of total billed charges,38% of total billed charges,735.15,38,,,percent of total billed charges,38% of total billed charges,1644.41,85,,,percent of total billed charges,85% of total billed charges,735.15,38,,,percent of total billed charges,38% of total billed charges,1574.76,81.4,,,percent of total billed charges,81.4% of total billed charges,1741.14,90,,,percent of total billed charges,90% of total billed charges,1741.14,90,,,percent of total billed charges,90% of total billed charges,735.15,38,,,percent of total billed charges,38% of total billed charges,735.15,38,,,percent of total billed charges,38% of total billed charges,735.15,38,,,percent of total billed charges,38% of total billed charges,1450.95,75,,,percent of total billed charges,75% of total billed charges,1644.41,85,,,percent of total billed charges,85% of total billed charges,735.15,1799.18,
OR FAC Penis - biopsy,6006,CDM,360,RC,54100,HCPCS,outpatient,,,1660.41,1245.31,,1494.37,90,,,percent of total billed charges,90% of total billed charges,1544.18,93,,,percent of total billed charges,93% of total billed charges,630.96,38,,,percent of total billed charges,38% of total billed charges,630.96,38,,,percent of total billed charges,38% of total billed charges,1411.35,85,,,percent of total billed charges,85% of total billed charges,630.96,38,,,percent of total billed charges,38% of total billed charges,1351.57,81.4,,,percent of total billed charges,81.4% of total billed charges,1494.37,90,,,percent of total billed charges,90% of total billed charges,1494.37,90,,,percent of total billed charges,90% of total billed charges,630.96,38,,,percent of total billed charges,38% of total billed charges,630.96,38,,,percent of total billed charges,38% of total billed charges,630.96,38,,,percent of total billed charges,38% of total billed charges,1245.31,75,,,percent of total billed charges,75% of total billed charges,1411.35,85,,,percent of total billed charges,85% of total billed charges,630.96,1544.18,
OR FAC Partial Amp of Penis,6007,CDM,360,RC,54120,HCPCS,outpatient,,,6570.14,4927.61,,5913.13,90,,,percent of total billed charges,90% of total billed charges,6110.23,93,,,percent of total billed charges,93% of total billed charges,2496.65,38,,,percent of total billed charges,38% of total billed charges,2496.65,38,,,percent of total billed charges,38% of total billed charges,5584.62,85,,,percent of total billed charges,85% of total billed charges,2496.65,38,,,percent of total billed charges,38% of total billed charges,5348.09,81.4,,,percent of total billed charges,81.4% of total billed charges,5913.13,90,,,percent of total billed charges,90% of total billed charges,5913.13,90,,,percent of total billed charges,90% of total billed charges,2496.65,38,,,percent of total billed charges,38% of total billed charges,2496.65,38,,,percent of total billed charges,38% of total billed charges,2496.65,38,,,percent of total billed charges,38% of total billed charges,4927.61,75,,,percent of total billed charges,75% of total billed charges,5584.62,85,,,percent of total billed charges,85% of total billed charges,2496.65,6110.23,
OR FAC Circumcision,6008,CDM,360,RC,54161,HCPCS,outpatient,,,2075.2,1556.4,,1867.68,90,,,percent of total billed charges,90% of total billed charges,1929.94,93,,,percent of total billed charges,93% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1763.92,85,,,percent of total billed charges,85% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1689.21,81.4,,,percent of total billed charges,81.4% of total billed charges,1867.68,90,,,percent of total billed charges,90% of total billed charges,1867.68,90,,,percent of total billed charges,90% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1556.4,75,,,percent of total billed charges,75% of total billed charges,1763.92,85,,,percent of total billed charges,85% of total billed charges,788.58,1929.94,
OR FAC Lysis preputal adhesions,6009,CDM,360,RC,54162,HCPCS,outpatient,,,3018.51,2263.88,,2716.66,90,,,percent of total billed charges,90% of total billed charges,2807.21,93,,,percent of total billed charges,93% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,2565.73,85,,,percent of total billed charges,85% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,2457.07,81.4,,,percent of total billed charges,81.4% of total billed charges,2716.66,90,,,percent of total billed charges,90% of total billed charges,2716.66,90,,,percent of total billed charges,90% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,1147.03,38,,,percent of total billed charges,38% of total billed charges,2263.88,75,,,percent of total billed charges,75% of total billed charges,2565.73,85,,,percent of total billed charges,85% of total billed charges,1147.03,2807.21,
"OR FAC Circumcision, repair incomplete",6010,CDM,360,RC,54163,HCPCS,outpatient,,,2075.2,1556.4,,1867.68,90,,,percent of total billed charges,90% of total billed charges,1929.94,93,,,percent of total billed charges,93% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1763.92,85,,,percent of total billed charges,85% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1689.21,81.4,,,percent of total billed charges,81.4% of total billed charges,1867.68,90,,,percent of total billed charges,90% of total billed charges,1867.68,90,,,percent of total billed charges,90% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,788.58,38,,,percent of total billed charges,38% of total billed charges,1556.4,75,,,percent of total billed charges,75% of total billed charges,1763.92,85,,,percent of total billed charges,85% of total billed charges,788.58,1929.94,
OR FAC Lysis fo Preputial Adhesions,6011,CDM,360,RC,54450,HCPCS,outpatient,,,492.15,369.11,,442.94,90,,,percent of total billed charges,90% of total billed charges,457.7,93,,,percent of total billed charges,93% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,418.33,85,,,percent of total billed charges,85% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,400.61,81.4,,,percent of total billed charges,81.4% of total billed charges,442.94,90,,,percent of total billed charges,90% of total billed charges,442.94,90,,,percent of total billed charges,90% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,187.02,38,,,percent of total billed charges,38% of total billed charges,369.11,75,,,percent of total billed charges,75% of total billed charges,418.33,85,,,percent of total billed charges,85% of total billed charges,187.02,457.7,
"OR FAC Testis, Incisional Biopsy",6012,CDM,360,RC,54505,HCPCS,outpatient,,,1019.45,764.59,,917.51,90,,,percent of total billed charges,90% of total billed charges,948.09,93,,,percent of total billed charges,93% of total billed charges,387.39,38,,,percent of total billed charges,38% of total billed charges,387.39,38,,,percent of total billed charges,38% of total billed charges,866.53,85,,,percent of total billed charges,85% of total billed charges,387.39,38,,,percent of total billed charges,38% of total billed charges,829.83,81.4,,,percent of total billed charges,81.4% of total billed charges,917.51,90,,,percent of total billed charges,90% of total billed charges,917.51,90,,,percent of total billed charges,90% of total billed charges,387.39,38,,,percent of total billed charges,38% of total billed charges,387.39,38,,,percent of total billed charges,38% of total billed charges,387.39,38,,,percent of total billed charges,38% of total billed charges,764.59,75,,,percent of total billed charges,75% of total billed charges,866.53,85,,,percent of total billed charges,85% of total billed charges,387.39,948.09,
"OR FAC Orchiectomy,simple",6013,CDM,360,RC,54520,HCPCS,outpatient,,,2376.37,1782.28,,2138.73,90,,,percent of total billed charges,90% of total billed charges,2210.02,93,,,percent of total billed charges,93% of total billed charges,903.02,38,,,percent of total billed charges,38% of total billed charges,903.02,38,,,percent of total billed charges,38% of total billed charges,2019.91,85,,,percent of total billed charges,85% of total billed charges,903.02,38,,,percent of total billed charges,38% of total billed charges,1934.37,81.4,,,percent of total billed charges,81.4% of total billed charges,2138.73,90,,,percent of total billed charges,90% of total billed charges,2138.73,90,,,percent of total billed charges,90% of total billed charges,903.02,38,,,percent of total billed charges,38% of total billed charges,903.02,38,,,percent of total billed charges,38% of total billed charges,903.02,38,,,percent of total billed charges,38% of total billed charges,1782.28,75,,,percent of total billed charges,75% of total billed charges,2019.91,85,,,percent of total billed charges,85% of total billed charges,903.02,2210.02,
"OR FAC Orchiectomy, inguinal approach",6014,CDM,360,RC,54530,HCPCS,outpatient,,,3041.93,2281.45,,2737.74,90,,,percent of total billed charges,90% of total billed charges,2828.99,93,,,percent of total billed charges,93% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,2585.64,85,,,percent of total billed charges,85% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,2476.13,81.4,,,percent of total billed charges,81.4% of total billed charges,2737.74,90,,,percent of total billed charges,90% of total billed charges,2737.74,90,,,percent of total billed charges,90% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,2281.45,75,,,percent of total billed charges,75% of total billed charges,2585.64,85,,,percent of total billed charges,85% of total billed charges,1155.93,2828.99,
"OR FAC Testis, Reduction of Torsion",6015,CDM,360,RC,54600,HCPCS,outpatient,,,1948.68,1461.51,,1753.81,90,,,percent of total billed charges,90% of total billed charges,1812.27,93,,,percent of total billed charges,93% of total billed charges,740.5,38,,,percent of total billed charges,38% of total billed charges,740.5,38,,,percent of total billed charges,38% of total billed charges,1656.38,85,,,percent of total billed charges,85% of total billed charges,740.5,38,,,percent of total billed charges,38% of total billed charges,1586.23,81.4,,,percent of total billed charges,81.4% of total billed charges,1753.81,90,,,percent of total billed charges,90% of total billed charges,1753.81,90,,,percent of total billed charges,90% of total billed charges,740.5,38,,,percent of total billed charges,38% of total billed charges,740.5,38,,,percent of total billed charges,38% of total billed charges,740.5,38,,,percent of total billed charges,38% of total billed charges,1461.51,75,,,percent of total billed charges,75% of total billed charges,1656.38,85,,,percent of total billed charges,85% of total billed charges,740.5,1812.27,
OR FAC Epidiymus-needle biopsy,6016,CDM,360,RC,54800,HCPCS,outpatient,,,414.8,311.1,,373.32,90,,,percent of total billed charges,90% of total billed charges,385.76,93,,,percent of total billed charges,93% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,337.65,81.4,,,percent of total billed charges,81.4% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,311.1,75,,,percent of total billed charges,75% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,385.76,
"OR Fac EXC, local lesion epididymus",6017,CDM,360,RC,54830,HCPCS,outpatient,,,4023.87,3017.9,,3621.48,90,,,percent of total billed charges,90% of total billed charges,3742.2,93,,,percent of total billed charges,93% of total billed charges,1529.07,38,,,percent of total billed charges,38% of total billed charges,1529.07,38,,,percent of total billed charges,38% of total billed charges,3420.29,85,,,percent of total billed charges,85% of total billed charges,1529.07,38,,,percent of total billed charges,38% of total billed charges,3275.43,81.4,,,percent of total billed charges,81.4% of total billed charges,3621.48,90,,,percent of total billed charges,90% of total billed charges,3621.48,90,,,percent of total billed charges,90% of total billed charges,1529.07,38,,,percent of total billed charges,38% of total billed charges,1529.07,38,,,percent of total billed charges,38% of total billed charges,1529.07,38,,,percent of total billed charges,38% of total billed charges,3017.9,75,,,percent of total billed charges,75% of total billed charges,3420.29,85,,,percent of total billed charges,85% of total billed charges,1529.07,3742.2,
OR FAC Spermatocelectomy,6018,CDM,360,RC,54840,HCPCS,outpatient,,,2098.65,1573.99,,1888.79,90,,,percent of total billed charges,90% of total billed charges,1951.74,93,,,percent of total billed charges,93% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,1783.85,85,,,percent of total billed charges,85% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,1708.3,81.4,,,percent of total billed charges,81.4% of total billed charges,1888.79,90,,,percent of total billed charges,90% of total billed charges,1888.79,90,,,percent of total billed charges,90% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,797.49,38,,,percent of total billed charges,38% of total billed charges,1573.99,75,,,percent of total billed charges,75% of total billed charges,1783.85,85,,,percent of total billed charges,85% of total billed charges,797.49,1951.74,
OR FAC Epididyectomy-unilateral,6019,CDM,360,RC,54860,HCPCS,outpatient,,,2224.03,1668.02,,2001.63,90,,,percent of total billed charges,90% of total billed charges,2068.35,93,,,percent of total billed charges,93% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,1890.43,85,,,percent of total billed charges,85% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,1810.36,81.4,,,percent of total billed charges,81.4% of total billed charges,2001.63,90,,,percent of total billed charges,90% of total billed charges,2001.63,90,,,percent of total billed charges,90% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,845.13,38,,,percent of total billed charges,38% of total billed charges,1668.02,75,,,percent of total billed charges,75% of total billed charges,1890.43,85,,,percent of total billed charges,85% of total billed charges,845.13,2068.35,
"OR FAC Hydrocele, excision, unilateral",6020,CDM,360,RC,55040,HCPCS,outpatient,,,3041.93,2281.45,,2737.74,90,,,percent of total billed charges,90% of total billed charges,2828.99,93,,,percent of total billed charges,93% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,2585.64,85,,,percent of total billed charges,85% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,2476.13,81.4,,,percent of total billed charges,81.4% of total billed charges,2737.74,90,,,percent of total billed charges,90% of total billed charges,2737.74,90,,,percent of total billed charges,90% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,1155.93,38,,,percent of total billed charges,38% of total billed charges,2281.45,75,,,percent of total billed charges,75% of total billed charges,2585.64,85,,,percent of total billed charges,85% of total billed charges,1155.93,2828.99,
OR FAC Bilateral Hydrocele,6021,CDM,360,RC,55041,HCPCS,outpatient,,,4680.08,3510.06,,4212.07,90,,,percent of total billed charges,90% of total billed charges,4352.47,93,,,percent of total billed charges,93% of total billed charges,1778.43,38,,,percent of total billed charges,38% of total billed charges,1778.43,38,,,percent of total billed charges,38% of total billed charges,3978.07,85,,,percent of total billed charges,85% of total billed charges,1778.43,38,,,percent of total billed charges,38% of total billed charges,3809.59,81.4,,,percent of total billed charges,81.4% of total billed charges,4212.07,90,,,percent of total billed charges,90% of total billed charges,4212.07,90,,,percent of total billed charges,90% of total billed charges,1778.43,38,,,percent of total billed charges,38% of total billed charges,1778.43,38,,,percent of total billed charges,38% of total billed charges,1778.43,38,,,percent of total billed charges,38% of total billed charges,3510.06,75,,,percent of total billed charges,75% of total billed charges,3978.07,85,,,percent of total billed charges,85% of total billed charges,1778.43,4352.47,
OR FAC Scrotal Exploration,6022,CDM,360,RC,55110,HCPCS,outpatient,,,3937.17,2952.88,,3543.45,90,,,percent of total billed charges,90% of total billed charges,3661.57,93,,,percent of total billed charges,93% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,3346.59,85,,,percent of total billed charges,85% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,3204.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3543.45,90,,,percent of total billed charges,90% of total billed charges,3543.45,90,,,percent of total billed charges,90% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,2952.88,75,,,percent of total billed charges,75% of total billed charges,3346.59,85,,,percent of total billed charges,85% of total billed charges,1496.12,3661.57,
OR FAC Removal/foreign body scrotum,6023,CDM,360,RC,55120,HCPCS,outpatient,,,3937.17,2952.88,,3543.45,90,,,percent of total billed charges,90% of total billed charges,3661.57,93,,,percent of total billed charges,93% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,3346.59,85,,,percent of total billed charges,85% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,3204.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3543.45,90,,,percent of total billed charges,90% of total billed charges,3543.45,90,,,percent of total billed charges,90% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,1496.12,38,,,percent of total billed charges,38% of total billed charges,2952.88,75,,,percent of total billed charges,75% of total billed charges,3346.59,85,,,percent of total billed charges,85% of total billed charges,1496.12,3661.57,
OR FAC Vasectomy,6024,CDM,360,RC,55250,HCPCS,outpatient,,,1470.59,1102.94,,1323.53,90,,,percent of total billed charges,90% of total billed charges,1367.65,93,,,percent of total billed charges,93% of total billed charges,558.82,38,,,percent of total billed charges,38% of total billed charges,558.82,38,,,percent of total billed charges,38% of total billed charges,1250,85,,,percent of total billed charges,85% of total billed charges,558.82,38,,,percent of total billed charges,38% of total billed charges,1197.06,81.4,,,percent of total billed charges,81.4% of total billed charges,1323.53,90,,,percent of total billed charges,90% of total billed charges,1323.53,90,,,percent of total billed charges,90% of total billed charges,558.82,38,,,percent of total billed charges,38% of total billed charges,558.82,38,,,percent of total billed charges,38% of total billed charges,558.82,38,,,percent of total billed charges,38% of total billed charges,1102.94,75,,,percent of total billed charges,75% of total billed charges,1250,85,,,percent of total billed charges,85% of total billed charges,558.82,1367.65,
OR FAC Prostate - needle biopsy,6025,CDM,360,RC,55700,HCPCS,outpatient,,,1176.46,882.35,,1058.81,90,,,percent of total billed charges,90% of total billed charges,1094.11,93,,,percent of total billed charges,93% of total billed charges,447.05,38,,,percent of total billed charges,38% of total billed charges,447.05,38,,,percent of total billed charges,38% of total billed charges,999.99,85,,,percent of total billed charges,85% of total billed charges,447.05,38,,,percent of total billed charges,38% of total billed charges,957.64,81.4,,,percent of total billed charges,81.4% of total billed charges,1058.81,90,,,percent of total billed charges,90% of total billed charges,1058.81,90,,,percent of total billed charges,90% of total billed charges,447.05,38,,,percent of total billed charges,38% of total billed charges,447.05,38,,,percent of total billed charges,38% of total billed charges,447.05,38,,,percent of total billed charges,38% of total billed charges,882.35,75,,,percent of total billed charges,75% of total billed charges,999.99,85,,,percent of total billed charges,85% of total billed charges,447.05,1094.11,
"OR FAC TVT, OB Sling, Mini Arc Abdominal Approach",6026,CDM,360,RC,57280,HCPCS,outpatient,,,3529.38,2647.04,,3176.44,90,,,percent of total billed charges,90% of total billed charges,3282.32,93,,,percent of total billed charges,93% of total billed charges,1341.16,38,,,percent of total billed charges,38% of total billed charges,1341.16,38,,,percent of total billed charges,38% of total billed charges,2999.97,85,,,percent of total billed charges,85% of total billed charges,1341.16,38,,,percent of total billed charges,38% of total billed charges,2872.92,81.4,,,percent of total billed charges,81.4% of total billed charges,3176.44,90,,,percent of total billed charges,90% of total billed charges,3176.44,90,,,percent of total billed charges,90% of total billed charges,1341.16,38,,,percent of total billed charges,38% of total billed charges,1341.16,38,,,percent of total billed charges,38% of total billed charges,1341.16,38,,,percent of total billed charges,38% of total billed charges,2647.04,75,,,percent of total billed charges,75% of total billed charges,2999.97,85,,,percent of total billed charges,85% of total billed charges,1341.16,3282.32,
"OR FAC TVT, OB Sling, Mini Arc",6027,CDM,360,RC,57288,HCPCS,outpatient,,,5433.51,4075.13,,4890.16,90,,,percent of total billed charges,90% of total billed charges,5053.16,93,,,percent of total billed charges,93% of total billed charges,2064.73,38,,,percent of total billed charges,38% of total billed charges,2064.73,38,,,percent of total billed charges,38% of total billed charges,4618.48,85,,,percent of total billed charges,85% of total billed charges,2064.73,38,,,percent of total billed charges,38% of total billed charges,4422.88,81.4,,,percent of total billed charges,81.4% of total billed charges,4890.16,90,,,percent of total billed charges,90% of total billed charges,4890.16,90,,,percent of total billed charges,90% of total billed charges,2064.73,38,,,percent of total billed charges,38% of total billed charges,2064.73,38,,,percent of total billed charges,38% of total billed charges,2064.73,38,,,percent of total billed charges,38% of total billed charges,4075.13,75,,,percent of total billed charges,75% of total billed charges,4618.48,85,,,percent of total billed charges,85% of total billed charges,2064.73,5053.16,
OR Epidural Inj interlam-C/T Fac,6028,CDM,360,RC,62321,HCPCS,outpatient,,,819.06,614.3,,737.15,90,,,percent of total billed charges,90% of total billed charges,761.73,93,,,percent of total billed charges,93% of total billed charges,311.24,38,,,percent of total billed charges,38% of total billed charges,311.24,38,,,percent of total billed charges,38% of total billed charges,696.2,85,,,percent of total billed charges,85% of total billed charges,311.24,38,,,percent of total billed charges,38% of total billed charges,666.71,81.4,,,percent of total billed charges,81.4% of total billed charges,737.15,90,,,percent of total billed charges,90% of total billed charges,737.15,90,,,percent of total billed charges,90% of total billed charges,311.24,38,,,percent of total billed charges,38% of total billed charges,311.24,38,,,percent of total billed charges,38% of total billed charges,311.24,38,,,percent of total billed charges,38% of total billed charges,614.3,75,,,percent of total billed charges,75% of total billed charges,696.2,85,,,percent of total billed charges,85% of total billed charges,311.24,761.73,
ANES Epidural Steroid Injection LS w/o images,6029,CDM,963,RC,62322,HCPCS,outpatient,,,675.69,506.77,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,80.77,100,,,fee schedule,Pays 100% Medicare OPPS,80.77,100,,,fee schedule,Pays 100% Medicare OPPS,104.78,119,,,fee schedule,119% of fee schedule,80.77,100,,,fee schedule,Pays 100% Medicare OPPS,80.77,100,,,fee schedule,100% of fee schedule,608.12,90,,,percent of total billed charges,90% of total billed charges,80.77,100,,,fee schedule,Pays 100% Medicare OPPS,80.77,100,,,fee schedule,Pays 100% Medicare OPPS,80.77,100,,,fee schedule,Pays 100% Medicare OPPS,80.77,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,80.77,100,,,fee schedule,100% of fee schedule,80.77,608.12,
OR L/LS epidural/subarch inj- Fac,6030,CDM,360,RC,62323,HCPCS,outpatient,,,928.2,696.15,,835.38,90,,,percent of total billed charges,90% of total billed charges,863.23,93,,,percent of total billed charges,93% of total billed charges,352.72,38,,,percent of total billed charges,38% of total billed charges,352.72,38,,,percent of total billed charges,38% of total billed charges,788.97,85,,,percent of total billed charges,85% of total billed charges,352.72,38,,,percent of total billed charges,38% of total billed charges,755.55,81.4,,,percent of total billed charges,81.4% of total billed charges,835.38,90,,,percent of total billed charges,90% of total billed charges,835.38,90,,,percent of total billed charges,90% of total billed charges,352.72,38,,,percent of total billed charges,38% of total billed charges,352.72,38,,,percent of total billed charges,38% of total billed charges,352.72,38,,,percent of total billed charges,38% of total billed charges,696.15,75,,,percent of total billed charges,75% of total billed charges,788.97,85,,,percent of total billed charges,85% of total billed charges,352.72,863.23,
OR spinal implant percutaneous epidural-fac,6031,CDM,360,RC,63650,HCPCS,outpatient,,,1683,1262.25,,1514.7,90,,,percent of total billed charges,90% of total billed charges,1565.19,93,,,percent of total billed charges,93% of total billed charges,639.54,38,,,percent of total billed charges,38% of total billed charges,639.54,38,,,percent of total billed charges,38% of total billed charges,1430.55,85,,,percent of total billed charges,85% of total billed charges,639.54,38,,,percent of total billed charges,38% of total billed charges,1369.96,81.4,,,percent of total billed charges,81.4% of total billed charges,1514.7,90,,,percent of total billed charges,90% of total billed charges,1514.7,90,,,percent of total billed charges,90% of total billed charges,639.54,38,,,percent of total billed charges,38% of total billed charges,639.54,38,,,percent of total billed charges,38% of total billed charges,639.54,38,,,percent of total billed charges,38% of total billed charges,1262.25,75,,,percent of total billed charges,75% of total billed charges,1430.55,85,,,percent of total billed charges,85% of total billed charges,639.54,1565.19,
OR Ins/Rep Spinal stimulator perm-FAC,6032,CDM,360,RC,63685,HCPCS,outpatient,,,2754,2065.5,,2478.6,90,,,percent of total billed charges,90% of total billed charges,2561.22,93,,,percent of total billed charges,93% of total billed charges,1046.52,38,,,percent of total billed charges,38% of total billed charges,1046.52,38,,,percent of total billed charges,38% of total billed charges,2340.9,85,,,percent of total billed charges,85% of total billed charges,1046.52,38,,,percent of total billed charges,38% of total billed charges,2241.76,81.4,,,percent of total billed charges,81.4% of total billed charges,2478.6,90,,,percent of total billed charges,90% of total billed charges,2478.6,90,,,percent of total billed charges,90% of total billed charges,1046.52,38,,,percent of total billed charges,38% of total billed charges,1046.52,38,,,percent of total billed charges,38% of total billed charges,1046.52,38,,,percent of total billed charges,38% of total billed charges,2065.5,75,,,percent of total billed charges,75% of total billed charges,2340.9,85,,,percent of total billed charges,85% of total billed charges,1046.52,2561.22,
OR-Axillary Nerve Block  Fac,6033,CDM,360,RC,64417,HCPCS,outpatient,,,1027.14,770.36,,924.43,90,,,percent of total billed charges,90% of total billed charges,955.24,93,,,percent of total billed charges,93% of total billed charges,390.31,38,,,percent of total billed charges,38% of total billed charges,390.31,38,,,percent of total billed charges,38% of total billed charges,873.07,85,,,percent of total billed charges,85% of total billed charges,390.31,38,,,percent of total billed charges,38% of total billed charges,836.09,81.4,,,percent of total billed charges,81.4% of total billed charges,924.43,90,,,percent of total billed charges,90% of total billed charges,924.43,90,,,percent of total billed charges,90% of total billed charges,390.31,38,,,percent of total billed charges,38% of total billed charges,390.31,38,,,percent of total billed charges,38% of total billed charges,390.31,38,,,percent of total billed charges,38% of total billed charges,770.36,75,,,percent of total billed charges,75% of total billed charges,873.07,85,,,percent of total billed charges,85% of total billed charges,390.31,955.24,
OR Suprascapular Nerve Block - FAC,6034,CDM,360,RC,64418,HCPCS,outpatient,,,798.66,599,,718.79,90,,,percent of total billed charges,90% of total billed charges,742.75,93,,,percent of total billed charges,93% of total billed charges,303.49,38,,,percent of total billed charges,38% of total billed charges,303.49,38,,,percent of total billed charges,38% of total billed charges,678.86,85,,,percent of total billed charges,85% of total billed charges,303.49,38,,,percent of total billed charges,38% of total billed charges,650.11,81.4,,,percent of total billed charges,81.4% of total billed charges,718.79,90,,,percent of total billed charges,90% of total billed charges,718.79,90,,,percent of total billed charges,90% of total billed charges,303.49,38,,,percent of total billed charges,38% of total billed charges,303.49,38,,,percent of total billed charges,38% of total billed charges,303.49,38,,,percent of total billed charges,38% of total billed charges,599,75,,,percent of total billed charges,75% of total billed charges,678.86,85,,,percent of total billed charges,85% of total billed charges,303.49,742.75,
OR Other Periph Nerve block,6035,CDM,360,RC,64450,HCPCS,outpatient,,,795.6,596.7,,716.04,90,,,percent of total billed charges,90% of total billed charges,739.91,93,,,percent of total billed charges,93% of total billed charges,302.33,38,,,percent of total billed charges,38% of total billed charges,302.33,38,,,percent of total billed charges,38% of total billed charges,676.26,85,,,percent of total billed charges,85% of total billed charges,302.33,38,,,percent of total billed charges,38% of total billed charges,647.62,81.4,,,percent of total billed charges,81.4% of total billed charges,716.04,90,,,percent of total billed charges,90% of total billed charges,716.04,90,,,percent of total billed charges,90% of total billed charges,302.33,38,,,percent of total billed charges,38% of total billed charges,302.33,38,,,percent of total billed charges,38% of total billed charges,302.33,38,,,percent of total billed charges,38% of total billed charges,596.7,75,,,percent of total billed charges,75% of total billed charges,676.26,85,,,percent of total billed charges,85% of total billed charges,302.33,739.91,
OR Genicular Knee inj/block Fac,6036,CDM,360,RC,64454,HCPCS,outpatient,,,860.88,645.66,,774.79,90,,,percent of total billed charges,90% of total billed charges,800.62,93,,,percent of total billed charges,93% of total billed charges,327.13,38,,,percent of total billed charges,38% of total billed charges,327.13,38,,,percent of total billed charges,38% of total billed charges,731.75,85,,,percent of total billed charges,85% of total billed charges,327.13,38,,,percent of total billed charges,38% of total billed charges,700.76,81.4,,,percent of total billed charges,81.4% of total billed charges,774.79,90,,,percent of total billed charges,90% of total billed charges,774.79,90,,,percent of total billed charges,90% of total billed charges,327.13,38,,,percent of total billed charges,38% of total billed charges,327.13,38,,,percent of total billed charges,38% of total billed charges,327.13,38,,,percent of total billed charges,38% of total billed charges,645.66,75,,,percent of total billed charges,75% of total billed charges,731.75,85,,,percent of total billed charges,85% of total billed charges,327.13,800.62,
OR Epidural Inj tranfor-L/LS Fac,6037,CDM,360,RC,64483,HCPCS,outpatient,,,1016.94,762.71,,915.25,90,,,percent of total billed charges,90% of total billed charges,945.75,93,,,percent of total billed charges,93% of total billed charges,386.44,38,,,percent of total billed charges,38% of total billed charges,386.44,38,,,percent of total billed charges,38% of total billed charges,864.4,85,,,percent of total billed charges,85% of total billed charges,386.44,38,,,percent of total billed charges,38% of total billed charges,827.79,81.4,,,percent of total billed charges,81.4% of total billed charges,915.25,90,,,percent of total billed charges,90% of total billed charges,915.25,90,,,percent of total billed charges,90% of total billed charges,386.44,38,,,percent of total billed charges,38% of total billed charges,386.44,38,,,percent of total billed charges,38% of total billed charges,386.44,38,,,percent of total billed charges,38% of total billed charges,762.71,75,,,percent of total billed charges,75% of total billed charges,864.4,85,,,percent of total billed charges,85% of total billed charges,386.44,945.75,
OR Epidural Inj add level L/LS Fac,6038,CDM,360,RC,64484,HCPCS,outpatient,,,306,229.5,,275.4,90,,,percent of total billed charges,90% of total billed charges,284.58,93,,,percent of total billed charges,93% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,260.1,85,,,percent of total billed charges,85% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,249.08,81.4,,,percent of total billed charges,81.4% of total billed charges,275.4,90,,,percent of total billed charges,90% of total billed charges,275.4,90,,,percent of total billed charges,90% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,229.5,75,,,percent of total billed charges,75% of total billed charges,260.1,85,,,percent of total billed charges,85% of total billed charges,116.28,284.58,
OR Facet joint injection,6039,CDM,360,RC,64490,HCPCS,outpatient,,,1030.2,772.65,,927.18,90,,,percent of total billed charges,90% of total billed charges,958.09,93,,,percent of total billed charges,93% of total billed charges,391.48,38,,,percent of total billed charges,38% of total billed charges,391.48,38,,,percent of total billed charges,38% of total billed charges,875.67,85,,,percent of total billed charges,85% of total billed charges,391.48,38,,,percent of total billed charges,38% of total billed charges,838.58,81.4,,,percent of total billed charges,81.4% of total billed charges,927.18,90,,,percent of total billed charges,90% of total billed charges,927.18,90,,,percent of total billed charges,90% of total billed charges,391.48,38,,,percent of total billed charges,38% of total billed charges,391.48,38,,,percent of total billed charges,38% of total billed charges,391.48,38,,,percent of total billed charges,38% of total billed charges,772.65,75,,,percent of total billed charges,75% of total billed charges,875.67,85,,,percent of total billed charges,85% of total billed charges,391.48,958.09,
OR-Facet Joint/nerve inj -add,6040,CDM,360,RC,64491,HCPCS,outpatient,,,1122,841.5,,1009.8,90,,,percent of total billed charges,90% of total billed charges,1043.46,93,,,percent of total billed charges,93% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,953.7,85,,,percent of total billed charges,85% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,913.31,81.4,,,percent of total billed charges,81.4% of total billed charges,1009.8,90,,,percent of total billed charges,90% of total billed charges,1009.8,90,,,percent of total billed charges,90% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,841.5,75,,,percent of total billed charges,75% of total billed charges,953.7,85,,,percent of total billed charges,85% of total billed charges,426.36,1043.46,
"OR Block,L/S medial branch-Fac",6041,CDM,360,RC,64493,HCPCS,outpatient,,,1020,765,,918,90,,,percent of total billed charges,90% of total billed charges,948.6,93,,,percent of total billed charges,93% of total billed charges,387.6,38,,,percent of total billed charges,38% of total billed charges,387.6,38,,,percent of total billed charges,38% of total billed charges,867,85,,,percent of total billed charges,85% of total billed charges,387.6,38,,,percent of total billed charges,38% of total billed charges,830.28,81.4,,,percent of total billed charges,81.4% of total billed charges,918,90,,,percent of total billed charges,90% of total billed charges,918,90,,,percent of total billed charges,90% of total billed charges,387.6,38,,,percent of total billed charges,38% of total billed charges,387.6,38,,,percent of total billed charges,38% of total billed charges,387.6,38,,,percent of total billed charges,38% of total billed charges,765,75,,,percent of total billed charges,75% of total billed charges,867,85,,,percent of total billed charges,85% of total billed charges,387.6,948.6,
"OR 2nd,3rd add level L/S facet",6042,CDM,360,RC,64494,HCPCS,outpatient,,,357,267.75,,321.3,90,,,percent of total billed charges,90% of total billed charges,332.01,93,,,percent of total billed charges,93% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,303.45,85,,,percent of total billed charges,85% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,290.6,81.4,,,percent of total billed charges,81.4% of total billed charges,321.3,90,,,percent of total billed charges,90% of total billed charges,321.3,90,,,percent of total billed charges,90% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,135.66,38,,,percent of total billed charges,38% of total billed charges,267.75,75,,,percent of total billed charges,75% of total billed charges,303.45,85,,,percent of total billed charges,85% of total billed charges,135.66,332.01,
OR RFA genicular nervex3(knee),6043,CDM,360,RC,64624,HCPCS,outpatient,,,3672,2754,,3304.8,90,,,percent of total billed charges,90% of total billed charges,3414.96,93,,,percent of total billed charges,93% of total billed charges,1395.36,38,,,percent of total billed charges,38% of total billed charges,1395.36,38,,,percent of total billed charges,38% of total billed charges,3121.2,85,,,percent of total billed charges,85% of total billed charges,1395.36,38,,,percent of total billed charges,38% of total billed charges,2989.01,81.4,,,percent of total billed charges,81.4% of total billed charges,3304.8,90,,,percent of total billed charges,90% of total billed charges,3304.8,90,,,percent of total billed charges,90% of total billed charges,1395.36,38,,,percent of total billed charges,38% of total billed charges,1395.36,38,,,percent of total billed charges,38% of total billed charges,1395.36,38,,,percent of total billed charges,38% of total billed charges,2754,75,,,percent of total billed charges,75% of total billed charges,3121.2,85,,,percent of total billed charges,85% of total billed charges,1395.36,3414.96,
OR-DEST IO L/S vert Intracept-2 level vert,6044,CDM,360,RC,64628,HCPCS,outpatient,,,12240,9180,,11016,90,,,percent of total billed charges,90% of total billed charges,11383.2,93,,,percent of total billed charges,93% of total billed charges,4651.2,38,,,percent of total billed charges,38% of total billed charges,4651.2,38,,,percent of total billed charges,38% of total billed charges,10404,85,,,percent of total billed charges,85% of total billed charges,4651.2,38,,,percent of total billed charges,38% of total billed charges,9963.36,81.4,,,percent of total billed charges,81.4% of total billed charges,11016,90,,,percent of total billed charges,90% of total billed charges,11016,90,,,percent of total billed charges,90% of total billed charges,4651.2,38,,,percent of total billed charges,38% of total billed charges,4651.2,38,,,percent of total billed charges,38% of total billed charges,4651.2,38,,,percent of total billed charges,38% of total billed charges,9180,75,,,percent of total billed charges,75% of total billed charges,10404,85,,,percent of total billed charges,85% of total billed charges,4651.2,11383.2,
OR-DEST IO L/S vert Intracept ADDT-Fac,6045,CDM,360,RC,64629,HCPCS,outpatient,,,510,382.5,,459,90,,,percent of total billed charges,90% of total billed charges,474.3,93,,,percent of total billed charges,93% of total billed charges,193.8,38,,,percent of total billed charges,38% of total billed charges,193.8,38,,,percent of total billed charges,38% of total billed charges,433.5,85,,,percent of total billed charges,85% of total billed charges,193.8,38,,,percent of total billed charges,38% of total billed charges,415.14,81.4,,,percent of total billed charges,81.4% of total billed charges,459,90,,,percent of total billed charges,90% of total billed charges,459,90,,,percent of total billed charges,90% of total billed charges,193.8,38,,,percent of total billed charges,38% of total billed charges,193.8,38,,,percent of total billed charges,38% of total billed charges,193.8,38,,,percent of total billed charges,38% of total billed charges,382.5,75,,,percent of total billed charges,75% of total billed charges,433.5,85,,,percent of total billed charges,85% of total billed charges,193.8,474.3,
OR RFA C or T per joint,6046,CDM,360,RC,64633,HCPCS,outpatient,,,3800,2850,,3420,90,,,percent of total billed charges,90% of total billed charges,3534,93,,,percent of total billed charges,93% of total billed charges,1444,38,,,percent of total billed charges,38% of total billed charges,1444,38,,,percent of total billed charges,38% of total billed charges,3230,85,,,percent of total billed charges,85% of total billed charges,1444,38,,,percent of total billed charges,38% of total billed charges,3093.2,81.4,,,percent of total billed charges,81.4% of total billed charges,3420,90,,,percent of total billed charges,90% of total billed charges,3420,90,,,percent of total billed charges,90% of total billed charges,1444,38,,,percent of total billed charges,38% of total billed charges,1444,38,,,percent of total billed charges,38% of total billed charges,1444,38,,,percent of total billed charges,38% of total billed charges,2850,75,,,percent of total billed charges,75% of total billed charges,3230,85,,,percent of total billed charges,85% of total billed charges,1444,3534,
OR RFA C/T add joint,6047,CDM,360,RC,64634,HCPCS,outpatient,,,1000,750,,900,90,,,percent of total billed charges,90% of total billed charges,930,93,,,percent of total billed charges,93% of total billed charges,380,38,,,percent of total billed charges,38% of total billed charges,380,38,,,percent of total billed charges,38% of total billed charges,850,85,,,percent of total billed charges,85% of total billed charges,380,38,,,percent of total billed charges,38% of total billed charges,814,81.4,,,percent of total billed charges,81.4% of total billed charges,900,90,,,percent of total billed charges,90% of total billed charges,900,90,,,percent of total billed charges,90% of total billed charges,380,38,,,percent of total billed charges,38% of total billed charges,380,38,,,percent of total billed charges,38% of total billed charges,380,38,,,percent of total billed charges,38% of total billed charges,750,75,,,percent of total billed charges,75% of total billed charges,850,85,,,percent of total billed charges,85% of total billed charges,380,930,
OR RFA facet nerve L/S single,6048,CDM,360,RC,64635,HCPCS,outpatient,,,3264,2448,,2937.6,90,,,percent of total billed charges,90% of total billed charges,3035.52,93,,,percent of total billed charges,93% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,2774.4,85,,,percent of total billed charges,85% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,2656.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2937.6,90,,,percent of total billed charges,90% of total billed charges,2937.6,90,,,percent of total billed charges,90% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,2448,75,,,percent of total billed charges,75% of total billed charges,2774.4,85,,,percent of total billed charges,85% of total billed charges,1240.32,3035.52,
OR RFA facet nerve L/S addt,6049,CDM,360,RC,64636,HCPCS,outpatient,,,1836,1377,,1652.4,90,,,percent of total billed charges,90% of total billed charges,1707.48,93,,,percent of total billed charges,93% of total billed charges,697.68,38,,,percent of total billed charges,38% of total billed charges,697.68,38,,,percent of total billed charges,38% of total billed charges,1560.6,85,,,percent of total billed charges,85% of total billed charges,697.68,38,,,percent of total billed charges,38% of total billed charges,1494.5,81.4,,,percent of total billed charges,81.4% of total billed charges,1652.4,90,,,percent of total billed charges,90% of total billed charges,1652.4,90,,,percent of total billed charges,90% of total billed charges,697.68,38,,,percent of total billed charges,38% of total billed charges,697.68,38,,,percent of total billed charges,38% of total billed charges,697.68,38,,,percent of total billed charges,38% of total billed charges,1377,75,,,percent of total billed charges,75% of total billed charges,1560.6,85,,,percent of total billed charges,85% of total billed charges,697.68,1707.48,
OR RFA perip nerve ie shoulder,6050,CDM,360,RC,64640,HCPCS,outpatient,,,1224,918,,1101.6,90,,,percent of total billed charges,90% of total billed charges,1138.32,93,,,percent of total billed charges,93% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,1040.4,85,,,percent of total billed charges,85% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,996.34,81.4,,,percent of total billed charges,81.4% of total billed charges,1101.6,90,,,percent of total billed charges,90% of total billed charges,1101.6,90,,,percent of total billed charges,90% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,465.12,38,,,percent of total billed charges,38% of total billed charges,918,75,,,percent of total billed charges,75% of total billed charges,1040.4,85,,,percent of total billed charges,85% of total billed charges,465.12,1138.32,
OR FAC ulnar nerve tranposition elbow,6051,CDM,360,RC,64718,HCPCS,outpatient,,,3583.89,2687.92,,3225.5,90,,,percent of total billed charges,90% of total billed charges,3333.02,93,,,percent of total billed charges,93% of total billed charges,1361.88,38,,,percent of total billed charges,38% of total billed charges,1361.88,38,,,percent of total billed charges,38% of total billed charges,3046.31,85,,,percent of total billed charges,85% of total billed charges,1361.88,38,,,percent of total billed charges,38% of total billed charges,2917.29,81.4,,,percent of total billed charges,81.4% of total billed charges,3225.5,90,,,percent of total billed charges,90% of total billed charges,3225.5,90,,,percent of total billed charges,90% of total billed charges,1361.88,38,,,percent of total billed charges,38% of total billed charges,1361.88,38,,,percent of total billed charges,38% of total billed charges,1361.88,38,,,percent of total billed charges,38% of total billed charges,2687.92,75,,,percent of total billed charges,75% of total billed charges,3046.31,85,,,percent of total billed charges,85% of total billed charges,1361.88,3333.02,
"OR FAC Carpal Tunnel, med rep",6052,CDM,360,RC,64721,HCPCS,outpatient,,,3181.37,2386.03,,2863.23,90,,,percent of total billed charges,90% of total billed charges,2958.67,93,,,percent of total billed charges,93% of total billed charges,1208.92,38,,,percent of total billed charges,38% of total billed charges,1208.92,38,,,percent of total billed charges,38% of total billed charges,2704.16,85,,,percent of total billed charges,85% of total billed charges,1208.92,38,,,percent of total billed charges,38% of total billed charges,2589.64,81.4,,,percent of total billed charges,81.4% of total billed charges,2863.23,90,,,percent of total billed charges,90% of total billed charges,2863.23,90,,,percent of total billed charges,90% of total billed charges,1208.92,38,,,percent of total billed charges,38% of total billed charges,1208.92,38,,,percent of total billed charges,38% of total billed charges,1208.92,38,,,percent of total billed charges,38% of total billed charges,2386.03,75,,,percent of total billed charges,75% of total billed charges,2704.16,85,,,percent of total billed charges,85% of total billed charges,1208.92,2958.67,
OR FAC Decompress Nerve,6053,CDM,360,RC,64722,HCPCS,outpatient,,,3044.26,2283.2,,2739.83,90,,,percent of total billed charges,90% of total billed charges,2831.16,93,,,percent of total billed charges,93% of total billed charges,1156.82,38,,,percent of total billed charges,38% of total billed charges,1156.82,38,,,percent of total billed charges,38% of total billed charges,2587.62,85,,,percent of total billed charges,85% of total billed charges,1156.82,38,,,percent of total billed charges,38% of total billed charges,2478.03,81.4,,,percent of total billed charges,81.4% of total billed charges,2739.83,90,,,percent of total billed charges,90% of total billed charges,2739.83,90,,,percent of total billed charges,90% of total billed charges,1156.82,38,,,percent of total billed charges,38% of total billed charges,1156.82,38,,,percent of total billed charges,38% of total billed charges,1156.82,38,,,percent of total billed charges,38% of total billed charges,2283.2,75,,,percent of total billed charges,75% of total billed charges,2587.62,85,,,percent of total billed charges,85% of total billed charges,1156.82,2831.16,
OR FAC Ocular Implant-reinsertion,6054,CDM,360,RC,65150,HCPCS,outpatient,,,3256.37,2442.28,,2930.73,90,,,percent of total billed charges,90% of total billed charges,3028.42,93,,,percent of total billed charges,93% of total billed charges,1237.42,38,,,percent of total billed charges,38% of total billed charges,1237.42,38,,,percent of total billed charges,38% of total billed charges,2767.91,85,,,percent of total billed charges,85% of total billed charges,1237.42,38,,,percent of total billed charges,38% of total billed charges,2650.69,81.4,,,percent of total billed charges,81.4% of total billed charges,2930.73,90,,,percent of total billed charges,90% of total billed charges,2930.73,90,,,percent of total billed charges,90% of total billed charges,1237.42,38,,,percent of total billed charges,38% of total billed charges,1237.42,38,,,percent of total billed charges,38% of total billed charges,1237.42,38,,,percent of total billed charges,38% of total billed charges,2442.28,75,,,percent of total billed charges,75% of total billed charges,2767.91,85,,,percent of total billed charges,85% of total billed charges,1237.42,3028.42,
OR FAC Corneal repair wound,6055,CDM,360,RC,65275,HCPCS,outpatient,,,2282.62,1711.97,,2054.36,90,,,percent of total billed charges,90% of total billed charges,2122.84,93,,,percent of total billed charges,93% of total billed charges,867.4,38,,,percent of total billed charges,38% of total billed charges,867.4,38,,,percent of total billed charges,38% of total billed charges,1940.23,85,,,percent of total billed charges,85% of total billed charges,867.4,38,,,percent of total billed charges,38% of total billed charges,1858.05,81.4,,,percent of total billed charges,81.4% of total billed charges,2054.36,90,,,percent of total billed charges,90% of total billed charges,2054.36,90,,,percent of total billed charges,90% of total billed charges,867.4,38,,,percent of total billed charges,38% of total billed charges,867.4,38,,,percent of total billed charges,38% of total billed charges,867.4,38,,,percent of total billed charges,38% of total billed charges,1711.97,75,,,percent of total billed charges,75% of total billed charges,1940.23,85,,,percent of total billed charges,85% of total billed charges,867.4,2122.84,
OR FAC Corneal lac,6056,CDM,360,RC,65280,HCPCS,outpatient,,,3448.52,2586.39,,3103.67,90,,,percent of total billed charges,90% of total billed charges,3207.12,93,,,percent of total billed charges,93% of total billed charges,1310.44,38,,,percent of total billed charges,38% of total billed charges,1310.44,38,,,percent of total billed charges,38% of total billed charges,2931.24,85,,,percent of total billed charges,85% of total billed charges,1310.44,38,,,percent of total billed charges,38% of total billed charges,2807.1,81.4,,,percent of total billed charges,81.4% of total billed charges,3103.67,90,,,percent of total billed charges,90% of total billed charges,3103.67,90,,,percent of total billed charges,90% of total billed charges,1310.44,38,,,percent of total billed charges,38% of total billed charges,1310.44,38,,,percent of total billed charges,38% of total billed charges,1310.44,38,,,percent of total billed charges,38% of total billed charges,2586.39,75,,,percent of total billed charges,75% of total billed charges,2931.24,85,,,percent of total billed charges,85% of total billed charges,1310.44,3207.12,
OR FAC Exc. corneal lesion,6057,CDM,360,RC,65400,HCPCS,outpatient,,,2731.42,2048.57,,2458.28,90,,,percent of total billed charges,90% of total billed charges,2540.22,93,,,percent of total billed charges,93% of total billed charges,1037.94,38,,,percent of total billed charges,38% of total billed charges,1037.94,38,,,percent of total billed charges,38% of total billed charges,2321.71,85,,,percent of total billed charges,85% of total billed charges,1037.94,38,,,percent of total billed charges,38% of total billed charges,2223.38,81.4,,,percent of total billed charges,81.4% of total billed charges,2458.28,90,,,percent of total billed charges,90% of total billed charges,2458.28,90,,,percent of total billed charges,90% of total billed charges,1037.94,38,,,percent of total billed charges,38% of total billed charges,1037.94,38,,,percent of total billed charges,38% of total billed charges,1037.94,38,,,percent of total billed charges,38% of total billed charges,2048.57,75,,,percent of total billed charges,75% of total billed charges,2321.71,85,,,percent of total billed charges,85% of total billed charges,1037.94,2540.22,
OR FAC Exc pterygium w/o graft,6058,CDM,360,RC,65420,HCPCS,outpatient,,,965.54,724.16,,868.99,90,,,percent of total billed charges,90% of total billed charges,897.95,93,,,percent of total billed charges,93% of total billed charges,366.91,38,,,percent of total billed charges,38% of total billed charges,366.91,38,,,percent of total billed charges,38% of total billed charges,820.71,85,,,percent of total billed charges,85% of total billed charges,366.91,38,,,percent of total billed charges,38% of total billed charges,785.95,81.4,,,percent of total billed charges,81.4% of total billed charges,868.99,90,,,percent of total billed charges,90% of total billed charges,868.99,90,,,percent of total billed charges,90% of total billed charges,366.91,38,,,percent of total billed charges,38% of total billed charges,366.91,38,,,percent of total billed charges,38% of total billed charges,366.91,38,,,percent of total billed charges,38% of total billed charges,724.16,75,,,percent of total billed charges,75% of total billed charges,820.71,85,,,percent of total billed charges,85% of total billed charges,366.91,897.95,
OR FAC Pterygium exc. with graft,6059,CDM,360,RC,65426,HCPCS,outpatient,,,4483.21,3362.41,,4034.89,90,,,percent of total billed charges,90% of total billed charges,4169.39,93,,,percent of total billed charges,93% of total billed charges,1703.62,38,,,percent of total billed charges,38% of total billed charges,1703.62,38,,,percent of total billed charges,38% of total billed charges,3810.73,85,,,percent of total billed charges,85% of total billed charges,1703.62,38,,,percent of total billed charges,38% of total billed charges,3649.33,81.4,,,percent of total billed charges,81.4% of total billed charges,4034.89,90,,,percent of total billed charges,90% of total billed charges,4034.89,90,,,percent of total billed charges,90% of total billed charges,1703.62,38,,,percent of total billed charges,38% of total billed charges,1703.62,38,,,percent of total billed charges,38% of total billed charges,1703.62,38,,,percent of total billed charges,38% of total billed charges,3362.41,75,,,percent of total billed charges,75% of total billed charges,3810.73,85,,,percent of total billed charges,85% of total billed charges,1703.62,4169.39,
OR FAC Penetrating Keratoplasty,6060,CDM,360,RC,65730,HCPCS,outpatient,,,6640.46,4980.35,,5976.41,90,,,percent of total billed charges,90% of total billed charges,6175.63,93,,,percent of total billed charges,93% of total billed charges,2523.37,38,,,percent of total billed charges,38% of total billed charges,2523.37,38,,,percent of total billed charges,38% of total billed charges,5644.39,85,,,percent of total billed charges,85% of total billed charges,2523.37,38,,,percent of total billed charges,38% of total billed charges,5405.33,81.4,,,percent of total billed charges,81.4% of total billed charges,5976.41,90,,,percent of total billed charges,90% of total billed charges,5976.41,90,,,percent of total billed charges,90% of total billed charges,2523.37,38,,,percent of total billed charges,38% of total billed charges,2523.37,38,,,percent of total billed charges,38% of total billed charges,2523.37,38,,,percent of total billed charges,38% of total billed charges,4980.35,75,,,percent of total billed charges,75% of total billed charges,5644.39,85,,,percent of total billed charges,85% of total billed charges,2523.37,6175.63,
"OR FAC LRI, Limbal relaxing Incision",6061,CDM,360,RC,65772,HCPCS,outpatient,,,2138.48,1603.86,,1924.63,90,,,percent of total billed charges,90% of total billed charges,1988.79,93,,,percent of total billed charges,93% of total billed charges,812.62,38,,,percent of total billed charges,38% of total billed charges,812.62,38,,,percent of total billed charges,38% of total billed charges,1817.71,85,,,percent of total billed charges,85% of total billed charges,812.62,38,,,percent of total billed charges,38% of total billed charges,1740.72,81.4,,,percent of total billed charges,81.4% of total billed charges,1924.63,90,,,percent of total billed charges,90% of total billed charges,1924.63,90,,,percent of total billed charges,90% of total billed charges,812.62,38,,,percent of total billed charges,38% of total billed charges,812.62,38,,,percent of total billed charges,38% of total billed charges,812.62,38,,,percent of total billed charges,38% of total billed charges,1603.86,75,,,percent of total billed charges,75% of total billed charges,1817.71,85,,,percent of total billed charges,85% of total billed charges,812.62,1988.79,
OR FAC Ocular surface reconstruct w/ amniotic membrane,6062,CDM,360,RC,65780,HCPCS,outpatient,,,6157.67,4618.25,,5541.9,90,,,percent of total billed charges,90% of total billed charges,5726.63,93,,,percent of total billed charges,93% of total billed charges,2339.91,38,,,percent of total billed charges,38% of total billed charges,2339.91,38,,,percent of total billed charges,38% of total billed charges,5234.02,85,,,percent of total billed charges,85% of total billed charges,2339.91,38,,,percent of total billed charges,38% of total billed charges,5012.34,81.4,,,percent of total billed charges,81.4% of total billed charges,5541.9,90,,,percent of total billed charges,90% of total billed charges,5541.9,90,,,percent of total billed charges,90% of total billed charges,2339.91,38,,,percent of total billed charges,38% of total billed charges,2339.91,38,,,percent of total billed charges,38% of total billed charges,2339.91,38,,,percent of total billed charges,38% of total billed charges,4618.25,75,,,percent of total billed charges,75% of total billed charges,5234.02,85,,,percent of total billed charges,85% of total billed charges,2339.91,5726.63,
OR FAC Inject Anterior Chamber eye,6063,CDM,360,RC,66020,HCPCS,outpatient,,,2977.47,2233.1,,2679.72,90,,,percent of total billed charges,90% of total billed charges,2769.05,93,,,percent of total billed charges,93% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,2530.85,85,,,percent of total billed charges,85% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,2423.66,81.4,,,percent of total billed charges,81.4% of total billed charges,2679.72,90,,,percent of total billed charges,90% of total billed charges,2679.72,90,,,percent of total billed charges,90% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,1131.44,38,,,percent of total billed charges,38% of total billed charges,2233.1,75,,,percent of total billed charges,75% of total billed charges,2530.85,85,,,percent of total billed charges,85% of total billed charges,1131.44,2769.05,
OR Repair of Surg wound-FAC,6064,CDM,360,RC,66250,HCPCS,outpatient,,,3183.62,2387.72,,2865.26,90,,,percent of total billed charges,90% of total billed charges,2960.77,93,,,percent of total billed charges,93% of total billed charges,1209.78,38,,,percent of total billed charges,38% of total billed charges,1209.78,38,,,percent of total billed charges,38% of total billed charges,2706.08,85,,,percent of total billed charges,85% of total billed charges,1209.78,38,,,percent of total billed charges,38% of total billed charges,2591.47,81.4,,,percent of total billed charges,81.4% of total billed charges,2865.26,90,,,percent of total billed charges,90% of total billed charges,2865.26,90,,,percent of total billed charges,90% of total billed charges,1209.78,38,,,percent of total billed charges,38% of total billed charges,1209.78,38,,,percent of total billed charges,38% of total billed charges,1209.78,38,,,percent of total billed charges,38% of total billed charges,2387.72,75,,,percent of total billed charges,75% of total billed charges,2706.08,85,,,percent of total billed charges,85% of total billed charges,1209.78,2960.77,
OR FAC Suture of Iris,6065,CDM,360,RC,66682,HCPCS,outpatient,,,3229.41,2422.06,,2906.47,90,,,percent of total billed charges,90% of total billed charges,3003.35,93,,,percent of total billed charges,93% of total billed charges,1227.18,38,,,percent of total billed charges,38% of total billed charges,1227.18,38,,,percent of total billed charges,38% of total billed charges,2745,85,,,percent of total billed charges,85% of total billed charges,1227.18,38,,,percent of total billed charges,38% of total billed charges,2628.74,81.4,,,percent of total billed charges,81.4% of total billed charges,2906.47,90,,,percent of total billed charges,90% of total billed charges,2906.47,90,,,percent of total billed charges,90% of total billed charges,1227.18,38,,,percent of total billed charges,38% of total billed charges,1227.18,38,,,percent of total billed charges,38% of total billed charges,1227.18,38,,,percent of total billed charges,38% of total billed charges,2422.06,75,,,percent of total billed charges,75% of total billed charges,2745,85,,,percent of total billed charges,85% of total billed charges,1227.18,3003.35,
OR FAC YAG-Iridotomy,6066,CDM,360,RC,66761,HCPCS,outpatient,,,999.53,749.65,,899.58,90,,,percent of total billed charges,90% of total billed charges,929.56,93,,,percent of total billed charges,93% of total billed charges,379.82,38,,,percent of total billed charges,38% of total billed charges,379.82,38,,,percent of total billed charges,38% of total billed charges,849.6,85,,,percent of total billed charges,85% of total billed charges,379.82,38,,,percent of total billed charges,38% of total billed charges,813.62,81.4,,,percent of total billed charges,81.4% of total billed charges,899.58,90,,,percent of total billed charges,90% of total billed charges,899.58,90,,,percent of total billed charges,90% of total billed charges,379.82,38,,,percent of total billed charges,38% of total billed charges,379.82,38,,,percent of total billed charges,38% of total billed charges,379.82,38,,,percent of total billed charges,38% of total billed charges,749.65,75,,,percent of total billed charges,75% of total billed charges,849.6,85,,,percent of total billed charges,85% of total billed charges,379.82,929.56,
OR FAC YAG-Iridotomy-Bilateral,6067,CDM,360,RC,66761,HCPCS,outpatient,,,1999.06,1499.3,,1799.15,90,,,percent of total billed charges,90% of total billed charges,1859.13,93,,,percent of total billed charges,93% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,1699.2,85,,,percent of total billed charges,85% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,1627.23,81.4,,,percent of total billed charges,81.4% of total billed charges,1799.15,90,,,percent of total billed charges,90% of total billed charges,1799.15,90,,,percent of total billed charges,90% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,1499.3,75,,,percent of total billed charges,75% of total billed charges,1699.2,85,,,percent of total billed charges,85% of total billed charges,759.64,1859.13,
OR FAC YAG-Iridotomy-Bilateral,6068,CDM,360,RC,66761,HCPCS,outpatient,,,1999.06,1499.3,,1799.15,90,,,percent of total billed charges,90% of total billed charges,1859.13,93,,,percent of total billed charges,93% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,1699.2,85,,,percent of total billed charges,85% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,1627.23,81.4,,,percent of total billed charges,81.4% of total billed charges,1799.15,90,,,percent of total billed charges,90% of total billed charges,1799.15,90,,,percent of total billed charges,90% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,759.64,38,,,percent of total billed charges,38% of total billed charges,1499.3,75,,,percent of total billed charges,75% of total billed charges,1699.2,85,,,percent of total billed charges,85% of total billed charges,759.64,1859.13,
OR FAC YAG-Capsulotomy,6069,CDM,360,RC,66821,HCPCS,outpatient,,,880.02,660.02,,792.02,90,,,percent of total billed charges,90% of total billed charges,818.42,93,,,percent of total billed charges,93% of total billed charges,334.41,38,,,percent of total billed charges,38% of total billed charges,334.41,38,,,percent of total billed charges,38% of total billed charges,748.02,85,,,percent of total billed charges,85% of total billed charges,334.41,38,,,percent of total billed charges,38% of total billed charges,716.34,81.4,,,percent of total billed charges,81.4% of total billed charges,792.02,90,,,percent of total billed charges,90% of total billed charges,792.02,90,,,percent of total billed charges,90% of total billed charges,334.41,38,,,percent of total billed charges,38% of total billed charges,334.41,38,,,percent of total billed charges,38% of total billed charges,334.41,38,,,percent of total billed charges,38% of total billed charges,660.02,75,,,percent of total billed charges,75% of total billed charges,748.02,85,,,percent of total billed charges,85% of total billed charges,334.41,818.42,
OR FAC YAG-Capsulotomy -Bilateral,6070,CDM,360,RC,66821,HCPCS,outpatient,,,1761.17,1320.88,,1585.05,90,,,percent of total billed charges,90% of total billed charges,1637.89,93,,,percent of total billed charges,93% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,1496.99,85,,,percent of total billed charges,85% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,1433.59,81.4,,,percent of total billed charges,81.4% of total billed charges,1585.05,90,,,percent of total billed charges,90% of total billed charges,1585.05,90,,,percent of total billed charges,90% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,1320.88,75,,,percent of total billed charges,75% of total billed charges,1496.99,85,,,percent of total billed charges,85% of total billed charges,669.24,1637.89,
OR FAC YAG-Capsulotomy -Bilateral,6071,CDM,360,RC,66821,HCPCS,outpatient,,,1761.17,1320.88,,1585.05,90,,,percent of total billed charges,90% of total billed charges,1637.89,93,,,percent of total billed charges,93% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,1496.99,85,,,percent of total billed charges,85% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,1433.59,81.4,,,percent of total billed charges,81.4% of total billed charges,1585.05,90,,,percent of total billed charges,90% of total billed charges,1585.05,90,,,percent of total billed charges,90% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,669.24,38,,,percent of total billed charges,38% of total billed charges,1320.88,75,,,percent of total billed charges,75% of total billed charges,1496.99,85,,,percent of total billed charges,85% of total billed charges,669.24,1637.89,
"OR FAC Cataract removal, aspiration",6072,CDM,360,RC,66840,HCPCS,outpatient,,,1917.03,1437.77,,1725.33,90,,,percent of total billed charges,90% of total billed charges,1782.84,93,,,percent of total billed charges,93% of total billed charges,728.47,38,,,percent of total billed charges,38% of total billed charges,728.47,38,,,percent of total billed charges,38% of total billed charges,1629.48,85,,,percent of total billed charges,85% of total billed charges,728.47,38,,,percent of total billed charges,38% of total billed charges,1560.46,81.4,,,percent of total billed charges,81.4% of total billed charges,1725.33,90,,,percent of total billed charges,90% of total billed charges,1725.33,90,,,percent of total billed charges,90% of total billed charges,728.47,38,,,percent of total billed charges,38% of total billed charges,728.47,38,,,percent of total billed charges,38% of total billed charges,728.47,38,,,percent of total billed charges,38% of total billed charges,1437.77,75,,,percent of total billed charges,75% of total billed charges,1629.48,85,,,percent of total billed charges,85% of total billed charges,728.47,1782.84,
removal of lens material by frag,6073,CDM,360,RC,66850,HCPCS,outpatient,,,2252.33,1689.25,,2027.1,90,,,percent of total billed charges,90% of total billed charges,2094.67,93,,,percent of total billed charges,93% of total billed charges,855.89,38,,,percent of total billed charges,38% of total billed charges,855.89,38,,,percent of total billed charges,38% of total billed charges,1914.48,85,,,percent of total billed charges,85% of total billed charges,855.89,38,,,percent of total billed charges,38% of total billed charges,1833.4,81.4,,,percent of total billed charges,81.4% of total billed charges,2027.1,90,,,percent of total billed charges,90% of total billed charges,2027.1,90,,,percent of total billed charges,90% of total billed charges,855.89,38,,,percent of total billed charges,38% of total billed charges,855.89,38,,,percent of total billed charges,38% of total billed charges,855.89,38,,,percent of total billed charges,38% of total billed charges,1689.25,75,,,percent of total billed charges,75% of total billed charges,1914.48,85,,,percent of total billed charges,85% of total billed charges,855.89,2094.67,
OR FAC Extra cap cataract-no IOL,6074,CDM,360,RC,66940,HCPCS,outpatient,,,2623.6,1967.7,,2361.24,90,,,percent of total billed charges,90% of total billed charges,2439.95,93,,,percent of total billed charges,93% of total billed charges,996.97,38,,,percent of total billed charges,38% of total billed charges,996.97,38,,,percent of total billed charges,38% of total billed charges,2230.06,85,,,percent of total billed charges,85% of total billed charges,996.97,38,,,percent of total billed charges,38% of total billed charges,2135.61,81.4,,,percent of total billed charges,81.4% of total billed charges,2361.24,90,,,percent of total billed charges,90% of total billed charges,2361.24,90,,,percent of total billed charges,90% of total billed charges,996.97,38,,,percent of total billed charges,38% of total billed charges,996.97,38,,,percent of total billed charges,38% of total billed charges,996.97,38,,,percent of total billed charges,38% of total billed charges,1967.7,75,,,percent of total billed charges,75% of total billed charges,2230.06,85,,,percent of total billed charges,85% of total billed charges,996.97,2439.95,
"OR FAC Cataract removal, complex",6075,CDM,360,RC,66982,HCPCS,outpatient,,,3734.44,2800.83,,3361,90,,,percent of total billed charges,90% of total billed charges,3473.03,93,,,percent of total billed charges,93% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,3174.27,85,,,percent of total billed charges,85% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,3039.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3361,90,,,percent of total billed charges,90% of total billed charges,3361,90,,,percent of total billed charges,90% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,2800.83,75,,,percent of total billed charges,75% of total billed charges,3174.27,85,,,percent of total billed charges,85% of total billed charges,1419.09,3473.03,
OR FAC Cataract removal,6076,CDM,360,RC,66984,HCPCS,outpatient,,,3734.44,2800.83,,3361,90,,,percent of total billed charges,90% of total billed charges,3473.03,93,,,percent of total billed charges,93% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,3174.27,85,,,percent of total billed charges,85% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,3039.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3361,90,,,percent of total billed charges,90% of total billed charges,3361,90,,,percent of total billed charges,90% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,2800.83,75,,,percent of total billed charges,75% of total billed charges,3174.27,85,,,percent of total billed charges,85% of total billed charges,1419.09,3473.03,
OR FAC Insertion of IOL w/o cataract removal,6077,CDM,360,RC,66985,HCPCS,outpatient,,,3734.44,2800.83,,3361,90,,,percent of total billed charges,90% of total billed charges,3473.03,93,,,percent of total billed charges,93% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,3174.27,85,,,percent of total billed charges,85% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,3039.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3361,90,,,percent of total billed charges,90% of total billed charges,3361,90,,,percent of total billed charges,90% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,1419.09,38,,,percent of total billed charges,38% of total billed charges,2800.83,75,,,percent of total billed charges,75% of total billed charges,3174.27,85,,,percent of total billed charges,85% of total billed charges,1419.09,3473.03,
OR FAC Exchange of IOL,6078,CDM,360,RC,66986,HCPCS,outpatient,,,3678.19,2758.64,,3310.37,90,,,percent of total billed charges,90% of total billed charges,3420.72,93,,,percent of total billed charges,93% of total billed charges,1397.71,38,,,percent of total billed charges,38% of total billed charges,1397.71,38,,,percent of total billed charges,38% of total billed charges,3126.46,85,,,percent of total billed charges,85% of total billed charges,1397.71,38,,,percent of total billed charges,38% of total billed charges,2994.05,81.4,,,percent of total billed charges,81.4% of total billed charges,3310.37,90,,,percent of total billed charges,90% of total billed charges,3310.37,90,,,percent of total billed charges,90% of total billed charges,1397.71,38,,,percent of total billed charges,38% of total billed charges,1397.71,38,,,percent of total billed charges,38% of total billed charges,1397.71,38,,,percent of total billed charges,38% of total billed charges,2758.64,75,,,percent of total billed charges,75% of total billed charges,3126.46,85,,,percent of total billed charges,85% of total billed charges,1397.71,3420.72,
OR FAC Anterior vitrectomy,6079,CDM,360,RC,67010,HCPCS,outpatient,,,4917.95,3688.46,,4426.16,90,,,percent of total billed charges,90% of total billed charges,4573.69,93,,,percent of total billed charges,93% of total billed charges,1868.82,38,,,percent of total billed charges,38% of total billed charges,1868.82,38,,,percent of total billed charges,38% of total billed charges,4180.26,85,,,percent of total billed charges,85% of total billed charges,1868.82,38,,,percent of total billed charges,38% of total billed charges,4003.21,81.4,,,percent of total billed charges,81.4% of total billed charges,4426.16,90,,,percent of total billed charges,90% of total billed charges,4426.16,90,,,percent of total billed charges,90% of total billed charges,1868.82,38,,,percent of total billed charges,38% of total billed charges,1868.82,38,,,percent of total billed charges,38% of total billed charges,1868.82,38,,,percent of total billed charges,38% of total billed charges,3688.46,75,,,percent of total billed charges,75% of total billed charges,4180.26,85,,,percent of total billed charges,85% of total billed charges,1868.82,4573.69,
"OR FAC Vitrectomy, mechanical",6080,CDM,360,RC,67036,HCPCS,outpatient,,,5035.11,3776.33,,4531.6,90,,,percent of total billed charges,90% of total billed charges,4682.65,93,,,percent of total billed charges,93% of total billed charges,1913.34,38,,,percent of total billed charges,38% of total billed charges,1913.34,38,,,percent of total billed charges,38% of total billed charges,4279.84,85,,,percent of total billed charges,85% of total billed charges,1913.34,38,,,percent of total billed charges,38% of total billed charges,4098.58,81.4,,,percent of total billed charges,81.4% of total billed charges,4531.6,90,,,percent of total billed charges,90% of total billed charges,4531.6,90,,,percent of total billed charges,90% of total billed charges,1913.34,38,,,percent of total billed charges,38% of total billed charges,1913.34,38,,,percent of total billed charges,38% of total billed charges,1913.34,38,,,percent of total billed charges,38% of total billed charges,3776.33,75,,,percent of total billed charges,75% of total billed charges,4279.84,85,,,percent of total billed charges,85% of total billed charges,1913.34,4682.65,
OR FAC exc. Chalazion mult same lid,6081,CDM,360,RC,67801,HCPCS,outpatient,,,591.74,443.81,,532.57,90,,,percent of total billed charges,90% of total billed charges,550.32,93,,,percent of total billed charges,93% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,481.68,81.4,,,percent of total billed charges,81.4% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,443.81,75,,,percent of total billed charges,75% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,550.32,
OR FAC EXC chalazion w anesthesia,6082,CDM,360,RC,67808,HCPCS,outpatient,,,2840.36,2130.27,,2556.32,90,,,percent of total billed charges,90% of total billed charges,2641.53,93,,,percent of total billed charges,93% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,2414.31,85,,,percent of total billed charges,85% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,2312.05,81.4,,,percent of total billed charges,81.4% of total billed charges,2556.32,90,,,percent of total billed charges,90% of total billed charges,2556.32,90,,,percent of total billed charges,90% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,2130.27,75,,,percent of total billed charges,75% of total billed charges,2414.31,85,,,percent of total billed charges,85% of total billed charges,1079.34,2641.53,
OR FAC Exc. eyelid with biopsy,6083,CDM,360,RC,67840,HCPCS,outpatient,,,1270.22,952.67,,1143.2,90,,,percent of total billed charges,90% of total billed charges,1181.3,93,,,percent of total billed charges,93% of total billed charges,482.68,38,,,percent of total billed charges,38% of total billed charges,482.68,38,,,percent of total billed charges,38% of total billed charges,1079.69,85,,,percent of total billed charges,85% of total billed charges,482.68,38,,,percent of total billed charges,38% of total billed charges,1033.96,81.4,,,percent of total billed charges,81.4% of total billed charges,1143.2,90,,,percent of total billed charges,90% of total billed charges,1143.2,90,,,percent of total billed charges,90% of total billed charges,482.68,38,,,percent of total billed charges,38% of total billed charges,482.68,38,,,percent of total billed charges,38% of total billed charges,482.68,38,,,percent of total billed charges,38% of total billed charges,952.67,75,,,percent of total billed charges,75% of total billed charges,1079.69,85,,,percent of total billed charges,85% of total billed charges,482.68,1181.3,
OR FAC Eyelid closure-suture,6084,CDM,360,RC,67875,HCPCS,outpatient,,,1249.11,936.83,,1124.2,90,,,percent of total billed charges,90% of total billed charges,1161.67,93,,,percent of total billed charges,93% of total billed charges,474.66,38,,,percent of total billed charges,38% of total billed charges,474.66,38,,,percent of total billed charges,38% of total billed charges,1061.74,85,,,percent of total billed charges,85% of total billed charges,474.66,38,,,percent of total billed charges,38% of total billed charges,1016.78,81.4,,,percent of total billed charges,81.4% of total billed charges,1124.2,90,,,percent of total billed charges,90% of total billed charges,1124.2,90,,,percent of total billed charges,90% of total billed charges,474.66,38,,,percent of total billed charges,38% of total billed charges,474.66,38,,,percent of total billed charges,38% of total billed charges,474.66,38,,,percent of total billed charges,38% of total billed charges,936.83,75,,,percent of total billed charges,75% of total billed charges,1061.74,85,,,percent of total billed charges,85% of total billed charges,474.66,1161.67,
OR FAC Brow Ptosis Repair,6085,CDM,360,RC,67900,HCPCS,outpatient,,,4455.08,3341.31,,4009.57,90,,,percent of total billed charges,90% of total billed charges,4143.22,93,,,percent of total billed charges,93% of total billed charges,1692.93,38,,,percent of total billed charges,38% of total billed charges,1692.93,38,,,percent of total billed charges,38% of total billed charges,3786.82,85,,,percent of total billed charges,85% of total billed charges,1692.93,38,,,percent of total billed charges,38% of total billed charges,3626.44,81.4,,,percent of total billed charges,81.4% of total billed charges,4009.57,90,,,percent of total billed charges,90% of total billed charges,4009.57,90,,,percent of total billed charges,90% of total billed charges,1692.93,38,,,percent of total billed charges,38% of total billed charges,1692.93,38,,,percent of total billed charges,38% of total billed charges,1692.93,38,,,percent of total billed charges,38% of total billed charges,3341.31,75,,,percent of total billed charges,75% of total billed charges,3786.82,85,,,percent of total billed charges,85% of total billed charges,1692.93,4143.22,
OR FAC Rep of blepharoptosis,6086,CDM,360,RC,67904,HCPCS,outpatient,,,2635.31,1976.48,,2371.78,90,,,percent of total billed charges,90% of total billed charges,2450.84,93,,,percent of total billed charges,93% of total billed charges,1001.42,38,,,percent of total billed charges,38% of total billed charges,1001.42,38,,,percent of total billed charges,38% of total billed charges,2240.01,85,,,percent of total billed charges,85% of total billed charges,1001.42,38,,,percent of total billed charges,38% of total billed charges,2145.14,81.4,,,percent of total billed charges,81.4% of total billed charges,2371.78,90,,,percent of total billed charges,90% of total billed charges,2371.78,90,,,percent of total billed charges,90% of total billed charges,1001.42,38,,,percent of total billed charges,38% of total billed charges,1001.42,38,,,percent of total billed charges,38% of total billed charges,1001.42,38,,,percent of total billed charges,38% of total billed charges,1976.48,75,,,percent of total billed charges,75% of total billed charges,2240.01,85,,,percent of total billed charges,85% of total billed charges,1001.42,2450.84,
OR FAC Reduction of overcorrection of ptosis,6087,CDM,360,RC,67909,HCPCS,outpatient,,,3140.36,2355.27,,2826.32,90,,,percent of total billed charges,90% of total billed charges,2920.53,93,,,percent of total billed charges,93% of total billed charges,1193.34,38,,,percent of total billed charges,38% of total billed charges,1193.34,38,,,percent of total billed charges,38% of total billed charges,2669.31,85,,,percent of total billed charges,85% of total billed charges,1193.34,38,,,percent of total billed charges,38% of total billed charges,2556.25,81.4,,,percent of total billed charges,81.4% of total billed charges,2826.32,90,,,percent of total billed charges,90% of total billed charges,2826.32,90,,,percent of total billed charges,90% of total billed charges,1193.34,38,,,percent of total billed charges,38% of total billed charges,1193.34,38,,,percent of total billed charges,38% of total billed charges,1193.34,38,,,percent of total billed charges,38% of total billed charges,2355.27,75,,,percent of total billed charges,75% of total billed charges,2669.31,85,,,percent of total billed charges,85% of total billed charges,1193.34,2920.53,
OR FAC Ectropion Repair,6088,CDM,360,RC,67916,HCPCS,outpatient,,,2840.36,2130.27,,2556.32,90,,,percent of total billed charges,90% of total billed charges,2641.53,93,,,percent of total billed charges,93% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,2414.31,85,,,percent of total billed charges,85% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,2312.05,81.4,,,percent of total billed charges,81.4% of total billed charges,2556.32,90,,,percent of total billed charges,90% of total billed charges,2556.32,90,,,percent of total billed charges,90% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,1079.34,38,,,percent of total billed charges,38% of total billed charges,2130.27,75,,,percent of total billed charges,75% of total billed charges,2414.31,85,,,percent of total billed charges,85% of total billed charges,1079.34,2641.53,
OR FAC Rep Ectop. ext.,6089,CDM,360,RC,67917,HCPCS,outpatient,,,3202.44,2401.83,,2882.2,90,,,percent of total billed charges,90% of total billed charges,2978.27,93,,,percent of total billed charges,93% of total billed charges,1216.93,38,,,percent of total billed charges,38% of total billed charges,1216.93,38,,,percent of total billed charges,38% of total billed charges,2722.07,85,,,percent of total billed charges,85% of total billed charges,1216.93,38,,,percent of total billed charges,38% of total billed charges,2606.79,81.4,,,percent of total billed charges,81.4% of total billed charges,2882.2,90,,,percent of total billed charges,90% of total billed charges,2882.2,90,,,percent of total billed charges,90% of total billed charges,1216.93,38,,,percent of total billed charges,38% of total billed charges,1216.93,38,,,percent of total billed charges,38% of total billed charges,1216.93,38,,,percent of total billed charges,38% of total billed charges,2401.83,75,,,percent of total billed charges,75% of total billed charges,2722.07,85,,,percent of total billed charges,85% of total billed charges,1216.93,2978.27,
OR FAC Rep of Entrop,6090,CDM,360,RC,67923,HCPCS,outpatient,,,2955.21,2216.41,,2659.69,90,,,percent of total billed charges,90% of total billed charges,2748.35,93,,,percent of total billed charges,93% of total billed charges,1122.98,38,,,percent of total billed charges,38% of total billed charges,1122.98,38,,,percent of total billed charges,38% of total billed charges,2511.93,85,,,percent of total billed charges,85% of total billed charges,1122.98,38,,,percent of total billed charges,38% of total billed charges,2405.54,81.4,,,percent of total billed charges,81.4% of total billed charges,2659.69,90,,,percent of total billed charges,90% of total billed charges,2659.69,90,,,percent of total billed charges,90% of total billed charges,1122.98,38,,,percent of total billed charges,38% of total billed charges,1122.98,38,,,percent of total billed charges,38% of total billed charges,1122.98,38,,,percent of total billed charges,38% of total billed charges,2216.41,75,,,percent of total billed charges,75% of total billed charges,2511.93,85,,,percent of total billed charges,85% of total billed charges,1122.98,2748.35,
OR FAC Rep Entrop ext,6091,CDM,360,RC,67924,HCPCS,outpatient,,,3265.74,2449.31,,2939.17,90,,,percent of total billed charges,90% of total billed charges,3037.14,93,,,percent of total billed charges,93% of total billed charges,1240.98,38,,,percent of total billed charges,38% of total billed charges,1240.98,38,,,percent of total billed charges,38% of total billed charges,2775.88,85,,,percent of total billed charges,85% of total billed charges,1240.98,38,,,percent of total billed charges,38% of total billed charges,2658.31,81.4,,,percent of total billed charges,81.4% of total billed charges,2939.17,90,,,percent of total billed charges,90% of total billed charges,2939.17,90,,,percent of total billed charges,90% of total billed charges,1240.98,38,,,percent of total billed charges,38% of total billed charges,1240.98,38,,,percent of total billed charges,38% of total billed charges,1240.98,38,,,percent of total billed charges,38% of total billed charges,2449.31,75,,,percent of total billed charges,75% of total billed charges,2775.88,85,,,percent of total billed charges,85% of total billed charges,1240.98,3037.14,
OR FAC Conjunctival  bx,6092,CDM,360,RC,68100,HCPCS,outpatient,,,949.15,711.86,,854.24,90,,,percent of total billed charges,90% of total billed charges,882.71,93,,,percent of total billed charges,93% of total billed charges,360.68,38,,,percent of total billed charges,38% of total billed charges,360.68,38,,,percent of total billed charges,38% of total billed charges,806.78,85,,,percent of total billed charges,85% of total billed charges,360.68,38,,,percent of total billed charges,38% of total billed charges,772.61,81.4,,,percent of total billed charges,81.4% of total billed charges,854.24,90,,,percent of total billed charges,90% of total billed charges,854.24,90,,,percent of total billed charges,90% of total billed charges,360.68,38,,,percent of total billed charges,38% of total billed charges,360.68,38,,,percent of total billed charges,38% of total billed charges,360.68,38,,,percent of total billed charges,38% of total billed charges,711.86,75,,,percent of total billed charges,75% of total billed charges,806.78,85,,,percent of total billed charges,85% of total billed charges,360.68,882.71,
OR FAC Biopsy lacrimal gland,6093,CDM,360,RC,68510,HCPCS,outpatient,,,2952.86,2214.65,,2657.57,90,,,percent of total billed charges,90% of total billed charges,2746.16,93,,,percent of total billed charges,93% of total billed charges,1122.09,38,,,percent of total billed charges,38% of total billed charges,1122.09,38,,,percent of total billed charges,38% of total billed charges,2509.93,85,,,percent of total billed charges,85% of total billed charges,1122.09,38,,,percent of total billed charges,38% of total billed charges,2403.63,81.4,,,percent of total billed charges,81.4% of total billed charges,2657.57,90,,,percent of total billed charges,90% of total billed charges,2657.57,90,,,percent of total billed charges,90% of total billed charges,1122.09,38,,,percent of total billed charges,38% of total billed charges,1122.09,38,,,percent of total billed charges,38% of total billed charges,1122.09,38,,,percent of total billed charges,38% of total billed charges,2214.65,75,,,percent of total billed charges,75% of total billed charges,2509.93,85,,,percent of total billed charges,85% of total billed charges,1122.09,2746.16,
OR FAC Surgery-IV Therapy-Initial,6096,CDM,360,RC,96365,HCPCS,outpatient,,,229.67,172.25,,206.7,90,,,percent of total billed charges,90% of total billed charges,213.59,93,,,percent of total billed charges,93% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,195.22,85,,,percent of total billed charges,85% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,186.95,81.4,,,percent of total billed charges,81.4% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,172.25,75,,,percent of total billed charges,75% of total billed charges,195.22,85,,,percent of total billed charges,85% of total billed charges,87.27,213.59,
OR Single use probe kit,6097,CDM,278,RC,A4649,HCPCS,both,,,4590,3442.5,,4131,90,,,percent of total billed charges,90% of total billed charges,4268.7,93,,,percent of total billed charges,93% of total billed charges,1744.2,38,,,percent of total billed charges,38% of total billed charges,1744.2,38,,,percent of total billed charges,38% of total billed charges,3901.5,85,,,percent of total billed charges,85% of total billed charges,1744.2,38,,,percent of total billed charges,38% of total billed charges,3736.26,81.4,,,percent of total billed charges,81.4% of total billed charges,4131,90,,,percent of total billed charges,90% of total billed charges,4131,90,,,percent of total billed charges,90% of total billed charges,1744.2,38,,,percent of total billed charges,38% of total billed charges,1744.2,38,,,percent of total billed charges,38% of total billed charges,1744.2,38,,,percent of total billed charges,38% of total billed charges,3442.5,75,,,percent of total billed charges,75% of total billed charges,3901.5,85,,,percent of total billed charges,85% of total billed charges,1744.2,4268.7,
Bactisure Wound Lavage,6098,CDM,272,RC,A6260,HCPCS,outpatient,,,1082.43,811.82,,974.19,90,,,percent of total billed charges,90% of total billed charges,1006.66,93,,,percent of total billed charges,93% of total billed charges,411.32,38,,,percent of total billed charges,38% of total billed charges,411.32,38,,,percent of total billed charges,38% of total billed charges,920.07,85,,,percent of total billed charges,85% of total billed charges,411.32,38,,,percent of total billed charges,38% of total billed charges,881.1,81.4,,,percent of total billed charges,81.4% of total billed charges,974.19,90,,,percent of total billed charges,90% of total billed charges,974.19,90,,,percent of total billed charges,90% of total billed charges,411.32,38,,,percent of total billed charges,38% of total billed charges,411.32,38,,,percent of total billed charges,38% of total billed charges,411.32,38,,,percent of total billed charges,38% of total billed charges,811.82,75,,,percent of total billed charges,75% of total billed charges,920.07,85,,,percent of total billed charges,85% of total billed charges,411.32,1006.66,
articular surface,6099,CDM,278,RC,,,both,,,1636.88,1227.66,,1473.19,90,,,percent of total billed charges,90% of total billed charges,1522.3,93,,,percent of total billed charges,93% of total billed charges,622.01,38,,,percent of total billed charges,38% of total billed charges,622.01,38,,,percent of total billed charges,38% of total billed charges,1391.35,85,,,percent of total billed charges,85% of total billed charges,622.01,38,,,percent of total billed charges,38% of total billed charges,1332.42,81.4,,,percent of total billed charges,81.4% of total billed charges,1473.19,90,,,percent of total billed charges,90% of total billed charges,1473.19,90,,,percent of total billed charges,90% of total billed charges,622.01,38,,,percent of total billed charges,38% of total billed charges,622.01,38,,,percent of total billed charges,38% of total billed charges,622.01,38,,,percent of total billed charges,38% of total billed charges,1227.66,75,,,percent of total billed charges,75% of total billed charges,1391.35,85,,,percent of total billed charges,85% of total billed charges,622.01,1522.3,
Articular surface-UNI,6100,CDM,278,RC,,,both,,,1174.59,880.94,,1057.13,90,,,percent of total billed charges,90% of total billed charges,1092.37,93,,,percent of total billed charges,93% of total billed charges,446.34,38,,,percent of total billed charges,38% of total billed charges,446.34,38,,,percent of total billed charges,38% of total billed charges,998.4,85,,,percent of total billed charges,85% of total billed charges,446.34,38,,,percent of total billed charges,38% of total billed charges,956.12,81.4,,,percent of total billed charges,81.4% of total billed charges,1057.13,90,,,percent of total billed charges,90% of total billed charges,1057.13,90,,,percent of total billed charges,90% of total billed charges,446.34,38,,,percent of total billed charges,38% of total billed charges,446.34,38,,,percent of total billed charges,38% of total billed charges,446.34,38,,,percent of total billed charges,38% of total billed charges,880.94,75,,,percent of total billed charges,75% of total billed charges,998.4,85,,,percent of total billed charges,85% of total billed charges,446.34,1092.37,
Articular surface inserter,6101,CDM,278,RC,,,both,,,219.61,164.71,,197.65,90,,,percent of total billed charges,90% of total billed charges,204.24,93,,,percent of total billed charges,93% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,186.67,85,,,percent of total billed charges,85% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,178.76,81.4,,,percent of total billed charges,81.4% of total billed charges,197.65,90,,,percent of total billed charges,90% of total billed charges,197.65,90,,,percent of total billed charges,90% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,164.71,75,,,percent of total billed charges,75% of total billed charges,186.67,85,,,percent of total billed charges,85% of total billed charges,83.45,204.24,
Blood conservation w PVC drain,6102,CDM,272,RC,,,outpatient,,,1654.1,1240.58,,1488.69,90,,,percent of total billed charges,90% of total billed charges,1538.31,93,,,percent of total billed charges,93% of total billed charges,628.56,38,,,percent of total billed charges,38% of total billed charges,628.56,38,,,percent of total billed charges,38% of total billed charges,1405.99,85,,,percent of total billed charges,85% of total billed charges,628.56,38,,,percent of total billed charges,38% of total billed charges,1346.44,81.4,,,percent of total billed charges,81.4% of total billed charges,1488.69,90,,,percent of total billed charges,90% of total billed charges,1488.69,90,,,percent of total billed charges,90% of total billed charges,628.56,38,,,percent of total billed charges,38% of total billed charges,628.56,38,,,percent of total billed charges,38% of total billed charges,628.56,38,,,percent of total billed charges,38% of total billed charges,1240.58,75,,,percent of total billed charges,75% of total billed charges,1405.99,85,,,percent of total billed charges,85% of total billed charges,628.56,1538.31,
Knee-uni slotted holding pin,6103,CDM,278,RC,C1713,HCPCS,both,,,274.79,206.09,,247.31,90,,,percent of total billed charges,90% of total billed charges,255.55,93,,,percent of total billed charges,93% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,233.57,85,,,percent of total billed charges,85% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,223.68,81.4,,,percent of total billed charges,81.4% of total billed charges,247.31,90,,,percent of total billed charges,90% of total billed charges,247.31,90,,,percent of total billed charges,90% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,104.42,38,,,percent of total billed charges,38% of total billed charges,206.09,75,,,percent of total billed charges,75% of total billed charges,233.57,85,,,percent of total billed charges,85% of total billed charges,104.42,255.55,
Mis Flex articular sur locking screw,6104,CDM,272,RC,C1713,HCPCS,outpatient,,,110.4,82.8,,99.36,90,,,percent of total billed charges,90% of total billed charges,102.67,93,,,percent of total billed charges,93% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,89.87,81.4,,,percent of total billed charges,81.4% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,41.95,38,,,percent of total billed charges,38% of total billed charges,82.8,75,,,percent of total billed charges,75% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,41.95,102.67,
MIS Head screw 48mm,6105,CDM,278,RC,C1713,HCPCS,both,,,101.36,76.02,,91.22,90,,,percent of total billed charges,90% of total billed charges,94.26,93,,,percent of total billed charges,93% of total billed charges,38.52,38,,,percent of total billed charges,38% of total billed charges,38.52,38,,,percent of total billed charges,38% of total billed charges,86.16,85,,,percent of total billed charges,85% of total billed charges,38.52,38,,,percent of total billed charges,38% of total billed charges,82.51,81.4,,,percent of total billed charges,81.4% of total billed charges,91.22,90,,,percent of total billed charges,90% of total billed charges,91.22,90,,,percent of total billed charges,90% of total billed charges,38.52,38,,,percent of total billed charges,38% of total billed charges,38.52,38,,,percent of total billed charges,38% of total billed charges,38.52,38,,,percent of total billed charges,38% of total billed charges,76.02,75,,,percent of total billed charges,75% of total billed charges,86.16,85,,,percent of total billed charges,85% of total billed charges,38.52,94.26,
OXF Uni TIB tray,6106,CDM,278,RC,C1713,HCPCS,both,,,2233.8,1675.35,,2010.42,90,,,percent of total billed charges,90% of total billed charges,2077.43,93,,,percent of total billed charges,93% of total billed charges,848.84,38,,,percent of total billed charges,38% of total billed charges,848.84,38,,,percent of total billed charges,38% of total billed charges,1898.73,85,,,percent of total billed charges,85% of total billed charges,848.84,38,,,percent of total billed charges,38% of total billed charges,1818.31,81.4,,,percent of total billed charges,81.4% of total billed charges,2010.42,90,,,percent of total billed charges,90% of total billed charges,2010.42,90,,,percent of total billed charges,90% of total billed charges,848.84,38,,,percent of total billed charges,38% of total billed charges,848.84,38,,,percent of total billed charges,38% of total billed charges,848.84,38,,,percent of total billed charges,38% of total billed charges,1675.35,75,,,percent of total billed charges,75% of total billed charges,1898.73,85,,,percent of total billed charges,85% of total billed charges,848.84,2077.43,
MIS Headed Screw 33mm,6107,CDM,278,RC,C1713,HCPCS,both,,,191.45,143.59,,172.31,90,,,percent of total billed charges,90% of total billed charges,178.05,93,,,percent of total billed charges,93% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,162.73,85,,,percent of total billed charges,85% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,155.84,81.4,,,percent of total billed charges,81.4% of total billed charges,172.31,90,,,percent of total billed charges,90% of total billed charges,172.31,90,,,percent of total billed charges,90% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,72.75,38,,,percent of total billed charges,38% of total billed charges,143.59,75,,,percent of total billed charges,75% of total billed charges,162.73,85,,,percent of total billed charges,85% of total billed charges,72.75,178.05,
OXFanatbrg LT size6,6108,CDM,278,RC,C1713,HCPCS,both,,,2182.8,1637.1,,1964.52,90,,,percent of total billed charges,90% of total billed charges,2030,93,,,percent of total billed charges,93% of total billed charges,829.46,38,,,percent of total billed charges,38% of total billed charges,829.46,38,,,percent of total billed charges,38% of total billed charges,1855.38,85,,,percent of total billed charges,85% of total billed charges,829.46,38,,,percent of total billed charges,38% of total billed charges,1776.8,81.4,,,percent of total billed charges,81.4% of total billed charges,1964.52,90,,,percent of total billed charges,90% of total billed charges,1964.52,90,,,percent of total billed charges,90% of total billed charges,829.46,38,,,percent of total billed charges,38% of total billed charges,829.46,38,,,percent of total billed charges,38% of total billed charges,829.46,38,,,percent of total billed charges,38% of total billed charges,1637.1,75,,,percent of total billed charges,75% of total billed charges,1855.38,85,,,percent of total billed charges,85% of total billed charges,829.46,2030,
OXF twin-peg FEM LG,6109,CDM,278,RC,C1713,HCPCS,both,,,3264,2448,,2937.6,90,,,percent of total billed charges,90% of total billed charges,3035.52,93,,,percent of total billed charges,93% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,2774.4,85,,,percent of total billed charges,85% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,2656.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2937.6,90,,,percent of total billed charges,90% of total billed charges,2937.6,90,,,percent of total billed charges,90% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,1240.32,38,,,percent of total billed charges,38% of total billed charges,2448,75,,,percent of total billed charges,75% of total billed charges,2774.4,85,,,percent of total billed charges,85% of total billed charges,1240.32,3035.52,
MIS Headless screw 48mm,6110,CDM,278,RC,C1713,HCPCS,both,,,219.61,164.71,,197.65,90,,,percent of total billed charges,90% of total billed charges,204.24,93,,,percent of total billed charges,93% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,186.67,85,,,percent of total billed charges,85% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,178.76,81.4,,,percent of total billed charges,81.4% of total billed charges,197.65,90,,,percent of total billed charges,90% of total billed charges,197.65,90,,,percent of total billed charges,90% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,83.45,38,,,percent of total billed charges,38% of total billed charges,164.71,75,,,percent of total billed charges,75% of total billed charges,186.67,85,,,percent of total billed charges,85% of total billed charges,83.45,204.24,
stem ext femur,6111,CDM,278,RC,C1713,HCPCS,both,,,954.56,715.92,,859.1,90,,,percent of total billed charges,90% of total billed charges,887.74,93,,,percent of total billed charges,93% of total billed charges,362.73,38,,,percent of total billed charges,38% of total billed charges,362.73,38,,,percent of total billed charges,38% of total billed charges,811.38,85,,,percent of total billed charges,85% of total billed charges,362.73,38,,,percent of total billed charges,38% of total billed charges,777.01,81.4,,,percent of total billed charges,81.4% of total billed charges,859.1,90,,,percent of total billed charges,90% of total billed charges,859.1,90,,,percent of total billed charges,90% of total billed charges,362.73,38,,,percent of total billed charges,38% of total billed charges,362.73,38,,,percent of total billed charges,38% of total billed charges,362.73,38,,,percent of total billed charges,38% of total billed charges,715.92,75,,,percent of total billed charges,75% of total billed charges,811.38,85,,,percent of total billed charges,85% of total billed charges,362.73,887.74,
OR spinal stim generator-NR wavewriter,6112,CDM,278,RC,C1767,HCPCS,both,,,41310,30982.5,,37179,90,,,percent of total billed charges,90% of total billed charges,38418.3,93,,,percent of total billed charges,93% of total billed charges,15697.8,38,,,percent of total billed charges,38% of total billed charges,15697.8,38,,,percent of total billed charges,38% of total billed charges,35113.5,85,,,percent of total billed charges,85% of total billed charges,15697.8,38,,,percent of total billed charges,38% of total billed charges,33626.34,81.4,,,percent of total billed charges,81.4% of total billed charges,37179,90,,,percent of total billed charges,90% of total billed charges,37179,90,,,percent of total billed charges,90% of total billed charges,15697.8,38,,,percent of total billed charges,38% of total billed charges,15697.8,38,,,percent of total billed charges,38% of total billed charges,15697.8,38,,,percent of total billed charges,38% of total billed charges,30982.5,75,,,percent of total billed charges,75% of total billed charges,35113.5,85,,,percent of total billed charges,85% of total billed charges,15697.8,38418.3,
Zimmer Patella 32mm,6113,CDM,278,RC,C1776,HCPCS,both,,,2080.8,1560.6,,1872.72,90,,,percent of total billed charges,90% of total billed charges,1935.14,93,,,percent of total billed charges,93% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,1768.68,85,,,percent of total billed charges,85% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,1693.77,81.4,,,percent of total billed charges,81.4% of total billed charges,1872.72,90,,,percent of total billed charges,90% of total billed charges,1872.72,90,,,percent of total billed charges,90% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,790.7,38,,,percent of total billed charges,38% of total billed charges,1560.6,75,,,percent of total billed charges,75% of total billed charges,1768.68,85,,,percent of total billed charges,85% of total billed charges,790.7,1935.14,
Tibial Base Plate,6114,CDM,278,RC,C1776,HCPCS,both,,,2758,2068.5,,2482.2,90,,,percent of total billed charges,90% of total billed charges,2564.94,93,,,percent of total billed charges,93% of total billed charges,1048.04,38,,,percent of total billed charges,38% of total billed charges,1048.04,38,,,percent of total billed charges,38% of total billed charges,2344.3,85,,,percent of total billed charges,85% of total billed charges,1048.04,38,,,percent of total billed charges,38% of total billed charges,2245.01,81.4,,,percent of total billed charges,81.4% of total billed charges,2482.2,90,,,percent of total billed charges,90% of total billed charges,2482.2,90,,,percent of total billed charges,90% of total billed charges,1048.04,38,,,percent of total billed charges,38% of total billed charges,1048.04,38,,,percent of total billed charges,38% of total billed charges,1048.04,38,,,percent of total billed charges,38% of total billed charges,2068.5,75,,,percent of total billed charges,75% of total billed charges,2344.3,85,,,percent of total billed charges,85% of total billed charges,1048.04,2564.94,
Zimmer Femur CR CMT,6115,CDM,278,RC,C1776,HCPCS,both,,,8323.2,6242.4,,7490.88,90,,,percent of total billed charges,90% of total billed charges,7740.58,93,,,percent of total billed charges,93% of total billed charges,3162.82,38,,,percent of total billed charges,38% of total billed charges,3162.82,38,,,percent of total billed charges,38% of total billed charges,7074.72,85,,,percent of total billed charges,85% of total billed charges,3162.82,38,,,percent of total billed charges,38% of total billed charges,6775.08,81.4,,,percent of total billed charges,81.4% of total billed charges,7490.88,90,,,percent of total billed charges,90% of total billed charges,7490.88,90,,,percent of total billed charges,90% of total billed charges,3162.82,38,,,percent of total billed charges,38% of total billed charges,3162.82,38,,,percent of total billed charges,38% of total billed charges,3162.82,38,,,percent of total billed charges,38% of total billed charges,6242.4,75,,,percent of total billed charges,75% of total billed charges,7074.72,85,,,percent of total billed charges,85% of total billed charges,3162.82,7740.58,
Femoral Size E-uni,6116,CDM,278,RC,C1776,HCPCS,both,,,4532.81,3399.61,,4079.53,90,,,percent of total billed charges,90% of total billed charges,4215.51,93,,,percent of total billed charges,93% of total billed charges,1722.47,38,,,percent of total billed charges,38% of total billed charges,1722.47,38,,,percent of total billed charges,38% of total billed charges,3852.89,85,,,percent of total billed charges,85% of total billed charges,1722.47,38,,,percent of total billed charges,38% of total billed charges,3689.71,81.4,,,percent of total billed charges,81.4% of total billed charges,4079.53,90,,,percent of total billed charges,90% of total billed charges,4079.53,90,,,percent of total billed charges,90% of total billed charges,1722.47,38,,,percent of total billed charges,38% of total billed charges,1722.47,38,,,percent of total billed charges,38% of total billed charges,1722.47,38,,,percent of total billed charges,38% of total billed charges,3399.61,75,,,percent of total billed charges,75% of total billed charges,3852.89,85,,,percent of total billed charges,85% of total billed charges,1722.47,4215.51,
TIB base uni,6117,CDM,278,RC,C1776,HCPCS,both,,,2702.8,2027.1,,2432.52,90,,,percent of total billed charges,90% of total billed charges,2513.6,93,,,percent of total billed charges,93% of total billed charges,1027.06,38,,,percent of total billed charges,38% of total billed charges,1027.06,38,,,percent of total billed charges,38% of total billed charges,2297.38,85,,,percent of total billed charges,85% of total billed charges,1027.06,38,,,percent of total billed charges,38% of total billed charges,2200.08,81.4,,,percent of total billed charges,81.4% of total billed charges,2432.52,90,,,percent of total billed charges,90% of total billed charges,2432.52,90,,,percent of total billed charges,90% of total billed charges,1027.06,38,,,percent of total billed charges,38% of total billed charges,1027.06,38,,,percent of total billed charges,38% of total billed charges,1027.06,38,,,percent of total billed charges,38% of total billed charges,2027.1,75,,,percent of total billed charges,75% of total billed charges,2297.38,85,,,percent of total billed charges,85% of total billed charges,1027.06,2513.6,
Zimmer PSN Tib stm5,6118,CDM,278,RC,C1776,HCPCS,both,,,3329.28,2496.96,,2996.35,90,,,percent of total billed charges,90% of total billed charges,3096.23,93,,,percent of total billed charges,93% of total billed charges,1265.13,38,,,percent of total billed charges,38% of total billed charges,1265.13,38,,,percent of total billed charges,38% of total billed charges,2829.89,85,,,percent of total billed charges,85% of total billed charges,1265.13,38,,,percent of total billed charges,38% of total billed charges,2710.03,81.4,,,percent of total billed charges,81.4% of total billed charges,2996.35,90,,,percent of total billed charges,90% of total billed charges,2996.35,90,,,percent of total billed charges,90% of total billed charges,1265.13,38,,,percent of total billed charges,38% of total billed charges,1265.13,38,,,percent of total billed charges,38% of total billed charges,1265.13,38,,,percent of total billed charges,38% of total billed charges,2496.96,75,,,percent of total billed charges,75% of total billed charges,2829.89,85,,,percent of total billed charges,85% of total billed charges,1265.13,3096.23,
Zimmer PSN MC 16mm,6119,CDM,278,RC,C1776,HCPCS,both,,,3121.2,2340.9,,2809.08,90,,,percent of total billed charges,90% of total billed charges,2902.72,93,,,percent of total billed charges,93% of total billed charges,1186.06,38,,,percent of total billed charges,38% of total billed charges,1186.06,38,,,percent of total billed charges,38% of total billed charges,2653.02,85,,,percent of total billed charges,85% of total billed charges,1186.06,38,,,percent of total billed charges,38% of total billed charges,2540.66,81.4,,,percent of total billed charges,81.4% of total billed charges,2809.08,90,,,percent of total billed charges,90% of total billed charges,2809.08,90,,,percent of total billed charges,90% of total billed charges,1186.06,38,,,percent of total billed charges,38% of total billed charges,1186.06,38,,,percent of total billed charges,38% of total billed charges,1186.06,38,,,percent of total billed charges,38% of total billed charges,2340.9,75,,,percent of total billed charges,75% of total billed charges,2653.02,85,,,percent of total billed charges,85% of total billed charges,1186.06,2902.72,
Femoral Implant with antibiotic,6120,CDM,278,RC,C1776,HCPCS,both,,,5953.37,4465.03,,5358.03,90,,,percent of total billed charges,90% of total billed charges,5536.63,93,,,percent of total billed charges,93% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,5060.36,85,,,percent of total billed charges,85% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,4846.04,81.4,,,percent of total billed charges,81.4% of total billed charges,5358.03,90,,,percent of total billed charges,90% of total billed charges,5358.03,90,,,percent of total billed charges,90% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,2262.28,38,,,percent of total billed charges,38% of total billed charges,4465.03,75,,,percent of total billed charges,75% of total billed charges,5060.36,85,,,percent of total billed charges,85% of total billed charges,2262.28,5536.63,
2mm Set Screw hex driver,6121,CDM,272,RC,C1776,HCPCS,outpatient,,,153,114.75,,137.7,90,,,percent of total billed charges,90% of total billed charges,142.29,93,,,percent of total billed charges,93% of total billed charges,58.14,38,,,percent of total billed charges,38% of total billed charges,58.14,38,,,percent of total billed charges,38% of total billed charges,130.05,85,,,percent of total billed charges,85% of total billed charges,58.14,38,,,percent of total billed charges,38% of total billed charges,124.54,81.4,,,percent of total billed charges,81.4% of total billed charges,137.7,90,,,percent of total billed charges,90% of total billed charges,137.7,90,,,percent of total billed charges,90% of total billed charges,58.14,38,,,percent of total billed charges,38% of total billed charges,58.14,38,,,percent of total billed charges,38% of total billed charges,58.14,38,,,percent of total billed charges,38% of total billed charges,114.75,75,,,percent of total billed charges,75% of total billed charges,130.05,85,,,percent of total billed charges,85% of total billed charges,58.14,142.29,
Zimmer PSN STR HYB 14x+30mm,6122,CDM,272,RC,C1776,HCPCS,outpatient,,,3162,2371.5,,2845.8,90,,,percent of total billed charges,90% of total billed charges,2940.66,93,,,percent of total billed charges,93% of total billed charges,1201.56,38,,,percent of total billed charges,38% of total billed charges,1201.56,38,,,percent of total billed charges,38% of total billed charges,2687.7,85,,,percent of total billed charges,85% of total billed charges,1201.56,38,,,percent of total billed charges,38% of total billed charges,2573.87,81.4,,,percent of total billed charges,81.4% of total billed charges,2845.8,90,,,percent of total billed charges,90% of total billed charges,2845.8,90,,,percent of total billed charges,90% of total billed charges,1201.56,38,,,percent of total billed charges,38% of total billed charges,1201.56,38,,,percent of total billed charges,38% of total billed charges,1201.56,38,,,percent of total billed charges,38% of total billed charges,2371.5,75,,,percent of total billed charges,75% of total billed charges,2687.7,85,,,percent of total billed charges,85% of total billed charges,1201.56,2940.66,
Femoral Implant,6123,CDM,278,RC,C1776,HCPCS,both,,,4773.94,3580.46,,4296.55,90,,,percent of total billed charges,90% of total billed charges,4439.76,93,,,percent of total billed charges,93% of total billed charges,1814.1,38,,,percent of total billed charges,38% of total billed charges,1814.1,38,,,percent of total billed charges,38% of total billed charges,4057.85,85,,,percent of total billed charges,85% of total billed charges,1814.1,38,,,percent of total billed charges,38% of total billed charges,3885.99,81.4,,,percent of total billed charges,81.4% of total billed charges,4296.55,90,,,percent of total billed charges,90% of total billed charges,4296.55,90,,,percent of total billed charges,90% of total billed charges,1814.1,38,,,percent of total billed charges,38% of total billed charges,1814.1,38,,,percent of total billed charges,38% of total billed charges,1814.1,38,,,percent of total billed charges,38% of total billed charges,3580.46,75,,,percent of total billed charges,75% of total billed charges,4057.85,85,,,percent of total billed charges,85% of total billed charges,1814.1,4439.76,
Nexgen Patella all-poly 38mm,6124,CDM,278,RC,C1776,HCPCS,both,,,1324.9,993.68,,1192.41,90,,,percent of total billed charges,90% of total billed charges,1232.16,93,,,percent of total billed charges,93% of total billed charges,503.46,38,,,percent of total billed charges,38% of total billed charges,503.46,38,,,percent of total billed charges,38% of total billed charges,1126.17,85,,,percent of total billed charges,85% of total billed charges,503.46,38,,,percent of total billed charges,38% of total billed charges,1078.47,81.4,,,percent of total billed charges,81.4% of total billed charges,1192.41,90,,,percent of total billed charges,90% of total billed charges,1192.41,90,,,percent of total billed charges,90% of total billed charges,503.46,38,,,percent of total billed charges,38% of total billed charges,503.46,38,,,percent of total billed charges,38% of total billed charges,503.46,38,,,percent of total billed charges,38% of total billed charges,993.68,75,,,percent of total billed charges,75% of total billed charges,1126.17,85,,,percent of total billed charges,85% of total billed charges,503.46,1232.16,
Patella all-poly  32mm,6125,CDM,278,RC,C1776,HCPCS,both,,,717.66,538.25,,645.89,90,,,percent of total billed charges,90% of total billed charges,667.42,93,,,percent of total billed charges,93% of total billed charges,272.71,38,,,percent of total billed charges,38% of total billed charges,272.71,38,,,percent of total billed charges,38% of total billed charges,610.01,85,,,percent of total billed charges,85% of total billed charges,272.71,38,,,percent of total billed charges,38% of total billed charges,584.18,81.4,,,percent of total billed charges,81.4% of total billed charges,645.89,90,,,percent of total billed charges,90% of total billed charges,645.89,90,,,percent of total billed charges,90% of total billed charges,272.71,38,,,percent of total billed charges,38% of total billed charges,272.71,38,,,percent of total billed charges,38% of total billed charges,272.71,38,,,percent of total billed charges,38% of total billed charges,538.25,75,,,percent of total billed charges,75% of total billed charges,610.01,85,,,percent of total billed charges,85% of total billed charges,272.71,667.42,
nexgen patella all-poly 35mm,6126,CDM,278,RC,C1776,HCPCS,both,,,795.91,596.93,,716.32,90,,,percent of total billed charges,90% of total billed charges,740.2,93,,,percent of total billed charges,93% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,676.52,85,,,percent of total billed charges,85% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,647.87,81.4,,,percent of total billed charges,81.4% of total billed charges,716.32,90,,,percent of total billed charges,90% of total billed charges,716.32,90,,,percent of total billed charges,90% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,596.93,75,,,percent of total billed charges,75% of total billed charges,676.52,85,,,percent of total billed charges,85% of total billed charges,302.45,740.2,
nexgen patella all-poly 29 mm,6127,CDM,278,RC,C1776,HCPCS,both,,,795.91,596.93,,716.32,90,,,percent of total billed charges,90% of total billed charges,740.2,93,,,percent of total billed charges,93% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,676.52,85,,,percent of total billed charges,85% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,647.87,81.4,,,percent of total billed charges,81.4% of total billed charges,716.32,90,,,percent of total billed charges,90% of total billed charges,716.32,90,,,percent of total billed charges,90% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,302.45,38,,,percent of total billed charges,38% of total billed charges,596.93,75,,,percent of total billed charges,75% of total billed charges,676.52,85,,,percent of total billed charges,85% of total billed charges,302.45,740.2,
Verilast NP TIp,6128,CDM,278,RC,C1776,HCPCS,both,,,7959.06,5969.3,,7163.15,90,,,percent of total billed charges,90% of total billed charges,7401.93,93,,,percent of total billed charges,93% of total billed charges,3024.44,38,,,percent of total billed charges,38% of total billed charges,3024.44,38,,,percent of total billed charges,38% of total billed charges,6765.2,85,,,percent of total billed charges,85% of total billed charges,3024.44,38,,,percent of total billed charges,38% of total billed charges,6478.67,81.4,,,percent of total billed charges,81.4% of total billed charges,7163.15,90,,,percent of total billed charges,90% of total billed charges,7163.15,90,,,percent of total billed charges,90% of total billed charges,3024.44,38,,,percent of total billed charges,38% of total billed charges,3024.44,38,,,percent of total billed charges,38% of total billed charges,3024.44,38,,,percent of total billed charges,38% of total billed charges,5969.3,75,,,percent of total billed charges,75% of total billed charges,6765.2,85,,,percent of total billed charges,85% of total billed charges,3024.44,7401.93,
OR Lead neuro stim imp,6129,CDM,278,RC,C1778,HCPCS,both,,,4080,3060,,3672,90,,,percent of total billed charges,90% of total billed charges,3794.4,93,,,percent of total billed charges,93% of total billed charges,1550.4,38,,,percent of total billed charges,38% of total billed charges,1550.4,38,,,percent of total billed charges,38% of total billed charges,3468,85,,,percent of total billed charges,85% of total billed charges,1550.4,38,,,percent of total billed charges,38% of total billed charges,3321.12,81.4,,,percent of total billed charges,81.4% of total billed charges,3672,90,,,percent of total billed charges,90% of total billed charges,3672,90,,,percent of total billed charges,90% of total billed charges,1550.4,38,,,percent of total billed charges,38% of total billed charges,1550.4,38,,,percent of total billed charges,38% of total billed charges,1550.4,38,,,percent of total billed charges,38% of total billed charges,3060,75,,,percent of total billed charges,75% of total billed charges,3468,85,,,percent of total billed charges,85% of total billed charges,1550.4,3794.4,
OR FAC Mini arc Precise Sling,6130,CDM,278,RC,C1781,HCPCS,both,,,2438.48,1828.86,,2194.63,90,,,percent of total billed charges,90% of total billed charges,2267.79,93,,,percent of total billed charges,93% of total billed charges,926.62,38,,,percent of total billed charges,38% of total billed charges,926.62,38,,,percent of total billed charges,38% of total billed charges,2072.71,85,,,percent of total billed charges,85% of total billed charges,926.62,38,,,percent of total billed charges,38% of total billed charges,1984.92,81.4,,,percent of total billed charges,81.4% of total billed charges,2194.63,90,,,percent of total billed charges,90% of total billed charges,2194.63,90,,,percent of total billed charges,90% of total billed charges,926.62,38,,,percent of total billed charges,38% of total billed charges,926.62,38,,,percent of total billed charges,38% of total billed charges,926.62,38,,,percent of total billed charges,38% of total billed charges,1828.86,75,,,percent of total billed charges,75% of total billed charges,2072.71,85,,,percent of total billed charges,85% of total billed charges,926.62,2267.79,
OR spine stim control kit,6131,CDM,272,RC,C1787,HCPCS,outpatient,,,1122,841.5,,1009.8,90,,,percent of total billed charges,90% of total billed charges,1043.46,93,,,percent of total billed charges,93% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,953.7,85,,,percent of total billed charges,85% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,913.31,81.4,,,percent of total billed charges,81.4% of total billed charges,1009.8,90,,,percent of total billed charges,90% of total billed charges,1009.8,90,,,percent of total billed charges,90% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,426.36,38,,,percent of total billed charges,38% of total billed charges,841.5,75,,,percent of total billed charges,75% of total billed charges,953.7,85,,,percent of total billed charges,85% of total billed charges,426.36,1043.46,
OR Pain Spine Stim w pt programmer,6132,CDM,278,RC,C1820,HCPCS,both,,,44778,33583.5,,40300.2,90,,,percent of total billed charges,90% of total billed charges,41643.54,93,,,percent of total billed charges,93% of total billed charges,17015.64,38,,,percent of total billed charges,38% of total billed charges,17015.64,38,,,percent of total billed charges,38% of total billed charges,38061.3,85,,,percent of total billed charges,85% of total billed charges,17015.64,38,,,percent of total billed charges,38% of total billed charges,36449.29,81.4,,,percent of total billed charges,81.4% of total billed charges,40300.2,90,,,percent of total billed charges,90% of total billed charges,40300.2,90,,,percent of total billed charges,90% of total billed charges,17015.64,38,,,percent of total billed charges,38% of total billed charges,17015.64,38,,,percent of total billed charges,38% of total billed charges,17015.64,38,,,percent of total billed charges,38% of total billed charges,33583.5,75,,,percent of total billed charges,75% of total billed charges,38061.3,85,,,percent of total billed charges,85% of total billed charges,17015.64,41643.54,
OR-Inracept Device 2VB,6133,CDM,278,RC,C1889,HCPCS,both,,,4447.2,3335.4,,4002.48,90,,,percent of total billed charges,90% of total billed charges,4135.9,93,,,percent of total billed charges,93% of total billed charges,1689.94,38,,,percent of total billed charges,38% of total billed charges,1689.94,38,,,percent of total billed charges,38% of total billed charges,3780.12,85,,,percent of total billed charges,85% of total billed charges,1689.94,38,,,percent of total billed charges,38% of total billed charges,3620.02,81.4,,,percent of total billed charges,81.4% of total billed charges,4002.48,90,,,percent of total billed charges,90% of total billed charges,4002.48,90,,,percent of total billed charges,90% of total billed charges,1689.94,38,,,percent of total billed charges,38% of total billed charges,1689.94,38,,,percent of total billed charges,38% of total billed charges,1689.94,38,,,percent of total billed charges,38% of total billed charges,3335.4,75,,,percent of total billed charges,75% of total billed charges,3780.12,85,,,percent of total billed charges,85% of total billed charges,1689.94,4135.9,
Cement for knee implants,6134,CDM,272,RC,,,outpatient,,,552.03,414.02,,496.83,90,,,percent of total billed charges,90% of total billed charges,513.39,93,,,percent of total billed charges,93% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,469.23,85,,,percent of total billed charges,85% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,449.35,81.4,,,percent of total billed charges,81.4% of total billed charges,496.83,90,,,percent of total billed charges,90% of total billed charges,496.83,90,,,percent of total billed charges,90% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,209.77,38,,,percent of total billed charges,38% of total billed charges,414.02,75,,,percent of total billed charges,75% of total billed charges,469.23,85,,,percent of total billed charges,85% of total billed charges,209.77,513.39,
COPAL Echange Trails,6135,CDM,278,RC,,,both,,,595.33,446.5,,535.8,90,,,percent of total billed charges,90% of total billed charges,553.66,93,,,percent of total billed charges,93% of total billed charges,226.23,38,,,percent of total billed charges,38% of total billed charges,226.23,38,,,percent of total billed charges,38% of total billed charges,506.03,85,,,percent of total billed charges,85% of total billed charges,226.23,38,,,percent of total billed charges,38% of total billed charges,484.6,81.4,,,percent of total billed charges,81.4% of total billed charges,535.8,90,,,percent of total billed charges,90% of total billed charges,535.8,90,,,percent of total billed charges,90% of total billed charges,226.23,38,,,percent of total billed charges,38% of total billed charges,226.23,38,,,percent of total billed charges,38% of total billed charges,226.23,38,,,percent of total billed charges,38% of total billed charges,446.5,75,,,percent of total billed charges,75% of total billed charges,506.03,85,,,percent of total billed charges,85% of total billed charges,226.23,553.66,
1/8 Quick Drl sterile,6136,CDM,272,RC,,,outpatient,,,127.5,95.63,,114.75,90,,,percent of total billed charges,90% of total billed charges,118.58,93,,,percent of total billed charges,93% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,103.79,81.4,,,percent of total billed charges,81.4% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,48.45,38,,,percent of total billed charges,38% of total billed charges,95.63,75,,,percent of total billed charges,75% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,48.45,118.58,
zimmer PSI PSN DR PIN,6137,CDM,272,RC,,,outpatient,,,1744.2,1308.15,,1569.78,90,,,percent of total billed charges,90% of total billed charges,1622.11,93,,,percent of total billed charges,93% of total billed charges,662.8,38,,,percent of total billed charges,38% of total billed charges,662.8,38,,,percent of total billed charges,38% of total billed charges,1482.57,85,,,percent of total billed charges,85% of total billed charges,662.8,38,,,percent of total billed charges,38% of total billed charges,1419.78,81.4,,,percent of total billed charges,81.4% of total billed charges,1569.78,90,,,percent of total billed charges,90% of total billed charges,1569.78,90,,,percent of total billed charges,90% of total billed charges,662.8,38,,,percent of total billed charges,38% of total billed charges,662.8,38,,,percent of total billed charges,38% of total billed charges,662.8,38,,,percent of total billed charges,38% of total billed charges,1308.15,75,,,percent of total billed charges,75% of total billed charges,1482.57,85,,,percent of total billed charges,85% of total billed charges,662.8,1622.11,
OR FAC Colonoscopy-Screening (high risk),6138,CDM,360,RC,,,outpatient,,,1511.6,1133.7,,1360.44,90,,,percent of total billed charges,90% of total billed charges,1405.79,93,,,percent of total billed charges,93% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,1284.86,85,,,percent of total billed charges,85% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,1230.44,81.4,,,percent of total billed charges,81.4% of total billed charges,1360.44,90,,,percent of total billed charges,90% of total billed charges,1360.44,90,,,percent of total billed charges,90% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,1133.7,75,,,percent of total billed charges,75% of total billed charges,1284.86,85,,,percent of total billed charges,85% of total billed charges,574.41,1405.79,
OR FAC Colonoscopy-Screening,6139,CDM,360,RC,,,outpatient,,,1511.6,1133.7,,1360.44,90,,,percent of total billed charges,90% of total billed charges,1405.79,93,,,percent of total billed charges,93% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,1284.86,85,,,percent of total billed charges,85% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,1230.44,81.4,,,percent of total billed charges,81.4% of total billed charges,1360.44,90,,,percent of total billed charges,90% of total billed charges,1360.44,90,,,percent of total billed charges,90% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,574.41,38,,,percent of total billed charges,38% of total billed charges,1133.7,75,,,percent of total billed charges,75% of total billed charges,1284.86,85,,,percent of total billed charges,85% of total billed charges,574.41,1405.79,
Headless Trocar Drill,6140,CDM,278,RC,,,both,,,432.97,324.73,,389.67,90,,,percent of total billed charges,90% of total billed charges,402.66,93,,,percent of total billed charges,93% of total billed charges,164.53,38,,,percent of total billed charges,38% of total billed charges,164.53,38,,,percent of total billed charges,38% of total billed charges,368.02,85,,,percent of total billed charges,85% of total billed charges,164.53,38,,,percent of total billed charges,38% of total billed charges,352.44,81.4,,,percent of total billed charges,81.4% of total billed charges,389.67,90,,,percent of total billed charges,90% of total billed charges,389.67,90,,,percent of total billed charges,90% of total billed charges,164.53,38,,,percent of total billed charges,38% of total billed charges,164.53,38,,,percent of total billed charges,38% of total billed charges,164.53,38,,,percent of total billed charges,38% of total billed charges,324.73,75,,,percent of total billed charges,75% of total billed charges,368.02,85,,,percent of total billed charges,85% of total billed charges,164.53,402.66,
4.5 incisor and blade,6141,CDM,270,RC,,,outpatient,,,287.17,215.38,,258.45,90,,,percent of total billed charges,90% of total billed charges,267.07,93,,,percent of total billed charges,93% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,244.09,85,,,percent of total billed charges,85% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,233.76,81.4,,,percent of total billed charges,81.4% of total billed charges,258.45,90,,,percent of total billed charges,90% of total billed charges,258.45,90,,,percent of total billed charges,90% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,109.12,38,,,percent of total billed charges,38% of total billed charges,215.38,75,,,percent of total billed charges,75% of total billed charges,244.09,85,,,percent of total billed charges,85% of total billed charges,109.12,267.07,
Dyonics 25 inflow tube set,6142,CDM,272,RC,,,outpatient,,,315.88,236.91,,284.29,90,,,percent of total billed charges,90% of total billed charges,293.77,93,,,percent of total billed charges,93% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,268.5,85,,,percent of total billed charges,85% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,257.13,81.4,,,percent of total billed charges,81.4% of total billed charges,284.29,90,,,percent of total billed charges,90% of total billed charges,284.29,90,,,percent of total billed charges,90% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,236.91,75,,,percent of total billed charges,75% of total billed charges,268.5,85,,,percent of total billed charges,85% of total billed charges,120.03,293.77,
Full radius bonecutter,6143,CDM,272,RC,,,outpatient,,,315.88,236.91,,284.29,90,,,percent of total billed charges,90% of total billed charges,293.77,93,,,percent of total billed charges,93% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,268.5,85,,,percent of total billed charges,85% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,257.13,81.4,,,percent of total billed charges,81.4% of total billed charges,284.29,90,,,percent of total billed charges,90% of total billed charges,284.29,90,,,percent of total billed charges,90% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,120.03,38,,,percent of total billed charges,38% of total billed charges,236.91,75,,,percent of total billed charges,75% of total billed charges,268.5,85,,,percent of total billed charges,85% of total billed charges,120.03,293.77,
MRI short osteotome 12mm,6144,CDM,278,RC,,,both,,,162.36,121.77,,146.12,90,,,percent of total billed charges,90% of total billed charges,150.99,93,,,percent of total billed charges,93% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,132.16,81.4,,,percent of total billed charges,81.4% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,146.12,90,,,percent of total billed charges,90% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,61.7,38,,,percent of total billed charges,38% of total billed charges,121.77,75,,,percent of total billed charges,75% of total billed charges,138.01,85,,,percent of total billed charges,85% of total billed charges,61.7,150.99,
Mri long osteotome 8mm,6145,CDM,278,RC,,,both,,,135.3,101.48,,121.77,90,,,percent of total billed charges,90% of total billed charges,125.83,93,,,percent of total billed charges,93% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,115.01,85,,,percent of total billed charges,85% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,110.13,81.4,,,percent of total billed charges,81.4% of total billed charges,121.77,90,,,percent of total billed charges,90% of total billed charges,121.77,90,,,percent of total billed charges,90% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,101.48,75,,,percent of total billed charges,75% of total billed charges,115.01,85,,,percent of total billed charges,85% of total billed charges,51.41,125.83,
OXF sawblade,6146,CDM,270,RC,,,outpatient,,,306,229.5,,275.4,90,,,percent of total billed charges,90% of total billed charges,284.58,93,,,percent of total billed charges,93% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,260.1,85,,,percent of total billed charges,85% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,249.08,81.4,,,percent of total billed charges,81.4% of total billed charges,275.4,90,,,percent of total billed charges,90% of total billed charges,275.4,90,,,percent of total billed charges,90% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,116.28,38,,,percent of total billed charges,38% of total billed charges,229.5,75,,,percent of total billed charges,75% of total billed charges,260.1,85,,,percent of total billed charges,85% of total billed charges,116.28,284.58,
Recip blade double,6147,CDM,272,RC,,,outpatient,,,103.49,77.62,,93.14,90,,,percent of total billed charges,90% of total billed charges,96.25,93,,,percent of total billed charges,93% of total billed charges,39.33,38,,,percent of total billed charges,38% of total billed charges,39.33,38,,,percent of total billed charges,38% of total billed charges,87.97,85,,,percent of total billed charges,85% of total billed charges,39.33,38,,,percent of total billed charges,38% of total billed charges,84.24,81.4,,,percent of total billed charges,81.4% of total billed charges,93.14,90,,,percent of total billed charges,90% of total billed charges,93.14,90,,,percent of total billed charges,90% of total billed charges,39.33,38,,,percent of total billed charges,38% of total billed charges,39.33,38,,,percent of total billed charges,38% of total billed charges,39.33,38,,,percent of total billed charges,38% of total billed charges,77.62,75,,,percent of total billed charges,75% of total billed charges,87.97,85,,,percent of total billed charges,85% of total billed charges,39.33,96.25,
Recip blade-Long,6148,CDM,272,RC,,,outpatient,,,91.89,68.92,,82.7,90,,,percent of total billed charges,90% of total billed charges,85.46,93,,,percent of total billed charges,93% of total billed charges,34.92,38,,,percent of total billed charges,38% of total billed charges,34.92,38,,,percent of total billed charges,38% of total billed charges,78.11,85,,,percent of total billed charges,85% of total billed charges,34.92,38,,,percent of total billed charges,38% of total billed charges,74.8,81.4,,,percent of total billed charges,81.4% of total billed charges,82.7,90,,,percent of total billed charges,90% of total billed charges,82.7,90,,,percent of total billed charges,90% of total billed charges,34.92,38,,,percent of total billed charges,38% of total billed charges,34.92,38,,,percent of total billed charges,38% of total billed charges,34.92,38,,,percent of total billed charges,38% of total billed charges,68.92,75,,,percent of total billed charges,75% of total billed charges,78.11,85,,,percent of total billed charges,85% of total billed charges,34.92,85.46,
Blade - sagittal,6149,CDM,272,RC,,,outpatient,,,173.44,130.08,,156.1,90,,,percent of total billed charges,90% of total billed charges,161.3,93,,,percent of total billed charges,93% of total billed charges,65.91,38,,,percent of total billed charges,38% of total billed charges,65.91,38,,,percent of total billed charges,38% of total billed charges,147.42,85,,,percent of total billed charges,85% of total billed charges,65.91,38,,,percent of total billed charges,38% of total billed charges,141.18,81.4,,,percent of total billed charges,81.4% of total billed charges,156.1,90,,,percent of total billed charges,90% of total billed charges,156.1,90,,,percent of total billed charges,90% of total billed charges,65.91,38,,,percent of total billed charges,38% of total billed charges,65.91,38,,,percent of total billed charges,38% of total billed charges,65.91,38,,,percent of total billed charges,38% of total billed charges,130.08,75,,,percent of total billed charges,75% of total billed charges,147.42,85,,,percent of total billed charges,85% of total billed charges,65.91,161.3,
Boneplast Supp Mold Tray,6150,CDM,278,RC,,,both,,,865.95,649.46,,779.36,90,,,percent of total billed charges,90% of total billed charges,805.33,93,,,percent of total billed charges,93% of total billed charges,329.06,38,,,percent of total billed charges,38% of total billed charges,329.06,38,,,percent of total billed charges,38% of total billed charges,736.06,85,,,percent of total billed charges,85% of total billed charges,329.06,38,,,percent of total billed charges,38% of total billed charges,704.88,81.4,,,percent of total billed charges,81.4% of total billed charges,779.36,90,,,percent of total billed charges,90% of total billed charges,779.36,90,,,percent of total billed charges,90% of total billed charges,329.06,38,,,percent of total billed charges,38% of total billed charges,329.06,38,,,percent of total billed charges,38% of total billed charges,329.06,38,,,percent of total billed charges,38% of total billed charges,649.46,75,,,percent of total billed charges,75% of total billed charges,736.06,85,,,percent of total billed charges,85% of total billed charges,329.06,805.33,
Uni-sagital blade,6151,CDM,272,RC,,,outpatient,,,86.59,64.94,,77.93,90,,,percent of total billed charges,90% of total billed charges,80.53,93,,,percent of total billed charges,93% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,73.6,85,,,percent of total billed charges,85% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,70.48,81.4,,,percent of total billed charges,81.4% of total billed charges,77.93,90,,,percent of total billed charges,90% of total billed charges,77.93,90,,,percent of total billed charges,90% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,64.94,75,,,percent of total billed charges,75% of total billed charges,73.6,85,,,percent of total billed charges,85% of total billed charges,32.9,80.53,
OR FAC IOL Anterior Chamber,6152,CDM,276,RC,V2630,HCPCS,both,,,408.95,306.71,,368.06,90,,,percent of total billed charges,90% of total billed charges,380.32,93,,,percent of total billed charges,93% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,347.61,85,,,percent of total billed charges,85% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,332.89,81.4,,,percent of total billed charges,81.4% of total billed charges,368.06,90,,,percent of total billed charges,90% of total billed charges,368.06,90,,,percent of total billed charges,90% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,306.71,75,,,percent of total billed charges,75% of total billed charges,347.61,85,,,percent of total billed charges,85% of total billed charges,155.4,380.32,
OR FAC IOL Posterior Chamber,6153,CDM,276,RC,V2632,HCPCS,both,,,408.95,306.71,,368.06,90,,,percent of total billed charges,90% of total billed charges,380.32,93,,,percent of total billed charges,93% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,347.61,85,,,percent of total billed charges,85% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,332.89,81.4,,,percent of total billed charges,81.4% of total billed charges,368.06,90,,,percent of total billed charges,90% of total billed charges,368.06,90,,,percent of total billed charges,90% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,155.4,38,,,percent of total billed charges,38% of total billed charges,306.71,75,,,percent of total billed charges,75% of total billed charges,347.61,85,,,percent of total billed charges,85% of total billed charges,155.4,380.32,
OR FAC Corneal tissue,6154,CDM,278,RC,V2785,HCPCS,both,,,6218.6,4663.95,,5596.74,90,,,percent of total billed charges,90% of total billed charges,5783.3,93,,,percent of total billed charges,93% of total billed charges,2363.07,38,,,percent of total billed charges,38% of total billed charges,2363.07,38,,,percent of total billed charges,38% of total billed charges,5285.81,85,,,percent of total billed charges,85% of total billed charges,2363.07,38,,,percent of total billed charges,38% of total billed charges,5061.94,81.4,,,percent of total billed charges,81.4% of total billed charges,5596.74,90,,,percent of total billed charges,90% of total billed charges,5596.74,90,,,percent of total billed charges,90% of total billed charges,2363.07,38,,,percent of total billed charges,38% of total billed charges,2363.07,38,,,percent of total billed charges,38% of total billed charges,2363.07,38,,,percent of total billed charges,38% of total billed charges,4663.95,75,,,percent of total billed charges,75% of total billed charges,5285.81,85,,,percent of total billed charges,85% of total billed charges,2363.07,5783.3,
OR FAC IOL Astigmatism Correcting,6155,CDM,276,RC,V2787,HCPCS,both,,,597.61,448.21,,537.85,90,,,percent of total billed charges,90% of total billed charges,555.78,93,,,percent of total billed charges,93% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,507.97,85,,,percent of total billed charges,85% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,486.45,81.4,,,percent of total billed charges,81.4% of total billed charges,537.85,90,,,percent of total billed charges,90% of total billed charges,537.85,90,,,percent of total billed charges,90% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,227.09,38,,,percent of total billed charges,38% of total billed charges,448.21,75,,,percent of total billed charges,75% of total billed charges,507.97,85,,,percent of total billed charges,85% of total billed charges,227.09,555.78,
OR FAC IOL Presbyopia correcting,6156,CDM,276,RC,V2788,HCPCS,both,,,994.83,746.12,,895.35,90,,,percent of total billed charges,90% of total billed charges,925.19,93,,,percent of total billed charges,93% of total billed charges,378.04,38,,,percent of total billed charges,38% of total billed charges,378.04,38,,,percent of total billed charges,38% of total billed charges,845.61,85,,,percent of total billed charges,85% of total billed charges,378.04,38,,,percent of total billed charges,38% of total billed charges,809.79,81.4,,,percent of total billed charges,81.4% of total billed charges,895.35,90,,,percent of total billed charges,90% of total billed charges,895.35,90,,,percent of total billed charges,90% of total billed charges,378.04,38,,,percent of total billed charges,38% of total billed charges,378.04,38,,,percent of total billed charges,38% of total billed charges,378.04,38,,,percent of total billed charges,38% of total billed charges,746.12,75,,,percent of total billed charges,75% of total billed charges,845.61,85,,,percent of total billed charges,85% of total billed charges,378.04,925.19,
OR FAC Human Amniotic Membrane,6157,CDM,272,RC,V2790,HCPCS,outpatient,,,721.82,541.37,,649.64,90,,,percent of total billed charges,90% of total billed charges,671.29,93,,,percent of total billed charges,93% of total billed charges,274.29,38,,,percent of total billed charges,38% of total billed charges,274.29,38,,,percent of total billed charges,38% of total billed charges,613.55,85,,,percent of total billed charges,85% of total billed charges,274.29,38,,,percent of total billed charges,38% of total billed charges,587.56,81.4,,,percent of total billed charges,81.4% of total billed charges,649.64,90,,,percent of total billed charges,90% of total billed charges,649.64,90,,,percent of total billed charges,90% of total billed charges,274.29,38,,,percent of total billed charges,38% of total billed charges,274.29,38,,,percent of total billed charges,38% of total billed charges,274.29,38,,,percent of total billed charges,38% of total billed charges,541.37,75,,,percent of total billed charges,75% of total billed charges,613.55,85,,,percent of total billed charges,85% of total billed charges,274.29,671.29,
Zimmer screw 25mm female,6158,CDM,272,RC,Zim25,HCPCS,outpatient,,,312.12,234.09,,280.91,90,,,percent of total billed charges,90% of total billed charges,290.27,93,,,percent of total billed charges,93% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,265.3,85,,,percent of total billed charges,85% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,254.07,81.4,,,percent of total billed charges,81.4% of total billed charges,280.91,90,,,percent of total billed charges,90% of total billed charges,280.91,90,,,percent of total billed charges,90% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,118.61,38,,,percent of total billed charges,38% of total billed charges,234.09,75,,,percent of total billed charges,75% of total billed charges,265.3,85,,,percent of total billed charges,85% of total billed charges,118.61,290.27,
Zimmer patella reamer blade,6159,CDM,272,RC,,,outpatient,,,291.31,218.48,,262.18,90,,,percent of total billed charges,90% of total billed charges,270.92,93,,,percent of total billed charges,93% of total billed charges,110.7,38,,,percent of total billed charges,38% of total billed charges,110.7,38,,,percent of total billed charges,38% of total billed charges,247.61,85,,,percent of total billed charges,85% of total billed charges,110.7,38,,,percent of total billed charges,38% of total billed charges,237.13,81.4,,,percent of total billed charges,81.4% of total billed charges,262.18,90,,,percent of total billed charges,90% of total billed charges,262.18,90,,,percent of total billed charges,90% of total billed charges,110.7,38,,,percent of total billed charges,38% of total billed charges,110.7,38,,,percent of total billed charges,38% of total billed charges,110.7,38,,,percent of total billed charges,38% of total billed charges,218.48,75,,,percent of total billed charges,75% of total billed charges,247.61,85,,,percent of total billed charges,85% of total billed charges,110.7,270.92,
Zimmer Headless Trocar Drill,6160,CDM,278,RC,,,both,,,665.86,499.4,,599.27,90,,,percent of total billed charges,90% of total billed charges,619.25,93,,,percent of total billed charges,93% of total billed charges,253.03,38,,,percent of total billed charges,38% of total billed charges,253.03,38,,,percent of total billed charges,38% of total billed charges,565.98,85,,,percent of total billed charges,85% of total billed charges,253.03,38,,,percent of total billed charges,38% of total billed charges,542.01,81.4,,,percent of total billed charges,81.4% of total billed charges,599.27,90,,,percent of total billed charges,90% of total billed charges,599.27,90,,,percent of total billed charges,90% of total billed charges,253.03,38,,,percent of total billed charges,38% of total billed charges,253.03,38,,,percent of total billed charges,38% of total billed charges,253.03,38,,,percent of total billed charges,38% of total billed charges,499.4,75,,,percent of total billed charges,75% of total billed charges,565.98,85,,,percent of total billed charges,85% of total billed charges,253.03,619.25,
Swing Bed Charge,6161,CDM,120,RC,1036,HCPCS,inpatient,,,1225.27,918.95,,1102.74,90,,,percent of total billed charges,90% of total billed charges,1139.5,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1102.74,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1025.55,83.7,,,percent of total billed charges,83.7% of total billed charges,1102.74,90,,,percent of total billed charges,90% of total billed charges,1102.74,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1025.55,2506,
Orthopedic followup,6162,CDM,121,RC,,,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
US THYROID/HEAD/NECK,6164,CDM,402,RC,76536,HCPCS,outpatient,,,571.84,428.88,,514.66,90,,,percent of total billed charges,90% of total billed charges,531.81,93,,,percent of total billed charges,93% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,486.06,85,,,percent of total billed charges,85% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,465.48,81.4,,,percent of total billed charges,81.4% of total billed charges,514.66,90,,,percent of total billed charges,90% of total billed charges,514.66,90,,,percent of total billed charges,90% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,428.88,75,,,percent of total billed charges,75% of total billed charges,486.06,85,,,percent of total billed charges,85% of total billed charges,217.3,531.81,
ER Soft Tissue/Head-US,6165,CDM,402,RC,76536,HCPCS,outpatient,,,225,168.75,,202.5,90,,,percent of total billed charges,90% of total billed charges,209.25,93,,,percent of total billed charges,93% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,183.15,81.4,,,percent of total billed charges,81.4% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,168.75,75,,,percent of total billed charges,75% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,209.25,
ER Mediastinum (FAST)-US,6166,CDM,402,RC,76604,HCPCS,outpatient,,,308.17,231.13,,277.35,90,,,percent of total billed charges,90% of total billed charges,286.6,93,,,percent of total billed charges,93% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,261.94,85,,,percent of total billed charges,85% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,250.85,81.4,,,percent of total billed charges,81.4% of total billed charges,277.35,90,,,percent of total billed charges,90% of total billed charges,277.35,90,,,percent of total billed charges,90% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,117.1,38,,,percent of total billed charges,38% of total billed charges,231.13,75,,,percent of total billed charges,75% of total billed charges,261.94,85,,,percent of total billed charges,85% of total billed charges,117.1,286.6,
"US Chest, lim, nonvas",6167,CDM,402,RC,76604,HCPCS,outpatient,,,251.73,188.8,,226.56,90,,,percent of total billed charges,90% of total billed charges,234.11,93,,,percent of total billed charges,93% of total billed charges,95.66,38,,,percent of total billed charges,38% of total billed charges,95.66,38,,,percent of total billed charges,38% of total billed charges,213.97,85,,,percent of total billed charges,85% of total billed charges,95.66,38,,,percent of total billed charges,38% of total billed charges,204.91,81.4,,,percent of total billed charges,81.4% of total billed charges,226.56,90,,,percent of total billed charges,90% of total billed charges,226.56,90,,,percent of total billed charges,90% of total billed charges,95.66,38,,,percent of total billed charges,38% of total billed charges,95.66,38,,,percent of total billed charges,38% of total billed charges,95.66,38,,,percent of total billed charges,38% of total billed charges,188.8,75,,,percent of total billed charges,75% of total billed charges,213.97,85,,,percent of total billed charges,85% of total billed charges,95.66,234.11,
US Breast Soft Tissue,6168,CDM,402,RC,76641,HCPCS,outpatient,,,472.23,354.17,,425.01,90,,,percent of total billed charges,90% of total billed charges,439.17,93,,,percent of total billed charges,93% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,401.4,85,,,percent of total billed charges,85% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,384.4,81.4,,,percent of total billed charges,81.4% of total billed charges,425.01,90,,,percent of total billed charges,90% of total billed charges,425.01,90,,,percent of total billed charges,90% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,354.17,75,,,percent of total billed charges,75% of total billed charges,401.4,85,,,percent of total billed charges,85% of total billed charges,179.45,439.17,
US Abdominal Complete,6169,CDM,402,RC,76700,HCPCS,outpatient,,,988.96,741.72,,890.06,90,,,percent of total billed charges,90% of total billed charges,919.73,93,,,percent of total billed charges,93% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,840.62,85,,,percent of total billed charges,85% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,805.01,81.4,,,percent of total billed charges,81.4% of total billed charges,890.06,90,,,percent of total billed charges,90% of total billed charges,890.06,90,,,percent of total billed charges,90% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,375.8,38,,,percent of total billed charges,38% of total billed charges,741.72,75,,,percent of total billed charges,75% of total billed charges,840.62,85,,,percent of total billed charges,85% of total billed charges,375.8,919.73,
US Abdominal-Limited,6170,CDM,402,RC,76705,HCPCS,outpatient,,,467.54,350.66,,420.79,90,,,percent of total billed charges,90% of total billed charges,434.81,93,,,percent of total billed charges,93% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,397.41,85,,,percent of total billed charges,85% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,380.58,81.4,,,percent of total billed charges,81.4% of total billed charges,420.79,90,,,percent of total billed charges,90% of total billed charges,420.79,90,,,percent of total billed charges,90% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,177.67,38,,,percent of total billed charges,38% of total billed charges,350.66,75,,,percent of total billed charges,75% of total billed charges,397.41,85,,,percent of total billed charges,85% of total billed charges,177.67,434.81,
ER Trauma Abd US (FAST),6171,CDM,402,RC,76705,HCPCS,outpatient,,,242.55,181.91,,218.3,90,,,percent of total billed charges,90% of total billed charges,225.57,93,,,percent of total billed charges,93% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,206.17,85,,,percent of total billed charges,85% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,197.44,81.4,,,percent of total billed charges,81.4% of total billed charges,218.3,90,,,percent of total billed charges,90% of total billed charges,218.3,90,,,percent of total billed charges,90% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,181.91,75,,,percent of total billed charges,75% of total billed charges,206.17,85,,,percent of total billed charges,85% of total billed charges,92.17,225.57,
ER Gallbladder US,6172,CDM,402,RC,76705,HCPCS,outpatient,,,242.55,181.91,,218.3,90,,,percent of total billed charges,90% of total billed charges,225.57,93,,,percent of total billed charges,93% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,206.17,85,,,percent of total billed charges,85% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,197.44,81.4,,,percent of total billed charges,81.4% of total billed charges,218.3,90,,,percent of total billed charges,90% of total billed charges,218.3,90,,,percent of total billed charges,90% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,181.91,75,,,percent of total billed charges,75% of total billed charges,206.17,85,,,percent of total billed charges,85% of total billed charges,92.17,225.57,
US Abdominal  for AAA screen  Medicare,6173,CDM,402,RC,76706,HCPCS,outpatient,,,467.16,350.37,,420.44,90,,,percent of total billed charges,90% of total billed charges,434.46,93,,,percent of total billed charges,93% of total billed charges,177.52,38,,,percent of total billed charges,38% of total billed charges,177.52,38,,,percent of total billed charges,38% of total billed charges,397.09,85,,,percent of total billed charges,85% of total billed charges,177.52,38,,,percent of total billed charges,38% of total billed charges,380.27,81.4,,,percent of total billed charges,81.4% of total billed charges,420.44,90,,,percent of total billed charges,90% of total billed charges,420.44,90,,,percent of total billed charges,90% of total billed charges,177.52,38,,,percent of total billed charges,38% of total billed charges,177.52,38,,,percent of total billed charges,38% of total billed charges,177.52,38,,,percent of total billed charges,38% of total billed charges,350.37,75,,,percent of total billed charges,75% of total billed charges,397.09,85,,,percent of total billed charges,85% of total billed charges,177.52,434.46,
US Renal Retroperitoneal,6174,CDM,402,RC,76770,HCPCS,outpatient,,,571.84,428.88,,514.66,90,,,percent of total billed charges,90% of total billed charges,531.81,93,,,percent of total billed charges,93% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,486.06,85,,,percent of total billed charges,85% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,465.48,81.4,,,percent of total billed charges,81.4% of total billed charges,514.66,90,,,percent of total billed charges,90% of total billed charges,514.66,90,,,percent of total billed charges,90% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,217.3,38,,,percent of total billed charges,38% of total billed charges,428.88,75,,,percent of total billed charges,75% of total billed charges,486.06,85,,,percent of total billed charges,85% of total billed charges,217.3,531.81,
ER Aorta US,6175,CDM,402,RC,76775,HCPCS,outpatient,,,241.38,181.04,,217.24,90,,,percent of total billed charges,90% of total billed charges,224.48,93,,,percent of total billed charges,93% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,205.17,85,,,percent of total billed charges,85% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,196.48,81.4,,,percent of total billed charges,81.4% of total billed charges,217.24,90,,,percent of total billed charges,90% of total billed charges,217.24,90,,,percent of total billed charges,90% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,181.04,75,,,percent of total billed charges,75% of total billed charges,205.17,85,,,percent of total billed charges,85% of total billed charges,91.72,224.48,
ER Renal US,6176,CDM,402,RC,76775,HCPCS,outpatient,,,241.38,181.04,,217.24,90,,,percent of total billed charges,90% of total billed charges,224.48,93,,,percent of total billed charges,93% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,205.17,85,,,percent of total billed charges,85% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,196.48,81.4,,,percent of total billed charges,81.4% of total billed charges,217.24,90,,,percent of total billed charges,90% of total billed charges,217.24,90,,,percent of total billed charges,90% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,91.72,38,,,percent of total billed charges,38% of total billed charges,181.04,75,,,percent of total billed charges,75% of total billed charges,205.17,85,,,percent of total billed charges,85% of total billed charges,91.72,224.48,
US OB 1st tri Complete,6177,CDM,402,RC,76801,HCPCS,outpatient,,,526.12,394.59,,473.51,90,,,percent of total billed charges,90% of total billed charges,489.29,93,,,percent of total billed charges,93% of total billed charges,199.93,38,,,percent of total billed charges,38% of total billed charges,199.93,38,,,percent of total billed charges,38% of total billed charges,447.2,85,,,percent of total billed charges,85% of total billed charges,199.93,38,,,percent of total billed charges,38% of total billed charges,428.26,81.4,,,percent of total billed charges,81.4% of total billed charges,473.51,90,,,percent of total billed charges,90% of total billed charges,473.51,90,,,percent of total billed charges,90% of total billed charges,199.93,38,,,percent of total billed charges,38% of total billed charges,199.93,38,,,percent of total billed charges,38% of total billed charges,199.93,38,,,percent of total billed charges,38% of total billed charges,394.59,75,,,percent of total billed charges,75% of total billed charges,447.2,85,,,percent of total billed charges,85% of total billed charges,199.93,489.29,
US OB-Complete,6178,CDM,402,RC,76811,HCPCS,outpatient,,,536.67,402.5,,483,90,,,percent of total billed charges,90% of total billed charges,499.1,93,,,percent of total billed charges,93% of total billed charges,203.93,38,,,percent of total billed charges,38% of total billed charges,203.93,38,,,percent of total billed charges,38% of total billed charges,456.17,85,,,percent of total billed charges,85% of total billed charges,203.93,38,,,percent of total billed charges,38% of total billed charges,436.85,81.4,,,percent of total billed charges,81.4% of total billed charges,483,90,,,percent of total billed charges,90% of total billed charges,483,90,,,percent of total billed charges,90% of total billed charges,203.93,38,,,percent of total billed charges,38% of total billed charges,203.93,38,,,percent of total billed charges,38% of total billed charges,203.93,38,,,percent of total billed charges,38% of total billed charges,402.5,75,,,percent of total billed charges,75% of total billed charges,456.17,85,,,percent of total billed charges,85% of total billed charges,203.93,499.1,
US OB Complete (Twin) Add,6179,CDM,402,RC,76812,HCPCS,outpatient,,,410.12,307.59,,369.11,90,,,percent of total billed charges,90% of total billed charges,381.41,93,,,percent of total billed charges,93% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,333.84,81.4,,,percent of total billed charges,81.4% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,369.11,90,,,percent of total billed charges,90% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,155.85,38,,,percent of total billed charges,38% of total billed charges,307.59,75,,,percent of total billed charges,75% of total billed charges,348.6,85,,,percent of total billed charges,85% of total billed charges,155.85,381.41,
US OB Limited,6180,CDM,402,RC,76815,HCPCS,outpatient,,,380.83,285.62,,342.75,90,,,percent of total billed charges,90% of total billed charges,354.17,93,,,percent of total billed charges,93% of total billed charges,144.72,38,,,percent of total billed charges,38% of total billed charges,144.72,38,,,percent of total billed charges,38% of total billed charges,323.71,85,,,percent of total billed charges,85% of total billed charges,144.72,38,,,percent of total billed charges,38% of total billed charges,310,81.4,,,percent of total billed charges,81.4% of total billed charges,342.75,90,,,percent of total billed charges,90% of total billed charges,342.75,90,,,percent of total billed charges,90% of total billed charges,144.72,38,,,percent of total billed charges,38% of total billed charges,144.72,38,,,percent of total billed charges,38% of total billed charges,144.72,38,,,percent of total billed charges,38% of total billed charges,285.62,75,,,percent of total billed charges,75% of total billed charges,323.71,85,,,percent of total billed charges,85% of total billed charges,144.72,354.17,
US OB Follow-up,6181,CDM,402,RC,76816,HCPCS,outpatient,,,424.18,318.14,,381.76,90,,,percent of total billed charges,90% of total billed charges,394.49,93,,,percent of total billed charges,93% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,360.55,85,,,percent of total billed charges,85% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,345.28,81.4,,,percent of total billed charges,81.4% of total billed charges,381.76,90,,,percent of total billed charges,90% of total billed charges,381.76,90,,,percent of total billed charges,90% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,161.19,38,,,percent of total billed charges,38% of total billed charges,318.14,75,,,percent of total billed charges,75% of total billed charges,360.55,85,,,percent of total billed charges,85% of total billed charges,161.19,394.49,
US OB Transvaginal -add,6182,CDM,402,RC,76817,HCPCS,outpatient,,,447.62,335.72,,402.86,90,,,percent of total billed charges,90% of total billed charges,416.29,93,,,percent of total billed charges,93% of total billed charges,170.1,38,,,percent of total billed charges,38% of total billed charges,170.1,38,,,percent of total billed charges,38% of total billed charges,380.48,85,,,percent of total billed charges,85% of total billed charges,170.1,38,,,percent of total billed charges,38% of total billed charges,364.36,81.4,,,percent of total billed charges,81.4% of total billed charges,402.86,90,,,percent of total billed charges,90% of total billed charges,402.86,90,,,percent of total billed charges,90% of total billed charges,170.1,38,,,percent of total billed charges,38% of total billed charges,170.1,38,,,percent of total billed charges,38% of total billed charges,170.1,38,,,percent of total billed charges,38% of total billed charges,335.72,75,,,percent of total billed charges,75% of total billed charges,380.48,85,,,percent of total billed charges,85% of total billed charges,170.1,416.29,
US Transvaginal Add,6183,CDM,402,RC,76830,HCPCS,outpatient,,,291.77,218.83,,262.59,90,,,percent of total billed charges,90% of total billed charges,271.35,93,,,percent of total billed charges,93% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,248,85,,,percent of total billed charges,85% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,237.5,81.4,,,percent of total billed charges,81.4% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,262.59,90,,,percent of total billed charges,90% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,110.87,38,,,percent of total billed charges,38% of total billed charges,218.83,75,,,percent of total billed charges,75% of total billed charges,248,85,,,percent of total billed charges,85% of total billed charges,110.87,271.35,
ER Pelvic Trans Abd US (FAST),6184,CDM,402,RC,76830,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
US Pelvic Complete,6185,CDM,402,RC,76856,HCPCS,outpatient,,,541.37,406.03,,487.23,90,,,percent of total billed charges,90% of total billed charges,503.47,93,,,percent of total billed charges,93% of total billed charges,205.72,38,,,percent of total billed charges,38% of total billed charges,205.72,38,,,percent of total billed charges,38% of total billed charges,460.16,85,,,percent of total billed charges,85% of total billed charges,205.72,38,,,percent of total billed charges,38% of total billed charges,440.68,81.4,,,percent of total billed charges,81.4% of total billed charges,487.23,90,,,percent of total billed charges,90% of total billed charges,487.23,90,,,percent of total billed charges,90% of total billed charges,205.72,38,,,percent of total billed charges,38% of total billed charges,205.72,38,,,percent of total billed charges,38% of total billed charges,205.72,38,,,percent of total billed charges,38% of total billed charges,406.03,75,,,percent of total billed charges,75% of total billed charges,460.16,85,,,percent of total billed charges,85% of total billed charges,205.72,503.47,
US Pelvic Limited,6186,CDM,402,RC,76857,HCPCS,outpatient,,,414.8,311.1,,373.32,90,,,percent of total billed charges,90% of total billed charges,385.76,93,,,percent of total billed charges,93% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,337.65,81.4,,,percent of total billed charges,81.4% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,311.1,75,,,percent of total billed charges,75% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,385.76,
ER Pelvic Endovaginal-US,6187,CDM,402,RC,76857,HCPCS,outpatient,,,271.84,203.88,,244.66,90,,,percent of total billed charges,90% of total billed charges,252.81,93,,,percent of total billed charges,93% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,231.06,85,,,percent of total billed charges,85% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,221.28,81.4,,,percent of total billed charges,81.4% of total billed charges,244.66,90,,,percent of total billed charges,90% of total billed charges,244.66,90,,,percent of total billed charges,90% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,203.88,75,,,percent of total billed charges,75% of total billed charges,231.06,85,,,percent of total billed charges,85% of total billed charges,103.3,252.81,
ER Limited Pelvis-US,6188,CDM,402,RC,76857,HCPCS,outpatient,,,271.84,203.88,,244.66,90,,,percent of total billed charges,90% of total billed charges,252.81,93,,,percent of total billed charges,93% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,231.06,85,,,percent of total billed charges,85% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,221.28,81.4,,,percent of total billed charges,81.4% of total billed charges,244.66,90,,,percent of total billed charges,90% of total billed charges,244.66,90,,,percent of total billed charges,90% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,103.3,38,,,percent of total billed charges,38% of total billed charges,203.88,75,,,percent of total billed charges,75% of total billed charges,231.06,85,,,percent of total billed charges,85% of total billed charges,103.3,252.81,
US Pelvic-Limited,6189,CDM,402,RC,76857,HCPCS,outpatient,,,414.8,311.1,,373.32,90,,,percent of total billed charges,90% of total billed charges,385.76,93,,,percent of total billed charges,93% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,337.65,81.4,,,percent of total billed charges,81.4% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,373.32,90,,,percent of total billed charges,90% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,157.62,38,,,percent of total billed charges,38% of total billed charges,311.1,75,,,percent of total billed charges,75% of total billed charges,352.58,85,,,percent of total billed charges,85% of total billed charges,157.62,385.76,
US Testicular,6190,CDM,402,RC,76870,HCPCS,outpatient,,,577.69,433.27,,519.92,90,,,percent of total billed charges,90% of total billed charges,537.25,93,,,percent of total billed charges,93% of total billed charges,219.52,38,,,percent of total billed charges,38% of total billed charges,219.52,38,,,percent of total billed charges,38% of total billed charges,491.04,85,,,percent of total billed charges,85% of total billed charges,219.52,38,,,percent of total billed charges,38% of total billed charges,470.24,81.4,,,percent of total billed charges,81.4% of total billed charges,519.92,90,,,percent of total billed charges,90% of total billed charges,519.92,90,,,percent of total billed charges,90% of total billed charges,219.52,38,,,percent of total billed charges,38% of total billed charges,219.52,38,,,percent of total billed charges,38% of total billed charges,219.52,38,,,percent of total billed charges,38% of total billed charges,433.27,75,,,percent of total billed charges,75% of total billed charges,491.04,85,,,percent of total billed charges,85% of total billed charges,219.52,537.25,
ER Scrotum US,6191,CDM,402,RC,76870,HCPCS,outpatient,,,220.29,165.22,,198.26,90,,,percent of total billed charges,90% of total billed charges,204.87,93,,,percent of total billed charges,93% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,187.25,85,,,percent of total billed charges,85% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,179.32,81.4,,,percent of total billed charges,81.4% of total billed charges,198.26,90,,,percent of total billed charges,90% of total billed charges,198.26,90,,,percent of total billed charges,90% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,83.71,38,,,percent of total billed charges,38% of total billed charges,165.22,75,,,percent of total billed charges,75% of total billed charges,187.25,85,,,percent of total billed charges,85% of total billed charges,83.71,204.87,
US Prostate Volume  Transrectal,6192,CDM,402,RC,76873,HCPCS,outpatient,,,591.74,443.81,,532.57,90,,,percent of total billed charges,90% of total billed charges,550.32,93,,,percent of total billed charges,93% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,481.68,81.4,,,percent of total billed charges,81.4% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,443.81,75,,,percent of total billed charges,75% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,550.32,
US Extremity Non-Vascular Limited,6193,CDM,402,RC,76882,HCPCS,outpatient,,,453.48,340.11,,408.13,90,,,percent of total billed charges,90% of total billed charges,421.74,93,,,percent of total billed charges,93% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,385.46,85,,,percent of total billed charges,85% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,369.13,81.4,,,percent of total billed charges,81.4% of total billed charges,408.13,90,,,percent of total billed charges,90% of total billed charges,408.13,90,,,percent of total billed charges,90% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,172.32,38,,,percent of total billed charges,38% of total billed charges,340.11,75,,,percent of total billed charges,75% of total billed charges,385.46,85,,,percent of total billed charges,85% of total billed charges,172.32,421.74,
US GUIDANCE AND NEEDLE PLACEMENT,6194,CDM,402,RC,76942,HCPCS,outpatient,,,233.17,174.88,,209.85,90,,,percent of total billed charges,90% of total billed charges,216.85,93,,,percent of total billed charges,93% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,198.19,85,,,percent of total billed charges,85% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,189.8,81.4,,,percent of total billed charges,81.4% of total billed charges,209.85,90,,,percent of total billed charges,90% of total billed charges,209.85,90,,,percent of total billed charges,90% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,174.88,75,,,percent of total billed charges,75% of total billed charges,198.19,85,,,percent of total billed charges,85% of total billed charges,88.6,216.85,
US GUIDANCE AND NEEDLE PLACEMENT,6195,CDM,402,RC,76942,HCPCS,outpatient,,,233.17,174.88,,209.85,90,,,percent of total billed charges,90% of total billed charges,216.85,93,,,percent of total billed charges,93% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,198.19,85,,,percent of total billed charges,85% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,189.8,81.4,,,percent of total billed charges,81.4% of total billed charges,209.85,90,,,percent of total billed charges,90% of total billed charges,209.85,90,,,percent of total billed charges,90% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,88.6,38,,,percent of total billed charges,38% of total billed charges,174.88,75,,,percent of total billed charges,75% of total billed charges,198.19,85,,,percent of total billed charges,85% of total billed charges,88.6,216.85,
ECHO Congenital Complete,6196,CDM,483,RC,93303,HCPCS,outpatient,,,1387.38,1040.54,,1248.64,90,,,percent of total billed charges,90% of total billed charges,1290.26,93,,,percent of total billed charges,93% of total billed charges,527.2,38,,,percent of total billed charges,38% of total billed charges,527.2,38,,,percent of total billed charges,38% of total billed charges,1179.27,85,,,percent of total billed charges,85% of total billed charges,527.2,38,,,percent of total billed charges,38% of total billed charges,1129.33,81.4,,,percent of total billed charges,81.4% of total billed charges,1248.64,90,,,percent of total billed charges,90% of total billed charges,1248.64,90,,,percent of total billed charges,90% of total billed charges,527.2,38,,,percent of total billed charges,38% of total billed charges,527.2,38,,,percent of total billed charges,38% of total billed charges,527.2,38,,,percent of total billed charges,38% of total billed charges,1040.54,75,,,percent of total billed charges,75% of total billed charges,1179.27,85,,,percent of total billed charges,85% of total billed charges,527.2,1290.26,
ECHO COMPLETE -Facility,6197,CDM,483,RC,93306,HCPCS,outpatient,,,1441.28,1080.96,,1297.15,90,,,percent of total billed charges,90% of total billed charges,1340.39,93,,,percent of total billed charges,93% of total billed charges,547.69,38,,,percent of total billed charges,38% of total billed charges,547.69,38,,,percent of total billed charges,38% of total billed charges,1225.09,85,,,percent of total billed charges,85% of total billed charges,547.69,38,,,percent of total billed charges,38% of total billed charges,1173.2,81.4,,,percent of total billed charges,81.4% of total billed charges,1297.15,90,,,percent of total billed charges,90% of total billed charges,1297.15,90,,,percent of total billed charges,90% of total billed charges,547.69,38,,,percent of total billed charges,38% of total billed charges,547.69,38,,,percent of total billed charges,38% of total billed charges,547.69,38,,,percent of total billed charges,38% of total billed charges,1080.96,75,,,percent of total billed charges,75% of total billed charges,1225.09,85,,,percent of total billed charges,85% of total billed charges,547.69,1340.39,
ER Cardiac (FAST)-US,6198,CDM,402,RC,93308,HCPCS,outpatient,,,133.59,100.19,,120.23,90,,,percent of total billed charges,90% of total billed charges,124.24,93,,,percent of total billed charges,93% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,113.55,85,,,percent of total billed charges,85% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,108.74,81.4,,,percent of total billed charges,81.4% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,100.19,75,,,percent of total billed charges,75% of total billed charges,113.55,85,,,percent of total billed charges,85% of total billed charges,50.76,124.24,
ECHO 2D limited,6199,CDM,483,RC,93308,HCPCS,outpatient,,,881.18,660.89,,793.06,90,,,percent of total billed charges,90% of total billed charges,819.5,93,,,percent of total billed charges,93% of total billed charges,334.85,38,,,percent of total billed charges,38% of total billed charges,334.85,38,,,percent of total billed charges,38% of total billed charges,749,85,,,percent of total billed charges,85% of total billed charges,334.85,38,,,percent of total billed charges,38% of total billed charges,717.28,81.4,,,percent of total billed charges,81.4% of total billed charges,793.06,90,,,percent of total billed charges,90% of total billed charges,793.06,90,,,percent of total billed charges,90% of total billed charges,334.85,38,,,percent of total billed charges,38% of total billed charges,334.85,38,,,percent of total billed charges,38% of total billed charges,334.85,38,,,percent of total billed charges,38% of total billed charges,660.89,75,,,percent of total billed charges,75% of total billed charges,749,85,,,percent of total billed charges,85% of total billed charges,334.85,819.5,
ECHO CLINIC-DOPPLER,6200,CDM,483,RC,93320,HCPCS,outpatient,,,372.63,279.47,,335.37,90,,,percent of total billed charges,90% of total billed charges,346.55,93,,,percent of total billed charges,93% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,303.32,81.4,,,percent of total billed charges,81.4% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,279.47,75,,,percent of total billed charges,75% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,346.55,
"ECHO CLINIC -DOPPLER,COLOR",6201,CDM,483,RC,93325,HCPCS,outpatient,,,475.75,356.81,,428.18,90,,,percent of total billed charges,90% of total billed charges,442.45,93,,,percent of total billed charges,93% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,404.39,85,,,percent of total billed charges,85% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,387.26,81.4,,,percent of total billed charges,81.4% of total billed charges,428.18,90,,,percent of total billed charges,90% of total billed charges,428.18,90,,,percent of total billed charges,90% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,180.79,38,,,percent of total billed charges,38% of total billed charges,356.81,75,,,percent of total billed charges,75% of total billed charges,404.39,85,,,percent of total billed charges,85% of total billed charges,180.79,442.45,
ECHO CLINIC-WITH STRESS,6202,CDM,483,RC,93350,HCPCS,outpatient,,,594.09,445.57,,534.68,90,,,percent of total billed charges,90% of total billed charges,552.5,93,,,percent of total billed charges,93% of total billed charges,225.75,38,,,percent of total billed charges,38% of total billed charges,225.75,38,,,percent of total billed charges,38% of total billed charges,504.98,85,,,percent of total billed charges,85% of total billed charges,225.75,38,,,percent of total billed charges,38% of total billed charges,483.59,81.4,,,percent of total billed charges,81.4% of total billed charges,534.68,90,,,percent of total billed charges,90% of total billed charges,534.68,90,,,percent of total billed charges,90% of total billed charges,225.75,38,,,percent of total billed charges,38% of total billed charges,225.75,38,,,percent of total billed charges,38% of total billed charges,225.75,38,,,percent of total billed charges,38% of total billed charges,445.57,75,,,percent of total billed charges,75% of total billed charges,504.98,85,,,percent of total billed charges,85% of total billed charges,225.75,552.5,
US VASC Carotid Duplex Bilateral,6203,CDM,921,RC,93880,HCPCS,outpatient,,,1031.15,773.36,,928.04,90,,,percent of total billed charges,90% of total billed charges,958.97,93,,,percent of total billed charges,93% of total billed charges,391.84,38,,,percent of total billed charges,38% of total billed charges,391.84,38,,,percent of total billed charges,38% of total billed charges,876.48,85,,,percent of total billed charges,85% of total billed charges,391.84,38,,,percent of total billed charges,38% of total billed charges,839.36,81.4,,,percent of total billed charges,81.4% of total billed charges,928.04,90,,,percent of total billed charges,90% of total billed charges,928.04,90,,,percent of total billed charges,90% of total billed charges,391.84,38,,,percent of total billed charges,38% of total billed charges,391.84,38,,,percent of total billed charges,38% of total billed charges,391.84,38,,,percent of total billed charges,38% of total billed charges,773.36,75,,,percent of total billed charges,75% of total billed charges,876.48,85,,,percent of total billed charges,85% of total billed charges,391.84,958.97,
ER Bi-Lateral Lower Extremity-US,6204,CDM,921,RC,93925,HCPCS,outpatient,,,974.9,731.18,,877.41,90,,,percent of total billed charges,90% of total billed charges,906.66,93,,,percent of total billed charges,93% of total billed charges,370.46,38,,,percent of total billed charges,38% of total billed charges,370.46,38,,,percent of total billed charges,38% of total billed charges,828.67,85,,,percent of total billed charges,85% of total billed charges,370.46,38,,,percent of total billed charges,38% of total billed charges,793.57,81.4,,,percent of total billed charges,81.4% of total billed charges,877.41,90,,,percent of total billed charges,90% of total billed charges,877.41,90,,,percent of total billed charges,90% of total billed charges,370.46,38,,,percent of total billed charges,38% of total billed charges,370.46,38,,,percent of total billed charges,38% of total billed charges,370.46,38,,,percent of total billed charges,38% of total billed charges,731.18,75,,,percent of total billed charges,75% of total billed charges,828.67,85,,,percent of total billed charges,85% of total billed charges,370.46,906.66,
US-duplex lower ext art BL,6205,CDM,402,RC,93925,HCPCS,outpatient,,,742.85,557.14,,668.57,90,,,percent of total billed charges,90% of total billed charges,690.85,93,,,percent of total billed charges,93% of total billed charges,282.28,38,,,percent of total billed charges,38% of total billed charges,282.28,38,,,percent of total billed charges,38% of total billed charges,631.42,85,,,percent of total billed charges,85% of total billed charges,282.28,38,,,percent of total billed charges,38% of total billed charges,604.68,81.4,,,percent of total billed charges,81.4% of total billed charges,668.57,90,,,percent of total billed charges,90% of total billed charges,668.57,90,,,percent of total billed charges,90% of total billed charges,282.28,38,,,percent of total billed charges,38% of total billed charges,282.28,38,,,percent of total billed charges,38% of total billed charges,282.28,38,,,percent of total billed charges,38% of total billed charges,557.14,75,,,percent of total billed charges,75% of total billed charges,631.42,85,,,percent of total billed charges,85% of total billed charges,282.28,690.85,
ER DVT-US,6206,CDM,921,RC,93926,HCPCS,outpatient,,,621.03,465.77,,558.93,90,,,percent of total billed charges,90% of total billed charges,577.56,93,,,percent of total billed charges,93% of total billed charges,235.99,38,,,percent of total billed charges,38% of total billed charges,235.99,38,,,percent of total billed charges,38% of total billed charges,527.88,85,,,percent of total billed charges,85% of total billed charges,235.99,38,,,percent of total billed charges,38% of total billed charges,505.52,81.4,,,percent of total billed charges,81.4% of total billed charges,558.93,90,,,percent of total billed charges,90% of total billed charges,558.93,90,,,percent of total billed charges,90% of total billed charges,235.99,38,,,percent of total billed charges,38% of total billed charges,235.99,38,,,percent of total billed charges,38% of total billed charges,235.99,38,,,percent of total billed charges,38% of total billed charges,465.77,75,,,percent of total billed charges,75% of total billed charges,527.88,85,,,percent of total billed charges,85% of total billed charges,235.99,577.56,
US VASC Venous Duplex Extrem Bilateral,6207,CDM,921,RC,93970,HCPCS,outpatient,,,991.33,743.5,,892.2,90,,,percent of total billed charges,90% of total billed charges,921.94,93,,,percent of total billed charges,93% of total billed charges,376.71,38,,,percent of total billed charges,38% of total billed charges,376.71,38,,,percent of total billed charges,38% of total billed charges,842.63,85,,,percent of total billed charges,85% of total billed charges,376.71,38,,,percent of total billed charges,38% of total billed charges,806.94,81.4,,,percent of total billed charges,81.4% of total billed charges,892.2,90,,,percent of total billed charges,90% of total billed charges,892.2,90,,,percent of total billed charges,90% of total billed charges,376.71,38,,,percent of total billed charges,38% of total billed charges,376.71,38,,,percent of total billed charges,38% of total billed charges,376.71,38,,,percent of total billed charges,38% of total billed charges,743.5,75,,,percent of total billed charges,75% of total billed charges,842.63,85,,,percent of total billed charges,85% of total billed charges,376.71,921.94,
US VASC Venous Duplex Extrem Unilateral,6208,CDM,921,RC,93971,HCPCS,outpatient,,,840.15,630.11,,756.14,90,,,percent of total billed charges,90% of total billed charges,781.34,93,,,percent of total billed charges,93% of total billed charges,319.26,38,,,percent of total billed charges,38% of total billed charges,319.26,38,,,percent of total billed charges,38% of total billed charges,714.13,85,,,percent of total billed charges,85% of total billed charges,319.26,38,,,percent of total billed charges,38% of total billed charges,683.88,81.4,,,percent of total billed charges,81.4% of total billed charges,756.14,90,,,percent of total billed charges,90% of total billed charges,756.14,90,,,percent of total billed charges,90% of total billed charges,319.26,38,,,percent of total billed charges,38% of total billed charges,319.26,38,,,percent of total billed charges,38% of total billed charges,319.26,38,,,percent of total billed charges,38% of total billed charges,630.11,75,,,percent of total billed charges,75% of total billed charges,714.13,85,,,percent of total billed charges,85% of total billed charges,319.26,781.34,
US VASC Renal Doppler,6209,CDM,921,RC,93976,HCPCS,outpatient,,,713.61,535.21,,642.25,90,,,percent of total billed charges,90% of total billed charges,663.66,93,,,percent of total billed charges,93% of total billed charges,271.17,38,,,percent of total billed charges,38% of total billed charges,271.17,38,,,percent of total billed charges,38% of total billed charges,606.57,85,,,percent of total billed charges,85% of total billed charges,271.17,38,,,percent of total billed charges,38% of total billed charges,580.88,81.4,,,percent of total billed charges,81.4% of total billed charges,642.25,90,,,percent of total billed charges,90% of total billed charges,642.25,90,,,percent of total billed charges,90% of total billed charges,271.17,38,,,percent of total billed charges,38% of total billed charges,271.17,38,,,percent of total billed charges,38% of total billed charges,271.17,38,,,percent of total billed charges,38% of total billed charges,535.21,75,,,percent of total billed charges,75% of total billed charges,606.57,85,,,percent of total billed charges,85% of total billed charges,271.17,663.66,
ECHO CLINIC contrast -perflutren/Definity,6210,CDM,636,RC,Q9957,HCPCS,both,,,452.3,339.23,,407.07,90,,,percent of total billed charges,90% of total billed charges,420.64,93,,,percent of total billed charges,93% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,368.17,81.4,,,percent of total billed charges,81.4% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,339.23,75,,,percent of total billed charges,75% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,420.64,
ECHO CLINIC contrast -perflutren/Definity,6211,CDM,636,RC,Q9957,HCPCS,both,,,452.3,339.23,,407.07,90,,,percent of total billed charges,90% of total billed charges,420.64,93,,,percent of total billed charges,93% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,368.17,81.4,,,percent of total billed charges,81.4% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,339.23,75,,,percent of total billed charges,75% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,420.64,
Anesthesia Technical Level I 1-29 min,77,CDM,370,RC,42222,HCPCS,outpatient,,,303.49,227.62,,273.14,90,,,percent of total billed charges,90% of total billed charges,282.25,93,,,percent of total billed charges,93% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,247.04,81.4,,,percent of total billed charges,81.4% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,273.14,90,,,percent of total billed charges,90% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,115.33,38,,,percent of total billed charges,38% of total billed charges,227.62,75,,,percent of total billed charges,75% of total billed charges,257.97,85,,,percent of total billed charges,85% of total billed charges,115.33,282.25,
UDS AMPHETAMINES,889,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS BUPRENORPHINE,891,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHAMPHETAMINE,893,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHYLENEDIOXYMETH,895,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS PROPOXYPHENE,897,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS OXYCODONE,899,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS BARBITURATES,902,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS BENZODIAZEPNS,904,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS COCAINE,906,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS CANNABINOIDS,908,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS OPIATES,910,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS PHENCYCLIDINE,912,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS TRICYCLIC ANTIDEPRES,914,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
UDS METHADONE,916,CDM,300,RC,G0431,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
Clinic drug testing,975,CDM,300,RC,80305,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
Blood Alcohol,992,CDM,300,RC,G0480,HCPCS,outpatient,,,121.86,91.4,,109.67,90,,,percent of total billed charges,90% of total billed charges,113.33,93,,,percent of total billed charges,93% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,99.19,81.4,,,percent of total billed charges,81.4% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,91.4,75,,,percent of total billed charges,75% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,113.33,
Drug Tox - alcohol metabolites quant UR,995,CDM,300,RC,G0480,HCPCS,outpatient,,,125,93.75,,112.5,90,,,percent of total billed charges,90% of total billed charges,116.25,93,,,percent of total billed charges,93% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,101.75,81.4,,,percent of total billed charges,81.4% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,112.5,90,,,percent of total billed charges,90% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,47.5,38,,,percent of total billed charges,38% of total billed charges,93.75,75,,,percent of total billed charges,75% of total billed charges,106.25,85,,,percent of total billed charges,85% of total billed charges,47.5,116.25,
Amphetamine quant urine,1002,CDM,300,RC,G0480,HCPCS,outpatient,,,156.77,117.58,,141.09,90,,,percent of total billed charges,90% of total billed charges,145.8,93,,,percent of total billed charges,93% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,127.61,81.4,,,percent of total billed charges,81.4% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,141.09,90,,,percent of total billed charges,90% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,59.57,38,,,percent of total billed charges,38% of total billed charges,117.58,75,,,percent of total billed charges,75% of total billed charges,133.25,85,,,percent of total billed charges,85% of total billed charges,59.57,145.8,
AMITRIPTYLINE,1006,CDM,300,RC,G0480,HCPCS,outpatient,,,166.67,125,,150,90,,,percent of total billed charges,90% of total billed charges,155,93,,,percent of total billed charges,93% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,135.67,81.4,,,percent of total billed charges,81.4% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,150,90,,,percent of total billed charges,90% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,63.33,38,,,percent of total billed charges,38% of total billed charges,125,75,,,percent of total billed charges,75% of total billed charges,141.67,85,,,percent of total billed charges,85% of total billed charges,63.33,155,
Drug monitoring - gabapentin quant UR,1017,CDM,300,RC,G0480,HCPCS,outpatient,,,126.97,95.23,,114.27,90,,,percent of total billed charges,90% of total billed charges,118.08,93,,,percent of total billed charges,93% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,107.92,85,,,percent of total billed charges,85% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,103.35,81.4,,,percent of total billed charges,81.4% of total billed charges,114.27,90,,,percent of total billed charges,90% of total billed charges,114.27,90,,,percent of total billed charges,90% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,48.25,38,,,percent of total billed charges,38% of total billed charges,95.23,75,,,percent of total billed charges,75% of total billed charges,107.92,85,,,percent of total billed charges,85% of total billed charges,48.25,118.08,
Oxy Drug Classess Confirmation,1023,CDM,300,RC,G0480,HCPCS,outpatient,,,129.51,97.13,,116.56,90,,,percent of total billed charges,90% of total billed charges,120.44,93,,,percent of total billed charges,93% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,110.08,85,,,percent of total billed charges,85% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,105.42,81.4,,,percent of total billed charges,81.4% of total billed charges,116.56,90,,,percent of total billed charges,90% of total billed charges,116.56,90,,,percent of total billed charges,90% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,49.21,38,,,percent of total billed charges,38% of total billed charges,97.13,75,,,percent of total billed charges,75% of total billed charges,110.08,85,,,percent of total billed charges,85% of total billed charges,49.21,120.44,
CBC w/ Auto Diff and Platelet,1744,CDM,300,RC,85027,HCPCS,outpatient,,,82.05,61.54,,73.85,90,,,percent of total billed charges,90% of total billed charges,76.31,93,,,percent of total billed charges,93% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,69.74,85,,,percent of total billed charges,85% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,66.79,81.4,,,percent of total billed charges,81.4% of total billed charges,73.85,90,,,percent of total billed charges,90% of total billed charges,73.85,90,,,percent of total billed charges,90% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,31.18,38,,,percent of total billed charges,38% of total billed charges,61.54,75,,,percent of total billed charges,75% of total billed charges,69.74,85,,,percent of total billed charges,85% of total billed charges,31.18,76.31,
** DO NOT USE OLD URINE DRUG SCREEN,3686,CDM,300,RC,G0478,HCPCS,outpatient,,,260.13,195.1,,234.12,90,,,percent of total billed charges,90% of total billed charges,241.92,93,,,percent of total billed charges,93% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,211.75,81.4,,,percent of total billed charges,81.4% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,234.12,90,,,percent of total billed charges,90% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,98.85,38,,,percent of total billed charges,38% of total billed charges,195.1,75,,,percent of total billed charges,75% of total billed charges,221.11,85,,,percent of total billed charges,85% of total billed charges,98.85,241.92,
Clinic Admin- flu vaccine,3945,CDM,771,RC,G0008,HCPCS,outpatient,,,35.7,26.78,,32.13,90,,,percent of total billed charges,90% of total billed charges,33.2,93,,,percent of total billed charges,93% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,29.06,81.4,,,percent of total billed charges,81.4% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,13.57,38,,,percent of total billed charges,38% of total billed charges,26.78,75,,,percent of total billed charges,75% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.57,33.2,
Clinic Flu vaccine 3 yrs and>,3999,CDM,636,RC,Q2038,HCPCS,both,,,25.5,19.13,,22.95,90,,,percent of total billed charges,90% of total billed charges,23.72,93,,,percent of total billed charges,93% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,20.76,81.4,,,percent of total billed charges,81.4% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,19.13,75,,,percent of total billed charges,75% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.69,23.72,
INJ OPTISON - ECHO CONTRAST,4018,CDM,636,RC,Q9956,HCPCS,both,,,337.48,253.11,,303.73,90,,,percent of total billed charges,90% of total billed charges,313.86,93,,,percent of total billed charges,93% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,274.71,81.4,,,percent of total billed charges,81.4% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,253.11,75,,,percent of total billed charges,75% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,313.86,
INJ OPTISON - ECHO CONTRAST,4019,CDM,636,RC,Q9956,HCPCS,both,,,337.48,253.11,,303.73,90,,,percent of total billed charges,90% of total billed charges,313.86,93,,,percent of total billed charges,93% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,274.71,81.4,,,percent of total billed charges,81.4% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,303.73,90,,,percent of total billed charges,90% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,128.24,38,,,percent of total billed charges,38% of total billed charges,253.11,75,,,percent of total billed charges,75% of total billed charges,286.86,85,,,percent of total billed charges,85% of total billed charges,128.24,313.86,
"Clinic Bicillin LA 100,000U",4023,CDM,636,RC,j0561,HCPCS,both,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
"Clinic Bicillin LA 100,000U",4024,CDM,636,RC,j0561,HCPCS,both,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
PT electrical stimulation,4135,CDM,420,RC,G0283,HCPCS,outpatient,,,50.38,37.79,,45.34,90,,,percent of total billed charges,90% of total billed charges,46.85,93,,,percent of total billed charges,93% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,41.01,81.4,,,percent of total billed charges,81.4% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,37.79,75,,,percent of total billed charges,75% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,46.85,
PT TENS evaluation/Training,4137,CDM,420,RC,97039,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
Work Comp Dry Needle trigger 3-,4186,CDM,420,RC,Z501,HCPCS,outpatient,,,41,30.75,,36.9,90,,,percent of total billed charges,90% of total billed charges,38.13,93,,,percent of total billed charges,93% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,34.85,85,,,percent of total billed charges,85% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,33.37,81.4,,,percent of total billed charges,81.4% of total billed charges,36.9,90,,,percent of total billed charges,90% of total billed charges,36.9,90,,,percent of total billed charges,90% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,15.58,38,,,percent of total billed charges,38% of total billed charges,30.75,75,,,percent of total billed charges,75% of total billed charges,34.85,85,,,percent of total billed charges,85% of total billed charges,15.58,38.13,
Work Comp Dry Needle Trigger +3 mus,4188,CDM,420,RC,Z502,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
Admin Flu vaccine,5282,CDM,636,RC,G0008,HCPCS,both,,,38.64,28.98,,34.78,90,,,percent of total billed charges,90% of total billed charges,35.94,93,,,percent of total billed charges,93% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,32.84,85,,,percent of total billed charges,85% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,31.45,81.4,,,percent of total billed charges,81.4% of total billed charges,34.78,90,,,percent of total billed charges,90% of total billed charges,34.78,90,,,percent of total billed charges,90% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,14.68,38,,,percent of total billed charges,38% of total billed charges,28.98,75,,,percent of total billed charges,75% of total billed charges,32.84,85,,,percent of total billed charges,85% of total billed charges,14.68,35.94,
Admin Vaccine Pneumovac,5284,CDM,636,RC,G0009,HCPCS,both,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
Telehealth visit Brief  RHC,5400,CDM,521,RC,99217,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.13,100.66,
Telehealth visit Brief  RHC,5401,CDM,521,RC,G2025,HCPCS,outpatient,,,108.24,81.18,,97.42,90,,,percent of total billed charges,90% of total billed charges,100.66,93,,,percent of total billed charges,93% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,92,85,,,percent of total billed charges,85% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,88.11,81.4,,,percent of total billed charges,81.4% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,97.42,90,,,percent of total billed charges,90% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,41.13,38,,,percent of total billed charges,38% of total billed charges,81.18,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.13,100.66,
Telehealth visit INT,5417,CDM,521,RC,G2025,HCPCS,outpatient,,,119.06,89.3,,107.15,90,,,percent of total billed charges,90% of total billed charges,110.73,93,,,percent of total billed charges,93% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,101.2,85,,,percent of total billed charges,85% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,96.91,81.4,,,percent of total billed charges,81.4% of total billed charges,107.15,90,,,percent of total billed charges,90% of total billed charges,107.15,90,,,percent of total billed charges,90% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,45.24,38,,,percent of total billed charges,38% of total billed charges,89.3,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,45.24,110.73,
Telehealth Visit EXT,5432,CDM,521,RC,G2025,HCPCS,outpatient,,,129.9,97.43,,116.91,90,,,percent of total billed charges,90% of total billed charges,120.81,93,,,percent of total billed charges,93% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,110.42,85,,,percent of total billed charges,85% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,105.74,81.4,,,percent of total billed charges,81.4% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,116.91,90,,,percent of total billed charges,90% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,49.36,38,,,percent of total billed charges,38% of total billed charges,97.43,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,49.36,120.81,
OFFICE CONSULT-MINOR- 15 MIN,5464,CDM,521,RC,99211,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,75.7,185.27,
OFFICE CONSULT-MINOR- 15 MIN,5465,CDM,521,RC,99211,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,75.7,185.27,
OFFICE CONSULT-LOW-30 MIN[Package],5469,CDM,521,RC,99212,HCPCS,outpatient,,,248.42,186.32,,223.58,90,,,percent of total billed charges,90% of total billed charges,231.03,93,,,percent of total billed charges,93% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,211.16,85,,,percent of total billed charges,85% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,202.21,81.4,,,percent of total billed charges,81.4% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,186.32,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,94.4,231.03,
OFFICE CONSULT-LOW-30 MIN[Package],5470,CDM,521,RC,99212,HCPCS,outpatient,,,248.42,186.32,,223.58,90,,,percent of total billed charges,90% of total billed charges,231.03,93,,,percent of total billed charges,93% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,211.16,85,,,percent of total billed charges,85% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,202.21,81.4,,,percent of total billed charges,81.4% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,223.58,90,,,percent of total billed charges,90% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,94.4,38,,,percent of total billed charges,38% of total billed charges,186.32,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,94.4,231.03,
OFFICE COUSULT-LOW-PRO 30 MIN,5472,CDM,982,RC,99212,HCPCS,outpatient,,,120.69,90.52,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,108.62,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,108.62,
OFFICE COUSULT-LOW-PRO 30 MIN,5473,CDM,982,RC,99212,HCPCS,outpatient,,,120.69,90.52,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,108.62,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,108.62,
OFFICE CONSULT-MODERATE-40 MIN,5476,CDM,521,RC,99213,HCPCS,outpatient,,,316.38,237.29,,284.74,90,,,percent of total billed charges,90% of total billed charges,294.23,93,,,percent of total billed charges,93% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,257.53,81.4,,,percent of total billed charges,81.4% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,237.29,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,120.22,294.23,
OFFICE CONSULT-MODERATE-40 MIN,5477,CDM,521,RC,99213,HCPCS,outpatient,,,316.38,237.29,,284.74,90,,,percent of total billed charges,90% of total billed charges,294.23,93,,,percent of total billed charges,93% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,268.92,85,,,percent of total billed charges,85% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,257.53,81.4,,,percent of total billed charges,81.4% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,284.74,90,,,percent of total billed charges,90% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,120.22,38,,,percent of total billed charges,38% of total billed charges,237.29,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,120.22,294.23,
OFFICE CONSULT-MOD/HIGH-60 MIN,5481,CDM,521,RC,99214,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-MOD/HIGH-60 MIN,5482,CDM,521,RC,99214,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-HIGH-HIGH-80 MIN,5486,CDM,521,RC,99215,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
OFFICE CONSULT-HIGH-HIGH-80 MIN,5487,CDM,521,RC,99215,HCPCS,outpatient,,,411.29,308.47,,370.16,90,,,percent of total billed charges,90% of total billed charges,382.5,93,,,percent of total billed charges,93% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,349.6,85,,,percent of total billed charges,85% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,334.79,81.4,,,percent of total billed charges,81.4% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,370.16,90,,,percent of total billed charges,90% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,156.29,38,,,percent of total billed charges,38% of total billed charges,308.47,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,156.29,382.5,
ORTHO-INPATIENT CONSULT-MINOR,5491,CDM,988,RC,99221,HCPCS,outpatient,,,233.17,174.88,,131.24,130,,,fee schedule,130% of fee schedule,131.24,130,,,fee schedule,130% of fee schedule,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,124,119,,,fee schedule,119% of fee schedule,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,100% of fee schedule,209.85,90,,,percent of total billed charges,90% of total billed charges,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,83.5,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,83.5,100,,,fee schedule,100% of fee schedule,53.93,209.85,
INPATIENT CONSULT LOW,5493,CDM,988,RC,99222,HCPCS,outpatient,,,291.77,218.83,,178.83,130,,,fee schedule,130% of fee schedule,178.83,130,,,fee schedule,130% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,167.66,119,,,fee schedule,119% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,100% of fee schedule,262.59,90,,,percent of total billed charges,90% of total billed charges,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,131.13,100,,,fee schedule,100% of fee schedule,89.88,262.59,
INPATIENT CONSULT LOW,5494,CDM,988,RC,99222,HCPCS,outpatient,,,291.77,218.83,,178.83,130,,,fee schedule,130% of fee schedule,178.83,130,,,fee schedule,130% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,167.66,119,,,fee schedule,119% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,100% of fee schedule,262.59,90,,,percent of total billed charges,90% of total billed charges,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,131.13,100,,,fee schedule,100% of fee schedule,89.88,262.59,
INPATIENT CONSULT 40 min,5496,CDM,988,RC,99222,HCPCS,outpatient,,,367.2,275.4,,178.83,130,,,fee schedule,130% of fee schedule,178.83,130,,,fee schedule,130% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,167.66,119,,,fee schedule,119% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,100% of fee schedule,330.48,90,,,percent of total billed charges,90% of total billed charges,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,131.13,100,,,fee schedule,100% of fee schedule,89.88,330.48,
INPATIENT CONSULT 40 min,5497,CDM,988,RC,99222,HCPCS,outpatient,,,367.2,275.4,,178.83,130,,,fee schedule,130% of fee schedule,178.83,130,,,fee schedule,130% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,167.66,119,,,fee schedule,119% of fee schedule,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,100% of fee schedule,330.48,90,,,percent of total billed charges,90% of total billed charges,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,131.13,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,131.13,100,,,fee schedule,100% of fee schedule,89.88,330.48,
INPATIENT CONSULT 60 min,5499,CDM,988,RC,99233,HCPCS,outpatient,,,456.96,342.72,,134.2,130,,,fee schedule,130% of fee schedule,134.2,130,,,fee schedule,130% of fee schedule,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,119,,,fee schedule,119% of fee schedule,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,100% of fee schedule,411.26,90,,,percent of total billed charges,90% of total billed charges,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,120.04,100,,,fee schedule,100% of fee schedule,89.88,411.26,
INPATIENT CONSULT 60 min,5500,CDM,988,RC,99233,HCPCS,outpatient,,,456.96,342.72,,134.2,130,,,fee schedule,130% of fee schedule,134.2,130,,,fee schedule,130% of fee schedule,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,119,,,fee schedule,119% of fee schedule,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,100% of fee schedule,411.26,90,,,percent of total billed charges,90% of total billed charges,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,120.04,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,120.04,100,,,fee schedule,100% of fee schedule,89.88,411.26,
Nursing Facility subse-:Low minorPRO,5519,CDM,521,RC,G2025,HCPCS,outpatient,,,108.97,81.73,,98.07,90,,,percent of total billed charges,90% of total billed charges,101.34,93,,,percent of total billed charges,93% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,92.62,85,,,percent of total billed charges,85% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,88.7,81.4,,,percent of total billed charges,81.4% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,98.07,90,,,percent of total billed charges,90% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,41.41,38,,,percent of total billed charges,38% of total billed charges,81.73,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,41.41,101.34,
Nursing facility Assess-Pro,5539,CDM,982,RC,G2025,HCPCS,outpatient,,,196.87,147.65,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,100.13,100,,,fee schedule,Pays 100% Medicare OPPS,100.13,100,,,fee schedule,Pays 100% Medicare OPPS,110.53,119,,,fee schedule,119% of fee schedule,100.13,100,,,fee schedule,Pays 100% Medicare OPPS,100.13,100,,,fee schedule,100% of fee schedule,177.18,90,,,percent of total billed charges,90% of total billed charges,100.13,100,,,fee schedule,Pays 100% Medicare OPPS,100.13,100,,,fee schedule,Pays 100% Medicare OPPS,100.13,100,,,fee schedule,Pays 100% Medicare OPPS,100.13,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,100.13,100,,,fee schedule,100% of fee schedule,100.13,177.18,
Floride Varnish Administation,5596,CDM,250,RC,99188,HCPCS,outpatient,,,22.08,16.56,,19.87,90,,,percent of total billed charges,90% of total billed charges,20.53,93,,,percent of total billed charges,93% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,18.77,85,,,percent of total billed charges,85% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,17.97,81.4,,,percent of total billed charges,81.4% of total billed charges,19.87,90,,,percent of total billed charges,90% of total billed charges,19.87,90,,,percent of total billed charges,90% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,8.39,38,,,percent of total billed charges,38% of total billed charges,16.56,75,,,percent of total billed charges,75% of total billed charges,18.77,85,,,percent of total billed charges,85% of total billed charges,8.39,20.53,
"Virtual Communication services, RHC",5600,CDM,521,RC,G2012,HCPCS,outpatient,,,43.3,32.48,,38.97,90,,,percent of total billed charges,90% of total billed charges,40.27,93,,,percent of total billed charges,93% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,35.25,81.4,,,percent of total billed charges,81.4% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,16.45,38,,,percent of total billed charges,38% of total billed charges,32.48,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,16.45,40.27,
Chronic care mgt -20 min/mo,5878,CDM,521,RC,G0511,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,20.98,51.34,
Chronic care mgt -20 min/mo,5879,CDM,521,RC,G0511,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,20.98,51.34,
ECHO CLINIC contrast -perflutren/Definity,6211,CDM,636,RC,A9700,HCPCS,both,,,452.3,339.23,,407.07,90,,,percent of total billed charges,90% of total billed charges,420.64,93,,,percent of total billed charges,93% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,368.17,81.4,,,percent of total billed charges,81.4% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,407.07,90,,,percent of total billed charges,90% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,171.87,38,,,percent of total billed charges,38% of total billed charges,339.23,75,,,percent of total billed charges,75% of total billed charges,384.46,85,,,percent of total billed charges,85% of total billed charges,171.87,420.64,
Acne surgery-FAC,263,CDM,510,RC,10040,HCPCS,outpatient,,,91.4,68.55,,82.26,90,,,percent of total billed charges,90% of total billed charges,85,93,,,percent of total billed charges,93% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,34.73,38,,,percent of total billed charges,38% of total billed charges,74.4,81.4,,,percent of total billed charges,81.4% of total billed charges,82.26,90,,,percent of total billed charges,90% of total billed charges,82.26,90,,,percent of total billed charges,90% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,34.73,38,,,percent of total billed charges,38% of total billed charges,68.55,75,,,percent of total billed charges,75% of total billed charges,77.69,85,,,percent of total billed charges,85% of total billed charges,34.73,85,
I&D Abcess Simple or Single (SQ)-Fac,265,CDM,510,RC,10060,HCPCS,outpatient,,,90.22,67.67,,81.2,90,,,percent of total billed charges,90% of total billed charges,83.9,93,,,percent of total billed charges,93% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,34.28,38,,,percent of total billed charges,38% of total billed charges,73.44,81.4,,,percent of total billed charges,81.4% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,67.67,75,,,percent of total billed charges,75% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,83.9,
FB Removal/Incision-Fac,271,CDM,510,RC,10120,HCPCS,outpatient,,,116,87,,104.4,90,,,percent of total billed charges,90% of total billed charges,107.88,93,,,percent of total billed charges,93% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,44.08,38,,,percent of total billed charges,38% of total billed charges,94.42,81.4,,,percent of total billed charges,81.4% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,44.08,38,,,percent of total billed charges,38% of total billed charges,87,75,,,percent of total billed charges,75% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,44.08,107.88,
FBR-complicated-Fac,273,CDM,510,RC,10121,HCPCS,outpatient,,,182.8,137.1,,164.52,90,,,percent of total billed charges,90% of total billed charges,170,93,,,percent of total billed charges,93% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,69.46,38,,,percent of total billed charges,38% of total billed charges,148.8,81.4,,,percent of total billed charges,81.4% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,137.1,75,,,percent of total billed charges,75% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,170,
"Punct. asp. abscess,hematoma,bulla or cyst-FAC",276,CDM,510,RC,10160,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
Exc. Benign Hyper. Lesion; 2-4-FAC,287,CDM,510,RC,11056,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
"Shave-Benign, Skin Tags1-15-FAC",289,CDM,510,RC,11200,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
"Shave Benign(tr,a,l); Diameter 0.6-1.0cm-FAC",291,CDM,982,RC,11301,HCPCS,outpatient,,,71.47,53.6,,68.85,130,,,fee schedule,130% of fee schedule,68.85,130,,,fee schedule,130% of fee schedule,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,64.77,119,,,fee schedule,119% of fee schedule,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,100% of fee schedule,64.32,90,,,percent of total billed charges,90% of total billed charges,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,51.85,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,51.85,100,,,fee schedule,100% of fee schedule,51.85,107.79,
Skin Rmv.: Shave;1.1-2.0cm-FAC,293,CDM,510,RC,11302,HCPCS,outpatient,,,107.79,80.84,,97.01,90,,,percent of total billed charges,90% of total billed charges,100.24,93,,,percent of total billed charges,93% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,40.96,38,,,percent of total billed charges,38% of total billed charges,87.74,81.4,,,percent of total billed charges,81.4% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,97.01,90,,,percent of total billed charges,90% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,40.96,38,,,percent of total billed charges,38% of total billed charges,80.84,75,,,percent of total billed charges,75% of total billed charges,91.62,85,,,percent of total billed charges,85% of total billed charges,40.96,100.24,
Skin Rmv.: Shave; over 2.0cm-FAC,295,CDM,510,RC,11303,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
"Shave Benign(sc,n,ha,fe,g);Lesion .5cm or less-FAC",297,CDM,510,RC,11305,HCPCS,outpatient,,,63.28,47.46,,56.95,90,,,percent of total billed charges,90% of total billed charges,58.85,93,,,percent of total billed charges,93% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,24.05,38,,,percent of total billed charges,38% of total billed charges,51.51,81.4,,,percent of total billed charges,81.4% of total billed charges,56.95,90,,,percent of total billed charges,90% of total billed charges,56.95,90,,,percent of total billed charges,90% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,47.46,75,,,percent of total billed charges,75% of total billed charges,53.79,85,,,percent of total billed charges,85% of total billed charges,24.05,58.85,
"Shave Benign(sc,n,ha,fe,g);Lesion 0.6-1.0cm-FAC",299,CDM,510,RC,11306,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
"Shave: Epid/Derm., Nonface; Lesion over 2.0cm-FAC",301,CDM,510,RC,11308,HCPCS,outpatient,,,123.04,92.28,,110.74,90,,,percent of total billed charges,90% of total billed charges,114.43,93,,,percent of total billed charges,93% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,46.76,38,,,percent of total billed charges,38% of total billed charges,100.15,81.4,,,percent of total billed charges,81.4% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,92.28,75,,,percent of total billed charges,75% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,114.43,
"Shave: Epid/Derm.,Face; 0.6 to 1.0cm-FAC",304,CDM,510,RC,11311,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
"Excision Benign(tr,a,l); Lesion 0.5cm/less-FAC",306,CDM,510,RC,11400,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
"Excision Benign(tr,a,l); Lesion .6 to 1.0cm-FAC",308,CDM,510,RC,11401,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
"Excision Benign(tr,a,l);1.1 to 2.0cm-FAC",310,CDM,510,RC,11402,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
"Excision Benign(tr,a,l);2.1-3.0cm-FAC",312,CDM,510,RC,11403,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,161.27,
"Excision Benign(tr,a,l);3.1-4.0cm-FAC",314,CDM,510,RC,11404,HCPCS,outpatient,,,200.38,150.29,,180.34,90,,,percent of total billed charges,90% of total billed charges,186.35,93,,,percent of total billed charges,93% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,76.14,38,,,percent of total billed charges,38% of total billed charges,163.11,81.4,,,percent of total billed charges,81.4% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,150.29,75,,,percent of total billed charges,75% of total billed charges,170.32,85,,,percent of total billed charges,85% of total billed charges,76.14,186.35,
"Excision Benign(tr,a,l);Over 4.0cm-FAC",316,CDM,510,RC,11406,HCPCS,outpatient,,,274.2,205.65,,246.78,90,,,percent of total billed charges,90% of total billed charges,255.01,93,,,percent of total billed charges,93% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,104.2,38,,,percent of total billed charges,38% of total billed charges,223.2,81.4,,,percent of total billed charges,81.4% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,205.65,75,,,percent of total billed charges,75% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,104.2,255.01,
"Excis Benign(sc,n,ha,fe,g); 0.6 to 1.0cm-FAC",319,CDM,510,RC,11421,HCPCS,outpatient,,,135.92,101.94,,122.33,90,,,percent of total billed charges,90% of total billed charges,126.41,93,,,percent of total billed charges,93% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,51.65,38,,,percent of total billed charges,38% of total billed charges,110.64,81.4,,,percent of total billed charges,81.4% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,122.33,90,,,percent of total billed charges,90% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,51.65,38,,,percent of total billed charges,38% of total billed charges,101.94,75,,,percent of total billed charges,75% of total billed charges,115.53,85,,,percent of total billed charges,85% of total billed charges,51.65,126.41,
"Excis Benign(sc,n,ha,fe,g);2.1 to 3.0cm-FAC",321,CDM,510,RC,11423,HCPCS,outpatient,,,192.17,144.13,,172.95,90,,,percent of total billed charges,90% of total billed charges,178.72,93,,,percent of total billed charges,93% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,73.02,38,,,percent of total billed charges,38% of total billed charges,156.43,81.4,,,percent of total billed charges,81.4% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,144.13,75,,,percent of total billed charges,75% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,178.72,
Excis Benign Face;0.5cm or <-FAC,323,CDM,510,RC,11440,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
Excis Benign(Face);0.6-1.0cm-FAC,325,CDM,510,RC,11441,HCPCS,outpatient,,,123.04,92.28,,110.74,90,,,percent of total billed charges,90% of total billed charges,114.43,93,,,percent of total billed charges,93% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,46.76,38,,,percent of total billed charges,38% of total billed charges,100.15,81.4,,,percent of total billed charges,81.4% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,110.74,90,,,percent of total billed charges,90% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,46.76,38,,,percent of total billed charges,38% of total billed charges,92.28,75,,,percent of total billed charges,75% of total billed charges,104.58,85,,,percent of total billed charges,85% of total billed charges,46.76,114.43,
Excis Benign(Face);1.1-2.0cm-FAC,327,CDM,510,RC,11442,HCPCS,outpatient,,,134.75,101.06,,121.28,90,,,percent of total billed charges,90% of total billed charges,125.32,93,,,percent of total billed charges,93% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,51.21,38,,,percent of total billed charges,38% of total billed charges,109.69,81.4,,,percent of total billed charges,81.4% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,101.06,75,,,percent of total billed charges,75% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,125.32,
"Exc,Skin,Mal-(tr,a,l);1.1-2.0cm-FAC",331,CDM,510,RC,11602,HCPCS,outpatient,,,157.01,117.76,,141.31,90,,,percent of total billed charges,90% of total billed charges,146.02,93,,,percent of total billed charges,93% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,59.66,38,,,percent of total billed charges,38% of total billed charges,127.81,81.4,,,percent of total billed charges,81.4% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,141.31,90,,,percent of total billed charges,90% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,59.66,38,,,percent of total billed charges,38% of total billed charges,117.76,75,,,percent of total billed charges,75% of total billed charges,133.46,85,,,percent of total billed charges,85% of total billed charges,59.66,146.02,
"Excision,Mal(tr,a,l);2.1-3.0cm-FAC",333,CDM,510,RC,11603,HCPCS,outpatient,,,868.28,651.21,,781.45,90,,,percent of total billed charges,90% of total billed charges,807.5,93,,,percent of total billed charges,93% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,329.95,38,,,percent of total billed charges,38% of total billed charges,706.78,81.4,,,percent of total billed charges,81.4% of total billed charges,781.45,90,,,percent of total billed charges,90% of total billed charges,781.45,90,,,percent of total billed charges,90% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,329.95,38,,,percent of total billed charges,38% of total billed charges,651.21,75,,,percent of total billed charges,75% of total billed charges,738.04,85,,,percent of total billed charges,85% of total billed charges,329.95,807.5,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen)0.5cm/less-FAC",335,CDM,510,RC,11620,HCPCS,outpatient,,,183.98,137.99,,165.58,90,,,percent of total billed charges,90% of total billed charges,171.1,93,,,percent of total billed charges,93% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,69.91,38,,,percent of total billed charges,38% of total billed charges,149.76,81.4,,,percent of total billed charges,81.4% of total billed charges,165.58,90,,,percent of total billed charges,90% of total billed charges,165.58,90,,,percent of total billed charges,90% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,69.91,38,,,percent of total billed charges,38% of total billed charges,137.99,75,,,percent of total billed charges,75% of total billed charges,156.38,85,,,percent of total billed charges,85% of total billed charges,69.91,171.1,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen);0.6-1.0cm-FAC",337,CDM,510,RC,11622,HCPCS,outpatient,,,212.1,159.08,,190.89,90,,,percent of total billed charges,90% of total billed charges,197.25,93,,,percent of total billed charges,93% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,80.6,38,,,percent of total billed charges,38% of total billed charges,172.65,81.4,,,percent of total billed charges,81.4% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,80.6,38,,,percent of total billed charges,38% of total billed charges,159.08,75,,,percent of total billed charges,75% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,80.6,197.25,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.6-1.0cm-FAC",340,CDM,510,RC,11641,HCPCS,outpatient,,,147.63,110.72,,132.87,90,,,percent of total billed charges,90% of total billed charges,137.3,93,,,percent of total billed charges,93% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,56.1,38,,,percent of total billed charges,38% of total billed charges,120.17,81.4,,,percent of total billed charges,81.4% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,132.87,90,,,percent of total billed charges,90% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,56.1,38,,,percent of total billed charges,38% of total billed charges,110.72,75,,,percent of total billed charges,75% of total billed charges,125.49,85,,,percent of total billed charges,85% of total billed charges,56.1,137.3,
"Excis, Mal Lesion(sc,n,ha,fe,g);1.1-2.0cm-FAC",342,CDM,510,RC,11642,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,161.27,
"Excis, Mal Lesion(sc,n,ha,fe,g);2.1-3.0cm-FAC",344,CDM,510,RC,11643,HCPCS,outpatient,,,341.01,255.76,,306.91,90,,,percent of total billed charges,90% of total billed charges,317.14,93,,,percent of total billed charges,93% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,129.58,38,,,percent of total billed charges,38% of total billed charges,277.58,81.4,,,percent of total billed charges,81.4% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,306.91,90,,,percent of total billed charges,90% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,129.58,38,,,percent of total billed charges,38% of total billed charges,255.76,75,,,percent of total billed charges,75% of total billed charges,289.86,85,,,percent of total billed charges,85% of total billed charges,129.58,317.14,
"Excis, Mal Lesion(sc,n,ha,fe,g);Over 4.0 cm-FAC",346,CDM,510,RC,11646,HCPCS,outpatient,,,381.99,286.49,,343.79,90,,,percent of total billed charges,90% of total billed charges,355.25,93,,,percent of total billed charges,93% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,145.16,38,,,percent of total billed charges,38% of total billed charges,310.94,81.4,,,percent of total billed charges,81.4% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,343.79,90,,,percent of total billed charges,90% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,145.16,38,,,percent of total billed charges,38% of total billed charges,286.49,75,,,percent of total billed charges,75% of total billed charges,324.69,85,,,percent of total billed charges,85% of total billed charges,145.16,355.25,
Debrid. of Nail(s) Any Method(s); 1-5-FAC,348,CDM,510,RC,11720,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Debrid. of Nail;Trim. Nondys.;6 or <-FAC,350,CDM,510,RC,11721,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
Debridement of Nail; Nail Plate-FAC,352,CDM,510,RC,11730,HCPCS,outpatient,,,57.41,43.06,,51.67,90,,,percent of total billed charges,90% of total billed charges,53.39,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,21.82,38,,,percent of total billed charges,38% of total billed charges,46.73,81.4,,,percent of total billed charges,81.4% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.06,75,,,percent of total billed charges,75% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,53.39,
Debrid. of Nail;Evac.;Sub.Hematoma-FAC,355,CDM,510,RC,11740,HCPCS,outpatient,,,30.46,22.85,,27.41,90,,,percent of total billed charges,90% of total billed charges,28.33,93,,,percent of total billed charges,93% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,11.57,38,,,percent of total billed charges,38% of total billed charges,24.79,81.4,,,percent of total billed charges,81.4% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,22.85,75,,,percent of total billed charges,75% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,28.33,
"Excision:Nail/Matrix, Part/Comp.Rmv.-FAC",357,CDM,510,RC,11750,HCPCS,outpatient,,,168.74,126.56,,151.87,90,,,percent of total billed charges,90% of total billed charges,156.93,93,,,percent of total billed charges,93% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,64.12,38,,,percent of total billed charges,38% of total billed charges,137.35,81.4,,,percent of total billed charges,81.4% of total billed charges,151.87,90,,,percent of total billed charges,90% of total billed charges,151.87,90,,,percent of total billed charges,90% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,126.56,75,,,percent of total billed charges,75% of total billed charges,143.43,85,,,percent of total billed charges,85% of total billed charges,64.12,156.93,
Debrid. Nail;Wedge Exc.of Skin;Fold-FAC,360,CDM,510,RC,11765,HCPCS,outpatient,,,66.79,50.09,,60.11,90,,,percent of total billed charges,90% of total billed charges,62.11,93,,,percent of total billed charges,93% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,25.38,38,,,percent of total billed charges,38% of total billed charges,54.37,81.4,,,percent of total billed charges,81.4% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,50.09,75,,,percent of total billed charges,75% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,62.11,
Treatment of Lesions; Inj.up to 7 Lesions-FAC,362,CDM,510,RC,11900,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Removal Contraceptive-FAC,364,CDM,510,RC,11976,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Lac Repair FAC Supf Nonface less than 2.5 cm,366,CDM,510,RC,12001,HCPCS,outpatient,,,111.33,83.5,,100.2,90,,,percent of total billed charges,90% of total billed charges,103.54,93,,,percent of total billed charges,93% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,42.31,38,,,percent of total billed charges,38% of total billed charges,90.62,81.4,,,percent of total billed charges,81.4% of total billed charges,100.2,90,,,percent of total billed charges,90% of total billed charges,100.2,90,,,percent of total billed charges,90% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,42.31,38,,,percent of total billed charges,38% of total billed charges,83.5,75,,,percent of total billed charges,75% of total billed charges,94.63,85,,,percent of total billed charges,85% of total billed charges,42.31,103.54,
Lac Repair-FAC Supf.Nonface;2.6-7.5 cm,368,CDM,510,RC,12002,HCPCS,outpatient,,,144.13,108.1,,129.72,90,,,percent of total billed charges,90% of total billed charges,134.04,93,,,percent of total billed charges,93% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,54.77,38,,,percent of total billed charges,38% of total billed charges,117.32,81.4,,,percent of total billed charges,81.4% of total billed charges,129.72,90,,,percent of total billed charges,90% of total billed charges,129.72,90,,,percent of total billed charges,90% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,54.77,38,,,percent of total billed charges,38% of total billed charges,108.1,75,,,percent of total billed charges,75% of total billed charges,122.51,85,,,percent of total billed charges,85% of total billed charges,54.77,134.04,
Lac Repair-FAC Supf.Nonface;12.6-20cm,371,CDM,510,RC,12005,HCPCS,outpatient,,,160.55,120.41,,144.5,90,,,percent of total billed charges,90% of total billed charges,149.31,93,,,percent of total billed charges,93% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,61.01,38,,,percent of total billed charges,38% of total billed charges,130.69,81.4,,,percent of total billed charges,81.4% of total billed charges,144.5,90,,,percent of total billed charges,90% of total billed charges,144.5,90,,,percent of total billed charges,90% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,61.01,38,,,percent of total billed charges,38% of total billed charges,120.41,75,,,percent of total billed charges,75% of total billed charges,136.47,85,,,percent of total billed charges,85% of total billed charges,61.01,149.31,
Lac Repair-FAC Supf.Nonface; 20.1-30.0cm,373,CDM,510,RC,12006,HCPCS,outpatient,,,307.01,230.26,,276.31,90,,,percent of total billed charges,90% of total billed charges,285.52,93,,,percent of total billed charges,93% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,116.66,38,,,percent of total billed charges,38% of total billed charges,249.91,81.4,,,percent of total billed charges,81.4% of total billed charges,276.31,90,,,percent of total billed charges,90% of total billed charges,276.31,90,,,percent of total billed charges,90% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,116.66,38,,,percent of total billed charges,38% of total billed charges,230.26,75,,,percent of total billed charges,75% of total billed charges,260.96,85,,,percent of total billed charges,85% of total billed charges,116.66,285.52,
"Suture-Sup.wounds(sc,n,ax,EG,tr,fe,ha); Over 30.0cm-FAC",375,CDM,510,RC,12007,HCPCS,outpatient,,,200.38,150.29,,180.34,90,,,percent of total billed charges,90% of total billed charges,186.35,93,,,percent of total billed charges,93% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,76.14,38,,,percent of total billed charges,38% of total billed charges,163.11,81.4,,,percent of total billed charges,81.4% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,180.34,90,,,percent of total billed charges,90% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,76.14,38,,,percent of total billed charges,38% of total billed charges,150.29,75,,,percent of total billed charges,75% of total billed charges,170.32,85,,,percent of total billed charges,85% of total billed charges,76.14,186.35,
Lac Repair Supf. Face/Head FAC; <2.5 cm,377,CDM,510,RC,12011,HCPCS,outpatient,,,103.12,77.34,,92.81,90,,,percent of total billed charges,90% of total billed charges,95.9,93,,,percent of total billed charges,93% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,39.19,38,,,percent of total billed charges,38% of total billed charges,83.94,81.4,,,percent of total billed charges,81.4% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,92.81,90,,,percent of total billed charges,90% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,39.19,38,,,percent of total billed charges,38% of total billed charges,77.34,75,,,percent of total billed charges,75% of total billed charges,87.65,85,,,percent of total billed charges,85% of total billed charges,39.19,95.9,
Lac Repair Supf. Face/Head FAC ; 2.6-5.0cm,379,CDM,510,RC,12013,HCPCS,outpatient,,,117.18,87.89,,105.46,90,,,percent of total billed charges,90% of total billed charges,108.98,93,,,percent of total billed charges,93% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,44.53,38,,,percent of total billed charges,38% of total billed charges,95.38,81.4,,,percent of total billed charges,81.4% of total billed charges,105.46,90,,,percent of total billed charges,90% of total billed charges,105.46,90,,,percent of total billed charges,90% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,87.89,75,,,percent of total billed charges,75% of total billed charges,99.6,85,,,percent of total billed charges,85% of total billed charges,44.53,108.98,
Lac Repair Supf. Face/Head FAC;5.1-7.5cm,381,CDM,510,RC,12014,HCPCS,outpatient,,,139.45,104.59,,125.51,90,,,percent of total billed charges,90% of total billed charges,129.69,93,,,percent of total billed charges,93% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,52.99,38,,,percent of total billed charges,38% of total billed charges,113.51,81.4,,,percent of total billed charges,81.4% of total billed charges,125.51,90,,,percent of total billed charges,90% of total billed charges,125.51,90,,,percent of total billed charges,90% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,52.99,38,,,percent of total billed charges,38% of total billed charges,104.59,75,,,percent of total billed charges,75% of total billed charges,118.53,85,,,percent of total billed charges,85% of total billed charges,52.99,129.69,
Lac Repair Supf. Face/Head FAC;7.6-12.5cm,383,CDM,510,RC,12015,HCPCS,outpatient,,,173.41,130.06,,156.07,90,,,percent of total billed charges,90% of total billed charges,161.27,93,,,percent of total billed charges,93% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,65.9,38,,,percent of total billed charges,38% of total billed charges,141.16,81.4,,,percent of total billed charges,81.4% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,156.07,90,,,percent of total billed charges,90% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,65.9,38,,,percent of total billed charges,38% of total billed charges,130.06,75,,,percent of total billed charges,75% of total billed charges,147.4,85,,,percent of total billed charges,85% of total billed charges,65.9,161.27,
Lac Repair Supf Head/Face FAC;20.1-30.0cm,386,CDM,510,RC,12017,HCPCS,outpatient,,,257.79,193.34,,232.01,90,,,percent of total billed charges,90% of total billed charges,239.74,93,,,percent of total billed charges,93% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,97.96,38,,,percent of total billed charges,38% of total billed charges,209.84,81.4,,,percent of total billed charges,81.4% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,232.01,90,,,percent of total billed charges,90% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,97.96,38,,,percent of total billed charges,38% of total billed charges,193.34,75,,,percent of total billed charges,75% of total billed charges,219.12,85,,,percent of total billed charges,85% of total billed charges,97.96,239.74,
Lac Repair-FAC Supf Head/Face;< 30.0cm,388,CDM,510,RC,12018,HCPCS,outpatient,,,310.53,232.9,,279.48,90,,,percent of total billed charges,90% of total billed charges,288.79,93,,,percent of total billed charges,93% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,118,38,,,percent of total billed charges,38% of total billed charges,252.77,81.4,,,percent of total billed charges,81.4% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,279.48,90,,,percent of total billed charges,90% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,118,38,,,percent of total billed charges,38% of total billed charges,232.9,75,,,percent of total billed charges,75% of total billed charges,263.95,85,,,percent of total billed charges,85% of total billed charges,118,288.79,
Sup. Wound Dehis Simp.-FAC,390,CDM,510,RC,12020,HCPCS,outpatient,,,185.14,138.86,,166.63,90,,,percent of total billed charges,90% of total billed charges,172.18,93,,,percent of total billed charges,93% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,70.35,38,,,percent of total billed charges,38% of total billed charges,150.7,81.4,,,percent of total billed charges,81.4% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,166.63,90,,,percent of total billed charges,90% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,70.35,38,,,percent of total billed charges,38% of total billed charges,138.86,75,,,percent of total billed charges,75% of total billed charges,157.37,85,,,percent of total billed charges,85% of total billed charges,70.35,172.18,
Sup. wound Dehis.; w/ Pack-FAC,392,CDM,510,RC,12021,HCPCS,outpatient,,,132.43,99.32,,119.19,90,,,percent of total billed charges,90% of total billed charges,123.16,93,,,percent of total billed charges,93% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,50.32,38,,,percent of total billed charges,38% of total billed charges,107.8,81.4,,,percent of total billed charges,81.4% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,119.19,90,,,percent of total billed charges,90% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,50.32,38,,,percent of total billed charges,38% of total billed charges,99.32,75,,,percent of total billed charges,75% of total billed charges,112.57,85,,,percent of total billed charges,85% of total billed charges,50.32,123.16,
Lac Repair-FAC Intermed. Nonface;2.5cm or <,394,CDM,510,RC,12031,HCPCS,outpatient,,,140.62,105.47,,126.56,90,,,percent of total billed charges,90% of total billed charges,130.78,93,,,percent of total billed charges,93% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,53.44,38,,,percent of total billed charges,38% of total billed charges,114.46,81.4,,,percent of total billed charges,81.4% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,105.47,75,,,percent of total billed charges,75% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,130.78,
Lac Repair-FAC Intermed. Nonface;2.6-7.5cm,396,CDM,510,RC,12032,HCPCS,outpatient,,,182.8,137.1,,164.52,90,,,percent of total billed charges,90% of total billed charges,170,93,,,percent of total billed charges,93% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,69.46,38,,,percent of total billed charges,38% of total billed charges,148.8,81.4,,,percent of total billed charges,81.4% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,137.1,75,,,percent of total billed charges,75% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,170,
Lac Repair-FAC Intermed. Nonface;7.6-12.5cm,398,CDM,510,RC,12034,HCPCS,outpatient,,,281.22,210.92,,253.1,90,,,percent of total billed charges,90% of total billed charges,261.53,93,,,percent of total billed charges,93% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,106.86,38,,,percent of total billed charges,38% of total billed charges,228.91,81.4,,,percent of total billed charges,81.4% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,253.1,90,,,percent of total billed charges,90% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,106.86,38,,,percent of total billed charges,38% of total billed charges,210.92,75,,,percent of total billed charges,75% of total billed charges,239.04,85,,,percent of total billed charges,85% of total billed charges,106.86,261.53,
Lac Repair-FAC Intermed. Nonface;12.6-20.0cm,400,CDM,510,RC,12035,HCPCS,outpatient,,,227.33,170.5,,204.6,90,,,percent of total billed charges,90% of total billed charges,211.42,93,,,percent of total billed charges,93% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,86.39,38,,,percent of total billed charges,38% of total billed charges,185.05,81.4,,,percent of total billed charges,81.4% of total billed charges,204.6,90,,,percent of total billed charges,90% of total billed charges,204.6,90,,,percent of total billed charges,90% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,86.39,38,,,percent of total billed charges,38% of total billed charges,170.5,75,,,percent of total billed charges,75% of total billed charges,193.23,85,,,percent of total billed charges,85% of total billed charges,86.39,211.42,
Lac Repair-FAC Intermed. Nonface;20.1-30.0cm,402,CDM,510,RC,12036,HCPCS,outpatient,,,263.65,197.74,,237.29,90,,,percent of total billed charges,90% of total billed charges,245.19,93,,,percent of total billed charges,93% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,100.19,38,,,percent of total billed charges,38% of total billed charges,214.61,81.4,,,percent of total billed charges,81.4% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,197.74,75,,,percent of total billed charges,75% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,245.19,
Lac Repair-FAC Intermed. Nonface;< 30.0cm,404,CDM,510,RC,12037,HCPCS,outpatient,,,309.36,232.02,,278.42,90,,,percent of total billed charges,90% of total billed charges,287.7,93,,,percent of total billed charges,93% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,117.56,38,,,percent of total billed charges,38% of total billed charges,251.82,81.4,,,percent of total billed charges,81.4% of total billed charges,278.42,90,,,percent of total billed charges,90% of total billed charges,278.42,90,,,percent of total billed charges,90% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,232.02,75,,,percent of total billed charges,75% of total billed charges,262.96,85,,,percent of total billed charges,85% of total billed charges,117.56,287.7,
Lac Repair-FAC Intermed. Head/Face;2.5cm or <,406,CDM,510,RC,12041,HCPCS,outpatient,,,151.15,113.36,,136.04,90,,,percent of total billed charges,90% of total billed charges,140.57,93,,,percent of total billed charges,93% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,57.44,38,,,percent of total billed charges,38% of total billed charges,123.04,81.4,,,percent of total billed charges,81.4% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,136.04,90,,,percent of total billed charges,90% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,57.44,38,,,percent of total billed charges,38% of total billed charges,113.36,75,,,percent of total billed charges,75% of total billed charges,128.48,85,,,percent of total billed charges,85% of total billed charges,57.44,140.57,
Lac Repair FAC Intermed. Head/Face;2.6-7.5cm,408,CDM,510,RC,12042,HCPCS,outpatient,,,182.8,137.1,,164.52,90,,,percent of total billed charges,90% of total billed charges,170,93,,,percent of total billed charges,93% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,69.46,38,,,percent of total billed charges,38% of total billed charges,148.8,81.4,,,percent of total billed charges,81.4% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,69.46,38,,,percent of total billed charges,38% of total billed charges,137.1,75,,,percent of total billed charges,75% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,69.46,170,
Lac Repair-FAC Intermed. Head/Face;7.6-12.5cm,410,CDM,510,RC,12044,HCPCS,outpatient,,,198.04,148.53,,178.24,90,,,percent of total billed charges,90% of total billed charges,184.18,93,,,percent of total billed charges,93% of total billed charges,75.26,38,,,percent of total billed charges,38% of total billed charges,75.26,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,75.26,38,,,percent of total billed charges,38% of total billed charges,161.2,81.4,,,percent of total billed charges,81.4% of total billed charges,178.24,90,,,percent of total billed charges,90% of total billed charges,178.24,90,,,percent of total billed charges,90% of total billed charges,75.26,38,,,percent of total billed charges,38% of total billed charges,75.26,38,,,percent of total billed charges,38% of total billed charges,75.26,38,,,percent of total billed charges,38% of total billed charges,148.53,75,,,percent of total billed charges,75% of total billed charges,168.33,85,,,percent of total billed charges,85% of total billed charges,75.26,184.18,
Lac Repair-FAC Intermed. Head/Face;12.6-20cm,412,CDM,510,RC,12045,HCPCS,outpatient,,,236.69,177.52,,213.02,90,,,percent of total billed charges,90% of total billed charges,220.12,93,,,percent of total billed charges,93% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,89.94,38,,,percent of total billed charges,38% of total billed charges,192.67,81.4,,,percent of total billed charges,81.4% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,213.02,90,,,percent of total billed charges,90% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,89.94,38,,,percent of total billed charges,38% of total billed charges,177.52,75,,,percent of total billed charges,75% of total billed charges,201.19,85,,,percent of total billed charges,85% of total billed charges,89.94,220.12,
Lac Repair-FAC Intermed. Head/Face;20.1-30.0cm,414,CDM,510,RC,12046,HCPCS,outpatient,,,274.2,205.65,,246.78,90,,,percent of total billed charges,90% of total billed charges,255.01,93,,,percent of total billed charges,93% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,104.2,38,,,percent of total billed charges,38% of total billed charges,223.2,81.4,,,percent of total billed charges,81.4% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,104.2,38,,,percent of total billed charges,38% of total billed charges,205.65,75,,,percent of total billed charges,75% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,104.2,255.01,
Lac Repair-FAC Intermed. Head/Face;< 30.0cm,416,CDM,510,RC,12047,HCPCS,outpatient,,,309.36,232.02,,278.42,90,,,percent of total billed charges,90% of total billed charges,287.7,93,,,percent of total billed charges,93% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,117.56,38,,,percent of total billed charges,38% of total billed charges,251.82,81.4,,,percent of total billed charges,81.4% of total billed charges,278.42,90,,,percent of total billed charges,90% of total billed charges,278.42,90,,,percent of total billed charges,90% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,117.56,38,,,percent of total billed charges,38% of total billed charges,232.02,75,,,percent of total billed charges,75% of total billed charges,262.96,85,,,percent of total billed charges,85% of total billed charges,117.56,287.7,
Lac Repair-FAC Intermed. Face;2.5cm or <,418,CDM,510,RC,12051,HCPCS,outpatient,,,166.39,124.79,,149.75,90,,,percent of total billed charges,90% of total billed charges,154.74,93,,,percent of total billed charges,93% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,63.23,38,,,percent of total billed charges,38% of total billed charges,135.44,81.4,,,percent of total billed charges,81.4% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,149.75,90,,,percent of total billed charges,90% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,63.23,38,,,percent of total billed charges,38% of total billed charges,124.79,75,,,percent of total billed charges,75% of total billed charges,141.43,85,,,percent of total billed charges,85% of total billed charges,63.23,154.74,
Lac Repair-FAC Intermed. Face;2.6-5.0cm,420,CDM,510,RC,12052,HCPCS,outpatient,,,193.34,145.01,,174.01,90,,,percent of total billed charges,90% of total billed charges,179.81,93,,,percent of total billed charges,93% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,73.47,38,,,percent of total billed charges,38% of total billed charges,157.38,81.4,,,percent of total billed charges,81.4% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,174.01,90,,,percent of total billed charges,90% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,73.47,38,,,percent of total billed charges,38% of total billed charges,145.01,75,,,percent of total billed charges,75% of total billed charges,164.34,85,,,percent of total billed charges,85% of total billed charges,73.47,179.81,
Lac Repair-FAC Intermed. Face;5.1-7.5cm,422,CDM,510,RC,12053,HCPCS,outpatient,,,199.21,149.41,,179.29,90,,,percent of total billed charges,90% of total billed charges,185.27,93,,,percent of total billed charges,93% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,75.7,38,,,percent of total billed charges,38% of total billed charges,162.16,81.4,,,percent of total billed charges,81.4% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,179.29,90,,,percent of total billed charges,90% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,75.7,38,,,percent of total billed charges,38% of total billed charges,149.41,75,,,percent of total billed charges,75% of total billed charges,169.33,85,,,percent of total billed charges,85% of total billed charges,75.7,185.27,
Lac Repair-FAC Intermed. Face;7.6-12.5cm,424,CDM,510,RC,12054,HCPCS,outpatient,,,178.11,133.58,,160.3,90,,,percent of total billed charges,90% of total billed charges,165.64,93,,,percent of total billed charges,93% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,67.68,38,,,percent of total billed charges,38% of total billed charges,144.98,81.4,,,percent of total billed charges,81.4% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,133.58,75,,,percent of total billed charges,75% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,165.64,
Lac Repair-FAC Intermed. Face;12.6-20.0cm,426,CDM,510,RC,12055,HCPCS,outpatient,,,339.82,254.87,,305.84,90,,,percent of total billed charges,90% of total billed charges,316.03,93,,,percent of total billed charges,93% of total billed charges,129.13,38,,,percent of total billed charges,38% of total billed charges,129.13,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,129.13,38,,,percent of total billed charges,38% of total billed charges,276.61,81.4,,,percent of total billed charges,81.4% of total billed charges,305.84,90,,,percent of total billed charges,90% of total billed charges,305.84,90,,,percent of total billed charges,90% of total billed charges,129.13,38,,,percent of total billed charges,38% of total billed charges,129.13,38,,,percent of total billed charges,38% of total billed charges,129.13,38,,,percent of total billed charges,38% of total billed charges,254.87,75,,,percent of total billed charges,75% of total billed charges,288.85,85,,,percent of total billed charges,85% of total billed charges,129.13,316.03,
"Suture,Complex(sa,a,l);2.6-7.5cm-FAC",434,CDM,510,RC,13121,HCPCS,outpatient,,,363.24,272.43,,326.92,90,,,percent of total billed charges,90% of total billed charges,337.81,93,,,percent of total billed charges,93% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,138.03,38,,,percent of total billed charges,38% of total billed charges,295.68,81.4,,,percent of total billed charges,81.4% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,326.92,90,,,percent of total billed charges,90% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,138.03,38,,,percent of total billed charges,38% of total billed charges,272.43,75,,,percent of total billed charges,75% of total billed charges,308.75,85,,,percent of total billed charges,85% of total billed charges,138.03,337.81,
"Suture,Cmplx(sa,a,l);Each Add. 5cm or <-FAC",436,CDM,510,RC,13122,HCPCS,outpatient,,,106.63,79.97,,95.97,90,,,percent of total billed charges,90% of total billed charges,99.17,93,,,percent of total billed charges,93% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,40.52,38,,,percent of total billed charges,38% of total billed charges,86.8,81.4,,,percent of total billed charges,81.4% of total billed charges,95.97,90,,,percent of total billed charges,90% of total billed charges,95.97,90,,,percent of total billed charges,90% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,40.52,38,,,percent of total billed charges,38% of total billed charges,79.97,75,,,percent of total billed charges,75% of total billed charges,90.64,85,,,percent of total billed charges,85% of total billed charges,40.52,99.17,
Burn Init. Trmt-FAC,443,CDM,510,RC,16000,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
"Burn, Debride <5%-FAC",445,CDM,510,RC,16020,HCPCS,outpatient,,,53.92,40.44,,48.53,90,,,percent of total billed charges,90% of total billed charges,50.15,93,,,percent of total billed charges,93% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,20.49,38,,,percent of total billed charges,38% of total billed charges,43.89,81.4,,,percent of total billed charges,81.4% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,40.44,75,,,percent of total billed charges,75% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,50.15,
Burn; Large> 10%-FAC,448,CDM,510,RC,16030,HCPCS,outpatient,,,127.72,95.79,,114.95,90,,,percent of total billed charges,90% of total billed charges,118.78,93,,,percent of total billed charges,93% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,48.53,38,,,percent of total billed charges,38% of total billed charges,103.96,81.4,,,percent of total billed charges,81.4% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,95.79,75,,,percent of total billed charges,75% of total billed charges,108.56,85,,,percent of total billed charges,85% of total billed charges,48.53,118.78,
Cryo-1st Lesion-FAC,450,CDM,510,RC,17000,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
Cryo:2-14 Lesions-FAC,452,CDM,510,RC,17003,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
Cryo Lesions 15+-FAC,454,CDM,510,RC,17004,HCPCS,outpatient,,,225,168.75,,202.5,90,,,percent of total billed charges,90% of total billed charges,209.25,93,,,percent of total billed charges,93% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,85.5,38,,,percent of total billed charges,38% of total billed charges,183.15,81.4,,,percent of total billed charges,81.4% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,202.5,90,,,percent of total billed charges,90% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,85.5,38,,,percent of total billed charges,38% of total billed charges,168.75,75,,,percent of total billed charges,75% of total billed charges,191.25,85,,,percent of total billed charges,85% of total billed charges,85.5,209.25,
Wart Removal;up to 14 Lesions-FAC,456,CDM,510,RC,17110,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
Chem. Cauterize of Gran Tissue-FAC,458,CDM,510,RC,17250,HCPCS,outpatient,,,35.15,26.36,,31.64,90,,,percent of total billed charges,90% of total billed charges,32.69,93,,,percent of total billed charges,93% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,13.36,38,,,percent of total billed charges,38% of total billed charges,28.61,81.4,,,percent of total billed charges,81.4% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,31.64,90,,,percent of total billed charges,90% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,13.36,38,,,percent of total billed charges,38% of total billed charges,26.36,75,,,percent of total billed charges,75% of total billed charges,29.88,85,,,percent of total billed charges,85% of total billed charges,13.36,32.69,
Malignant Lesion Destruc. .5 or <;Trunk Ext.-FAC,460,CDM,510,RC,17260,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Malignant Lesion Destruc. 0.6-1.0cm;Trunk Ext.-FAC,462,CDM,510,RC,17261,HCPCS,outpatient,,,119.52,89.64,,107.57,90,,,percent of total billed charges,90% of total billed charges,111.15,93,,,percent of total billed charges,93% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,45.42,38,,,percent of total billed charges,38% of total billed charges,97.29,81.4,,,percent of total billed charges,81.4% of total billed charges,107.57,90,,,percent of total billed charges,90% of total billed charges,107.57,90,,,percent of total billed charges,90% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,45.42,38,,,percent of total billed charges,38% of total billed charges,89.64,75,,,percent of total billed charges,75% of total billed charges,101.59,85,,,percent of total billed charges,85% of total billed charges,45.42,111.15,
Malignant Lesion Destruc. 1.1-2.0cm;Trunk Ext-FAC,464,CDM,510,RC,17262,HCPCS,outpatient,,,142.95,107.21,,128.66,90,,,percent of total billed charges,90% of total billed charges,132.94,93,,,percent of total billed charges,93% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,54.32,38,,,percent of total billed charges,38% of total billed charges,116.36,81.4,,,percent of total billed charges,81.4% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,128.66,90,,,percent of total billed charges,90% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,54.32,38,,,percent of total billed charges,38% of total billed charges,107.21,75,,,percent of total billed charges,75% of total billed charges,121.51,85,,,percent of total billed charges,85% of total billed charges,54.32,132.94,
Acne/Hair Removal Cryo.-FAC,466,CDM,510,RC,17340,HCPCS,outpatient,,,62.11,46.58,,55.9,90,,,percent of total billed charges,90% of total billed charges,57.76,93,,,percent of total billed charges,93% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,23.6,38,,,percent of total billed charges,38% of total billed charges,50.56,81.4,,,percent of total billed charges,81.4% of total billed charges,55.9,90,,,percent of total billed charges,90% of total billed charges,55.9,90,,,percent of total billed charges,90% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,23.6,38,,,percent of total billed charges,38% of total billed charges,46.58,75,,,percent of total billed charges,75% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,23.6,57.76,
FB Rmv. Muscle/Tendon sheath- FAC,469,CDM,510,RC,20520,HCPCS,outpatient,,,158.18,118.64,,142.36,90,,,percent of total billed charges,90% of total billed charges,147.11,93,,,percent of total billed charges,93% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,60.11,38,,,percent of total billed charges,38% of total billed charges,128.76,81.4,,,percent of total billed charges,81.4% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,142.36,90,,,percent of total billed charges,90% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,60.11,38,,,percent of total billed charges,38% of total billed charges,118.64,75,,,percent of total billed charges,75% of total billed charges,134.45,85,,,percent of total billed charges,85% of total billed charges,60.11,147.11,
Inj. Tendon/Ligament-FAC,472,CDM,510,RC,20550,HCPCS,outpatient,,,55.08,41.31,,49.57,90,,,percent of total billed charges,90% of total billed charges,51.22,93,,,percent of total billed charges,93% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,20.93,38,,,percent of total billed charges,38% of total billed charges,44.84,81.4,,,percent of total billed charges,81.4% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,49.57,90,,,percent of total billed charges,90% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,20.93,38,,,percent of total billed charges,38% of total billed charges,41.31,75,,,percent of total billed charges,75% of total billed charges,46.82,85,,,percent of total billed charges,85% of total billed charges,20.93,51.22,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-FAC,474,CDM,510,RC,20552,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-FAC,475,CDM,510,RC,20552,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
Asp/Inj-small joint (w/o ultra)-FAC,479,CDM,982,RC,20600,HCPCS,outpatient,,,65.63,49.22,,51.1,130,,,fee schedule,130% of fee schedule,51.1,130,,,fee schedule,130% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,44.7,119,,,fee schedule,119% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,100% of fee schedule,59.07,90,,,percent of total billed charges,90% of total billed charges,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,35.66,100,,,fee schedule,100% of fee schedule,21.56,59.07,
Asp/Inj-Intermed Jnt (w/o ultra)-FAC,482,CDM,510,RC,20605,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
Asp/Inj-Major joint (w/o ultra)-FAC,486,CDM,510,RC,20610,HCPCS,outpatient,,,104.31,78.23,,93.88,90,,,percent of total billed charges,90% of total billed charges,97.01,93,,,percent of total billed charges,93% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,39.64,38,,,percent of total billed charges,38% of total billed charges,84.91,81.4,,,percent of total billed charges,81.4% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,93.88,90,,,percent of total billed charges,90% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,39.64,38,,,percent of total billed charges,38% of total billed charges,78.23,75,,,percent of total billed charges,75% of total billed charges,88.66,85,,,percent of total billed charges,85% of total billed charges,39.64,97.01,
Asp/Inj. of Ganglion-FAC,489,CDM,510,RC,20612,HCPCS,outpatient,,,64.44,48.33,,58,90,,,percent of total billed charges,90% of total billed charges,59.93,93,,,percent of total billed charges,93% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,24.49,38,,,percent of total billed charges,38% of total billed charges,52.45,81.4,,,percent of total billed charges,81.4% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,48.33,75,,,percent of total billed charges,75% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,59.93,
FRX/DIS-Clsd.Nasal W/O Manip.-FAC,491,CDM,510,RC,21310,HCPCS,outpatient,,,154.67,116,,139.2,90,,,percent of total billed charges,90% of total billed charges,143.84,93,,,percent of total billed charges,93% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,58.77,38,,,percent of total billed charges,38% of total billed charges,125.9,81.4,,,percent of total billed charges,81.4% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,139.2,90,,,percent of total billed charges,90% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,58.77,38,,,percent of total billed charges,38% of total billed charges,116,75,,,percent of total billed charges,75% of total billed charges,131.47,85,,,percent of total billed charges,85% of total billed charges,58.77,143.84,
FRX/DIS-Mandible W/O Manip.-FAC,494,CDM,510,RC,21450,HCPCS,outpatient,,,462.85,347.14,,416.57,90,,,percent of total billed charges,90% of total billed charges,430.45,93,,,percent of total billed charges,93% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,175.88,38,,,percent of total billed charges,38% of total billed charges,376.76,81.4,,,percent of total billed charges,81.4% of total billed charges,416.57,90,,,percent of total billed charges,90% of total billed charges,416.57,90,,,percent of total billed charges,90% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,175.88,38,,,percent of total billed charges,38% of total billed charges,347.14,75,,,percent of total billed charges,75% of total billed charges,393.42,85,,,percent of total billed charges,85% of total billed charges,175.88,430.45,
FXR- Sternum Closed-FAC,497,CDM,510,RC,21820,HCPCS,outpatient,,,229.67,172.25,,206.7,90,,,percent of total billed charges,90% of total billed charges,213.59,93,,,percent of total billed charges,93% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,87.27,38,,,percent of total billed charges,38% of total billed charges,186.95,81.4,,,percent of total billed charges,81.4% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,206.7,90,,,percent of total billed charges,90% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,87.27,38,,,percent of total billed charges,38% of total billed charges,172.25,75,,,percent of total billed charges,75% of total billed charges,195.22,85,,,percent of total billed charges,85% of total billed charges,87.27,213.59,
FRX-humerus clsd (w/o manip)-FAC,513,CDM,982,RC,24500,HCPCS,outpatient,,,291.77,218.83,,379.3,130,,,fee schedule,130% of fee schedule,379.3,130,,,fee schedule,130% of fee schedule,291.77,100,,,fee schedule,Pays 100% Medicare OPPS,291.77,100,,,fee schedule,Pays 100% Medicare OPPS,347.21,119,,,fee schedule,119% of fee schedule,291.77,100,,,fee schedule,Pays 100% Medicare OPPS,291.77,100,,,fee schedule,100% of fee schedule,262.59,90,,,percent of total billed charges,90% of total billed charges,291.77,100,,,fee schedule,Pays 100% Medicare OPPS,291.77,100,,,fee schedule,Pays 100% Medicare OPPS,291.77,100,,,fee schedule,Pays 100% Medicare OPPS,291.77,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,291.77,100,,,fee schedule,100% of fee schedule,93.42,379.3,
FX-HUM epicon W/O manip-FAC,517,CDM,510,RC,24560,HCPCS,outpatient,,,256.62,192.47,,230.96,90,,,percent of total billed charges,90% of total billed charges,238.66,93,,,percent of total billed charges,93% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,97.52,38,,,percent of total billed charges,38% of total billed charges,208.89,81.4,,,percent of total billed charges,81.4% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,230.96,90,,,percent of total billed charges,90% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,97.52,38,,,percent of total billed charges,38% of total billed charges,192.47,75,,,percent of total billed charges,75% of total billed charges,218.13,85,,,percent of total billed charges,85% of total billed charges,97.52,238.66,
"Disl-Elbow,Closed W/O Manip-FAC",519,CDM,510,RC,24600,HCPCS,outpatient,,,315.21,236.41,,283.69,90,,,percent of total billed charges,90% of total billed charges,293.15,93,,,percent of total billed charges,93% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,119.78,38,,,percent of total billed charges,38% of total billed charges,256.58,81.4,,,percent of total billed charges,81.4% of total billed charges,283.69,90,,,percent of total billed charges,90% of total billed charges,283.69,90,,,percent of total billed charges,90% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,119.78,38,,,percent of total billed charges,38% of total billed charges,236.41,75,,,percent of total billed charges,75% of total billed charges,267.93,85,,,percent of total billed charges,85% of total billed charges,119.78,293.15,
FRX-Radial Head W/O Manip-FAC,522,CDM,510,RC,24650,HCPCS,outpatient,,,242.55,181.91,,218.3,90,,,percent of total billed charges,90% of total billed charges,225.57,93,,,percent of total billed charges,93% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,92.17,38,,,percent of total billed charges,38% of total billed charges,197.44,81.4,,,percent of total billed charges,81.4% of total billed charges,218.3,90,,,percent of total billed charges,90% of total billed charges,218.3,90,,,percent of total billed charges,90% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,92.17,38,,,percent of total billed charges,38% of total billed charges,181.91,75,,,percent of total billed charges,75% of total billed charges,206.17,85,,,percent of total billed charges,85% of total billed charges,92.17,225.57,
FRX-Radial/Ulnar Shaft w/o manip-FAC,531,CDM,510,RC,25560,HCPCS,outpatient,,,250.76,188.07,,225.68,90,,,percent of total billed charges,90% of total billed charges,233.21,93,,,percent of total billed charges,93% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,95.29,38,,,percent of total billed charges,38% of total billed charges,204.12,81.4,,,percent of total billed charges,81.4% of total billed charges,225.68,90,,,percent of total billed charges,90% of total billed charges,225.68,90,,,percent of total billed charges,90% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,188.07,75,,,percent of total billed charges,75% of total billed charges,213.15,85,,,percent of total billed charges,85% of total billed charges,95.29,233.21,
FRX-Carpal Bone W/O Manip-FAC,538,CDM,510,RC,25630,HCPCS,outpatient,,,250.76,188.07,,225.68,90,,,percent of total billed charges,90% of total billed charges,233.21,93,,,percent of total billed charges,93% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,95.29,38,,,percent of total billed charges,38% of total billed charges,204.12,81.4,,,percent of total billed charges,81.4% of total billed charges,225.68,90,,,percent of total billed charges,90% of total billed charges,225.68,90,,,percent of total billed charges,90% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,95.29,38,,,percent of total billed charges,38% of total billed charges,188.07,75,,,percent of total billed charges,75% of total billed charges,213.15,85,,,percent of total billed charges,85% of total billed charges,95.29,233.21,
FRX-Ulnar Styloid-FAC,540,CDM,510,RC,25650,HCPCS,outpatient,,,299.97,224.98,,269.97,90,,,percent of total billed charges,90% of total billed charges,278.97,93,,,percent of total billed charges,93% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,113.99,38,,,percent of total billed charges,38% of total billed charges,244.18,81.4,,,percent of total billed charges,81.4% of total billed charges,269.97,90,,,percent of total billed charges,90% of total billed charges,269.97,90,,,percent of total billed charges,90% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,113.99,38,,,percent of total billed charges,38% of total billed charges,224.98,75,,,percent of total billed charges,75% of total billed charges,254.97,85,,,percent of total billed charges,85% of total billed charges,113.99,278.97,
FRX/DIS-Carpo:Thumb W/ Manip-FAC,547,CDM,510,RC,26645,HCPCS,outpatient,,,355.05,266.29,,319.55,90,,,percent of total billed charges,90% of total billed charges,330.2,93,,,percent of total billed charges,93% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,134.92,38,,,percent of total billed charges,38% of total billed charges,289.01,81.4,,,percent of total billed charges,81.4% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,319.55,90,,,percent of total billed charges,90% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,134.92,38,,,percent of total billed charges,38% of total billed charges,266.29,75,,,percent of total billed charges,75% of total billed charges,301.79,85,,,percent of total billed charges,85% of total billed charges,134.92,330.2,
"DISL.-METACARP. W/ Manip, W/O Anes-FAC",549,CDM,510,RC,26700,HCPCS,outpatient,,,267.17,200.38,,240.45,90,,,percent of total billed charges,90% of total billed charges,248.47,93,,,percent of total billed charges,93% of total billed charges,101.52,38,,,percent of total billed charges,38% of total billed charges,101.52,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,101.52,38,,,percent of total billed charges,38% of total billed charges,217.48,81.4,,,percent of total billed charges,81.4% of total billed charges,240.45,90,,,percent of total billed charges,90% of total billed charges,240.45,90,,,percent of total billed charges,90% of total billed charges,101.52,38,,,percent of total billed charges,38% of total billed charges,101.52,38,,,percent of total billed charges,38% of total billed charges,101.52,38,,,percent of total billed charges,38% of total billed charges,200.38,75,,,percent of total billed charges,75% of total billed charges,227.09,85,,,percent of total billed charges,85% of total billed charges,101.52,248.47,
FRX/DIS-W/ Manip; W/ or W/O Skin/Skele. Tract.-FAC,553,CDM,510,RC,26725,HCPCS,outpatient,,,284.74,213.56,,256.27,90,,,percent of total billed charges,90% of total billed charges,264.81,93,,,percent of total billed charges,93% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,108.2,38,,,percent of total billed charges,38% of total billed charges,231.78,81.4,,,percent of total billed charges,81.4% of total billed charges,256.27,90,,,percent of total billed charges,90% of total billed charges,256.27,90,,,percent of total billed charges,90% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,108.2,38,,,percent of total billed charges,38% of total billed charges,213.56,75,,,percent of total billed charges,75% of total billed charges,242.03,85,,,percent of total billed charges,85% of total billed charges,108.2,264.81,
FRX-Distal phalangeal closed w/o manip-FAC,555,CDM,510,RC,26750,HCPCS,outpatient,,,168.74,126.56,,151.87,90,,,percent of total billed charges,90% of total billed charges,156.93,93,,,percent of total billed charges,93% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,64.12,38,,,percent of total billed charges,38% of total billed charges,137.35,81.4,,,percent of total billed charges,81.4% of total billed charges,151.87,90,,,percent of total billed charges,90% of total billed charges,151.87,90,,,percent of total billed charges,90% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,64.12,38,,,percent of total billed charges,38% of total billed charges,126.56,75,,,percent of total billed charges,75% of total billed charges,143.43,85,,,percent of total billed charges,85% of total billed charges,64.12,156.93,
"FRX-Tibial, Proximal; W/O Mantip-FAC",575,CDM,510,RC,27530,HCPCS,outpatient,,,377.3,282.98,,339.57,90,,,percent of total billed charges,90% of total billed charges,350.89,93,,,percent of total billed charges,93% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,143.37,38,,,percent of total billed charges,38% of total billed charges,307.12,81.4,,,percent of total billed charges,81.4% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,339.57,90,,,percent of total billed charges,90% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,143.37,38,,,percent of total billed charges,38% of total billed charges,282.98,75,,,percent of total billed charges,75% of total billed charges,320.71,85,,,percent of total billed charges,85% of total billed charges,143.37,350.89,
"Turb.inj.FB, intranasal-FAC",635,CDM,510,RC,30300,HCPCS,outpatient,,,120.69,90.52,,108.62,90,,,percent of total billed charges,90% of total billed charges,112.24,93,,,percent of total billed charges,93% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,45.86,38,,,percent of total billed charges,38% of total billed charges,98.24,81.4,,,percent of total billed charges,81.4% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,108.62,90,,,percent of total billed charges,90% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,45.86,38,,,percent of total billed charges,38% of total billed charges,90.52,75,,,percent of total billed charges,75% of total billed charges,102.59,85,,,percent of total billed charges,85% of total billed charges,45.86,112.24,
Gastric intubations treatment-NG tube-Fac,664,CDM,120,RC,43752,HCPCS,inpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
Procuder of Endo; Samp.W/or W/O Endo. Samp. W/O Dilation-FAC,694,CDM,510,RC,58100,HCPCS,outpatient,,,192.17,144.13,,172.95,90,,,percent of total billed charges,90% of total billed charges,178.72,93,,,percent of total billed charges,93% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,73.02,38,,,percent of total billed charges,38% of total billed charges,156.43,81.4,,,percent of total billed charges,81.4% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,172.95,90,,,percent of total billed charges,90% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,73.02,38,,,percent of total billed charges,38% of total billed charges,144.13,75,,,percent of total billed charges,75% of total billed charges,163.34,85,,,percent of total billed charges,85% of total billed charges,73.02,178.72,
FB Removal:Eye;Conjunctival Superficial-FAC,707,CDM,510,RC,65205,HCPCS,outpatient,,,49.22,36.92,,44.3,90,,,percent of total billed charges,90% of total billed charges,45.77,93,,,percent of total billed charges,93% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.7,38,,,percent of total billed charges,38% of total billed charges,40.07,81.4,,,percent of total billed charges,81.4% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,44.3,90,,,percent of total billed charges,90% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,18.7,38,,,percent of total billed charges,38% of total billed charges,36.92,75,,,percent of total billed charges,75% of total billed charges,41.84,85,,,percent of total billed charges,85% of total billed charges,18.7,45.77,
"FB Rmv:Eye;Conj Embedded,Sub./Scleral Nonper.-FAC",709,CDM,510,RC,65210,HCPCS,outpatient,,,46.87,35.15,,42.18,90,,,percent of total billed charges,90% of total billed charges,43.59,93,,,percent of total billed charges,93% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,17.81,38,,,percent of total billed charges,38% of total billed charges,38.15,81.4,,,percent of total billed charges,81.4% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,35.15,75,,,percent of total billed charges,75% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,43.59,
"Excis. Proc:Exter. Ear/Canal;Rmv from Canal,W/O Anes.-FAC",716,CDM,510,RC,69200,HCPCS,outpatient,,,125.38,94.04,,112.84,90,,,percent of total billed charges,90% of total billed charges,116.6,93,,,percent of total billed charges,93% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,47.64,38,,,percent of total billed charges,38% of total billed charges,102.06,81.4,,,percent of total billed charges,81.4% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,112.84,90,,,percent of total billed charges,90% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,47.64,38,,,percent of total billed charges,38% of total billed charges,94.04,75,,,percent of total billed charges,75% of total billed charges,106.57,85,,,percent of total billed charges,85% of total billed charges,47.64,116.6,
"IV infusion therapy, for hydration > 30 minutes",729,CDM,761,RC,96360,HCPCS,outpatient,,,232.01,174.01,,208.81,90,,,percent of total billed charges,90% of total billed charges,215.77,93,,,percent of total billed charges,93% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,88.16,38,,,percent of total billed charges,38% of total billed charges,188.86,81.4,,,percent of total billed charges,81.4% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,174.01,75,,,percent of total billed charges,75% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,215.77,
"IV infusion therapy, for hydration > 30 minutes",730,CDM,761,RC,96360,HCPCS,outpatient,,,232.01,174.01,,208.81,90,,,percent of total billed charges,90% of total billed charges,215.77,93,,,percent of total billed charges,93% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,88.16,38,,,percent of total billed charges,38% of total billed charges,188.86,81.4,,,percent of total billed charges,81.4% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,174.01,75,,,percent of total billed charges,75% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,215.77,
"IV infusion therapy, for hydration > 30 minutes",731,CDM,510,RC,96360,HCPCS,outpatient,,,232.01,174.01,,208.81,90,,,percent of total billed charges,90% of total billed charges,215.77,93,,,percent of total billed charges,93% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,88.16,38,,,percent of total billed charges,38% of total billed charges,188.86,81.4,,,percent of total billed charges,81.4% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,208.81,90,,,percent of total billed charges,90% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,88.16,38,,,percent of total billed charges,38% of total billed charges,174.01,75,,,percent of total billed charges,75% of total billed charges,197.21,85,,,percent of total billed charges,85% of total billed charges,88.16,215.77,
"IV infusion therapy, 1 hour",737,CDM,761,RC,96365,HCPCS,outpatient,,,278.88,209.16,,250.99,90,,,percent of total billed charges,90% of total billed charges,259.36,93,,,percent of total billed charges,93% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,105.97,38,,,percent of total billed charges,38% of total billed charges,227.01,81.4,,,percent of total billed charges,81.4% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,209.16,75,,,percent of total billed charges,75% of total billed charges,237.05,85,,,percent of total billed charges,85% of total billed charges,105.97,259.36,
"IV infusion therapy, 1 hour",738,CDM,761,RC,96365,HCPCS,outpatient,,,278.88,209.16,,250.99,90,,,percent of total billed charges,90% of total billed charges,259.36,93,,,percent of total billed charges,93% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,105.97,38,,,percent of total billed charges,38% of total billed charges,227.01,81.4,,,percent of total billed charges,81.4% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,250.99,90,,,percent of total billed charges,90% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,105.97,38,,,percent of total billed charges,38% of total billed charges,209.16,75,,,percent of total billed charges,75% of total billed charges,237.05,85,,,percent of total billed charges,85% of total billed charges,105.97,259.36,
"IV infusion therapy, 1 hour",739,CDM,510,RC,96365,HCPCS,outpatient,,,96.09,72.07,,86.48,90,,,percent of total billed charges,90% of total billed charges,89.36,93,,,percent of total billed charges,93% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.51,38,,,percent of total billed charges,38% of total billed charges,78.22,81.4,,,percent of total billed charges,81.4% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,86.48,90,,,percent of total billed charges,90% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,36.51,38,,,percent of total billed charges,38% of total billed charges,72.07,75,,,percent of total billed charges,75% of total billed charges,81.68,85,,,percent of total billed charges,85% of total billed charges,36.51,89.36,
Rmv. Inf./Devit.Tissue;Partial Thick-FAC,3914,CDM,510,RC,11040,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
I&D Abcess Simple or Single (SQ)-PRO,4203,CDM,982,RC,10060,HCPCS,outpatient,,,134.75,101.06,,125.29,130,,,fee schedule,130% of fee schedule,125.29,130,,,fee schedule,130% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,124.88,119,,,fee schedule,119% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,100% of fee schedule,121.28,90,,,percent of total billed charges,90% of total billed charges,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,108.83,100,,,fee schedule,100% of fee schedule,57.49,125.29,
FB Removal/Incision -PRO,4216,CDM,982,RC,10120,HCPCS,outpatient,,,107.79,80.84,,122.29,130,,,fee schedule,130% of fee schedule,122.29,130,,,fee schedule,130% of fee schedule,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,127.98,119,,,fee schedule,119% of fee schedule,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,97.01,90,,,percent of total billed charges,90% of total billed charges,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,107.79,100,,,fee schedule,100% of fee schedule,71.86,127.98,
FBR-Complicated -PRO,4219,CDM,982,RC,10121,HCPCS,outpatient,,,270.67,203,,245.09,130,,,fee schedule,130% of fee schedule,245.09,130,,,fee schedule,130% of fee schedule,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,230.31,119,,,fee schedule,119% of fee schedule,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,100% of fee schedule,243.6,90,,,percent of total billed charges,90% of total billed charges,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,187.19,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,187.19,100,,,fee schedule,100% of fee schedule,143.72,245.09,
"Punct. asp. abscess,hematoma,bulla or cyst-PRO",4228,CDM,982,RC,10160,HCPCS,outpatient,,,139.45,104.59,,125.48,130,,,fee schedule,130% of fee schedule,125.48,130,,,fee schedule,130% of fee schedule,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,117.62,119,,,fee schedule,119% of fee schedule,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,100% of fee schedule,125.51,90,,,percent of total billed charges,90% of total billed charges,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,99.11,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,99.11,100,,,fee schedule,100% of fee schedule,21.56,125.51,
Exc. Benign Hyper. Lesion; 2-4-PRO,4267,CDM,982,RC,11056,HCPCS,outpatient,,,75,56.25,,36.75,130,,,fee schedule,130% of fee schedule,36.75,130,,,fee schedule,130% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,119,,,fee schedule,119% of fee schedule,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,100% of fee schedule,67.5,90,,,percent of total billed charges,90% of total billed charges,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,22.02,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,22.02,100,,,fee schedule,100% of fee schedule,22.02,67.5,
Skin Rmv.: Shave;1.1-2.0cm-PRO,4315,CDM,982,RC,11302,HCPCS,outpatient,,,99.59,74.69,,85.74,130,,,fee schedule,130% of fee schedule,85.74,130,,,fee schedule,130% of fee schedule,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.98,119,,,fee schedule,119% of fee schedule,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,100% of fee schedule,89.63,90,,,percent of total billed charges,90% of total billed charges,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,60.43,100,,,fee schedule,100% of fee schedule,60.43,129.35,
Skin Rmv.: Shave; over 2.0cm-PRO,4319,CDM,982,RC,11303,HCPCS,outpatient,,,123.04,92.28,,101.19,130,,,fee schedule,130% of fee schedule,101.19,130,,,fee schedule,130% of fee schedule,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,89.39,119,,,fee schedule,119% of fee schedule,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,100% of fee schedule,110.74,90,,,percent of total billed charges,90% of total billed charges,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,71.61,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,71.61,100,,,fee schedule,100% of fee schedule,71.61,110.74,
"Shave Benign(sc,n,ha,fe,g);Lesion .5cm or less-PRO",4324,CDM,982,RC,11305,HCPCS,outpatient,,,93.74,70.31,,43.45,130,,,fee schedule,130% of fee schedule,43.45,130,,,fee schedule,130% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,48.55,119,,,fee schedule,119% of fee schedule,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,100% of fee schedule,84.37,90,,,percent of total billed charges,90% of total billed charges,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,37.67,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,37.67,100,,,fee schedule,100% of fee schedule,37.67,86.23,
"Shave Benign(sc,n,ha,fe,g);Lesion 0.6-1.0cm-PRO",4327,CDM,982,RC,11306,HCPCS,outpatient,,,107.79,80.84,,71.84,130,,,fee schedule,130% of fee schedule,71.84,130,,,fee schedule,130% of fee schedule,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,62.46,119,,,fee schedule,119% of fee schedule,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,100% of fee schedule,97.01,90,,,percent of total billed charges,90% of total billed charges,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,49.62,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,49.62,100,,,fee schedule,100% of fee schedule,49.62,122.16,
"Shave: Epid/Derm., Nonface; Lesion over 2.0cm-PRO",4330,CDM,982,RC,11308,HCPCS,outpatient,,,187.48,140.61,,99.8,130,,,fee schedule,130% of fee schedule,99.8,130,,,fee schedule,130% of fee schedule,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,90.87,119,,,fee schedule,119% of fee schedule,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,100% of fee schedule,168.73,90,,,percent of total billed charges,90% of total billed charges,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,70.39,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,70.39,100,,,fee schedule,100% of fee schedule,70.39,168.73,
"Shave: Epid/Derm.,Face; 0.6 to 1.0cm-PRO",4335,CDM,982,RC,11311,HCPCS,outpatient,,,363.24,272.43,,85.74,130,,,fee schedule,130% of fee schedule,85.74,130,,,fee schedule,130% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,79.02,119,,,fee schedule,119% of fee schedule,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,100% of fee schedule,326.92,90,,,percent of total billed charges,90% of total billed charges,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,63.47,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,63.47,100,,,fee schedule,100% of fee schedule,63.47,326.92,
"Excision Benign(tr,a,l); Lesion 0.5cm/less-PRO",4339,CDM,982,RC,11400,HCPCS,outpatient,,,200.38,150.29,,104.31,130,,,fee schedule,130% of fee schedule,104.31,130,,,fee schedule,130% of fee schedule,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,101.48,119,,,fee schedule,119% of fee schedule,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,86.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,86.9,100,,,fee schedule,100% of fee schedule,57.49,180.34,
"Excision Benign(tr,a,l); Lesion .6 to 1.0cm-PRO",4345,CDM,982,RC,11401,HCPCS,outpatient,,,180.45,135.34,,137.53,130,,,fee schedule,130% of fee schedule,137.53,130,,,fee schedule,130% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,128.67,119,,,fee schedule,119% of fee schedule,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,100% of fee schedule,162.41,90,,,percent of total billed charges,90% of total billed charges,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,109.29,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,109.29,100,,,fee schedule,100% of fee schedule,71.86,162.41,
"Excision Benign(tr,a,l);1.1 to 2.0cm-PRO",4351,CDM,982,RC,11402,HCPCS,outpatient,,,200.38,150.29,,151.2,130,,,fee schedule,130% of fee schedule,151.2,130,,,fee schedule,130% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,141.97,119,,,fee schedule,119% of fee schedule,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,118.91,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,118.91,100,,,fee schedule,100% of fee schedule,86.23,180.34,
"Excision Benign(tr,a,l);2.1-3.0cm-PRO",4357,CDM,982,RC,11403,HCPCS,outpatient,,,262.48,196.86,,194.04,130,,,fee schedule,130% of fee schedule,194.04,130,,,fee schedule,130% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,183.51,119,,,fee schedule,119% of fee schedule,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,100% of fee schedule,236.23,90,,,percent of total billed charges,90% of total billed charges,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,153.21,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,153.21,100,,,fee schedule,100% of fee schedule,107.79,236.23,
"Excision Benign(tr,a,l);Over 4.0cm-PRO",4365,CDM,982,RC,11406,HCPCS,outpatient,,,411.29,308.47,,323.25,130,,,fee schedule,130% of fee schedule,323.25,130,,,fee schedule,130% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,306.03,119,,,fee schedule,119% of fee schedule,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,100% of fee schedule,370.16,90,,,percent of total billed charges,90% of total billed charges,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,252,100,,,fee schedule,Pays 100% Medicare OPPS,150.91,100,,,fee schedule,100% of fee schedule,252,100,,,fee schedule,100% of fee schedule,150.91,370.16,
"Excis Benign(sc,n,ha,fe,g);0.5cm or <-PRO",4370,CDM,982,RC,11420,HCPCS,outpatient,,,117.18,87.89,,107.77,130,,,fee schedule,130% of fee schedule,107.77,130,,,fee schedule,130% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,101.75,119,,,fee schedule,119% of fee schedule,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,100% of fee schedule,105.46,90,,,percent of total billed charges,90% of total billed charges,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,84.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,84.66,100,,,fee schedule,100% of fee schedule,57.49,107.77,
"Excis Benign(sc,n,ha,fe,g); 0.6 to 1.0cm-PRO",4376,CDM,982,RC,11421,HCPCS,outpatient,,,155.85,116.89,,147.17,130,,,fee schedule,130% of fee schedule,147.17,130,,,fee schedule,130% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,135.78,119,,,fee schedule,119% of fee schedule,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,100% of fee schedule,140.27,90,,,percent of total billed charges,90% of total billed charges,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,112.56,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,112.56,100,,,fee schedule,100% of fee schedule,71.86,147.17,
"Excis Benign(sc,n,ha,fe,g);2.1 to 3.0cm-PRO",4386,CDM,982,RC,11423,HCPCS,outpatient,,,285.92,214.44,,208.66,130,,,fee schedule,130% of fee schedule,208.66,130,,,fee schedule,130% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,192.96,119,,,fee schedule,119% of fee schedule,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,100% of fee schedule,257.33,90,,,percent of total billed charges,90% of total billed charges,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,160.35,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,160.35,100,,,fee schedule,100% of fee schedule,129.35,257.33,
Excis Benign Face;0.5cm or <-PRO,4394,CDM,982,RC,11440,HCPCS,outpatient,,,140.62,105.47,,135.36,130,,,fee schedule,130% of fee schedule,135.36,130,,,fee schedule,130% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,128.33,119,,,fee schedule,119% of fee schedule,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,100% of fee schedule,126.56,90,,,percent of total billed charges,90% of total billed charges,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,110.24,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,110.24,100,,,fee schedule,100% of fee schedule,71.86,135.36,
Excis Benign(Face);0.6-1.0cm-PRO,4400,CDM,981,RC,11441,HCPCS,outpatient,,,185.14,138.86,,174.36,130,,,fee schedule,130% of fee schedule,174.36,130,,,fee schedule,130% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,162.26,119,,,fee schedule,119% of fee schedule,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,100% of fee schedule,166.63,90,,,percent of total billed charges,90% of total billed charges,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,137.29,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,137.29,100,,,fee schedule,100% of fee schedule,100.6,174.36,
Excis Benign(Face);1.1-2.0cm-PRO,4406,CDM,982,RC,11442,HCPCS,outpatient,,,203.89,152.92,,193.79,130,,,fee schedule,130% of fee schedule,193.79,130,,,fee schedule,130% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,179.83,119,,,fee schedule,119% of fee schedule,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,100% of fee schedule,183.5,90,,,percent of total billed charges,90% of total billed charges,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,151.17,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,151.17,100,,,fee schedule,100% of fee schedule,129.35,193.79,
"Exc,Skin,Mal-(tr,a,l);0.5 or <-PRO",4412,CDM,982,RC,11600,HCPCS,outpatient,,,155.85,116.89,,159.04,130,,,fee schedule,130% of fee schedule,159.04,130,,,fee schedule,130% of fee schedule,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,150.02,119,,,fee schedule,119% of fee schedule,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,100% of fee schedule,140.27,90,,,percent of total billed charges,90% of total billed charges,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,125.14,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,125.14,100,,,fee schedule,100% of fee schedule,86.23,159.04,
"Exc,Skin,Mal-(tr,a,l);0.5 or <-FAC",4414,CDM,510,RC,11600,HCPCS,outpatient,,,105.47,79.1,,94.92,90,,,percent of total billed charges,90% of total billed charges,98.09,93,,,percent of total billed charges,93% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,40.08,38,,,percent of total billed charges,38% of total billed charges,85.85,81.4,,,percent of total billed charges,81.4% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,94.92,90,,,percent of total billed charges,90% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,40.08,38,,,percent of total billed charges,38% of total billed charges,79.1,75,,,percent of total billed charges,75% of total billed charges,89.65,85,,,percent of total billed charges,85% of total billed charges,40.08,98.09,
"Exc,Skin,Mal-(tr,a,l);0.6-1.0cm-PRO",4419,CDM,982,RC,11601,HCPCS,outpatient,,,202.73,152.05,,200.08,130,,,fee schedule,130% of fee schedule,200.08,130,,,fee schedule,130% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,183.78,119,,,fee schedule,119% of fee schedule,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,100% of fee schedule,182.46,90,,,percent of total billed charges,90% of total billed charges,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,151.61,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,151.61,100,,,fee schedule,100% of fee schedule,114.98,200.08,
"Excision,Mal(tr,a,l);2.1-3.0cm-PRO",4429,CDM,982,RC,11603,HCPCS,outpatient,,,338.64,253.98,,263.16,130,,,fee schedule,130% of fee schedule,263.16,130,,,fee schedule,130% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,240.01,119,,,fee schedule,119% of fee schedule,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,100% of fee schedule,304.78,90,,,percent of total billed charges,90% of total billed charges,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,196.93,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,196.93,100,,,fee schedule,100% of fee schedule,172.46,304.78,
"Lesion Rmv.:Malig.(ma,tr,ar,le); exc. 3.1-4.0cm-PRO",4434,CDM,982,RC,11604,HCPCS,outpatient,,,454.65,340.99,,289,130,,,fee schedule,130% of fee schedule,289,130,,,fee schedule,130% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,264.75,119,,,fee schedule,119% of fee schedule,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,100% of fee schedule,409.19,90,,,percent of total billed charges,90% of total billed charges,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,216.44,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,216.44,100,,,fee schedule,100% of fee schedule,201.21,409.19,
"Lesion Rmv.:Malig.(ma,tr,ar,le); exc. 3.1-4.0cm-FAC",4436,CDM,510,RC,11604,HCPCS,outpatient,,,304.66,228.5,,274.19,90,,,percent of total billed charges,90% of total billed charges,283.33,93,,,percent of total billed charges,93% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,115.77,38,,,percent of total billed charges,38% of total billed charges,247.99,81.4,,,percent of total billed charges,81.4% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,228.5,75,,,percent of total billed charges,75% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,283.33,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen)0.5cm/less-PRO",4441,CDM,982,RC,11620,HCPCS,outpatient,,,271.84,203.88,,161.76,130,,,fee schedule,130% of fee schedule,161.76,130,,,fee schedule,130% of fee schedule,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,151.74,119,,,fee schedule,119% of fee schedule,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,100% of fee schedule,244.66,90,,,percent of total billed charges,90% of total billed charges,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,125.84,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,125.84,100,,,fee schedule,100% of fee schedule,125.84,244.66,
"Exc., Mal(sc,n,ha,fe,g);0.6-1.0cm-PRO",4444,CDM,982,RC,11621,HCPCS,outpatient,,,203.89,152.92,,201.9,130,,,fee schedule,130% of fee schedule,201.9,130,,,fee schedule,130% of fee schedule,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,185.05,119,,,fee schedule,119% of fee schedule,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,100% of fee schedule,183.5,90,,,percent of total billed charges,90% of total billed charges,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,152.58,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,152.58,100,,,fee schedule,100% of fee schedule,152.58,215.58,
"Exc., Mal(sc,n,ha,fe,g);0.6-1.0cm-FAC",4446,CDM,510,RC,11621,HCPCS,outpatient,,,134.75,101.06,,121.28,90,,,percent of total billed charges,90% of total billed charges,125.32,93,,,percent of total billed charges,93% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,51.21,38,,,percent of total billed charges,38% of total billed charges,109.69,81.4,,,percent of total billed charges,81.4% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,121.28,90,,,percent of total billed charges,90% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,51.21,38,,,percent of total billed charges,38% of total billed charges,101.06,75,,,percent of total billed charges,75% of total billed charges,114.54,85,,,percent of total billed charges,85% of total billed charges,51.21,125.32,
"Lesion Rmv.;Malig.(sc,ne,fe,ha,gen);0.6-1.0cm-PRO",4451,CDM,982,RC,11622,HCPCS,outpatient,,,318.73,239.05,,232.1,130,,,fee schedule,130% of fee schedule,232.1,130,,,fee schedule,130% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,210.26,119,,,fee schedule,119% of fee schedule,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,100% of fee schedule,286.86,90,,,percent of total billed charges,90% of total billed charges,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,172.62,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,172.62,100,,,fee schedule,100% of fee schedule,172.62,287.44,
"Excision, Mal(sc,n,ha,fe,g);< 4.0cm-PRO",4456,CDM,982,RC,11626,HCPCS,outpatient,,,419.5,314.63,,397.11,130,,,fee schedule,130% of fee schedule,397.11,130,,,fee schedule,130% of fee schedule,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,363.82,119,,,fee schedule,119% of fee schedule,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,100% of fee schedule,377.55,90,,,percent of total billed charges,90% of total billed charges,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,294.67,100,,,fee schedule,Pays 100% Medicare OPPS,503.02,100,,,fee schedule,100% of fee schedule,294.67,100,,,fee schedule,100% of fee schedule,294.67,503.02,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.5cm or <-PRO",4459,CDM,982,RC,11640,HCPCS,outpatient,,,168.74,126.56,,167.65,130,,,fee schedule,130% of fee schedule,167.65,130,,,fee schedule,130% of fee schedule,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,155.74,119,,,fee schedule,119% of fee schedule,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,100% of fee schedule,151.87,90,,,percent of total billed charges,90% of total billed charges,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,129.52,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,129.52,100,,,fee schedule,100% of fee schedule,129.52,215.58,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.5cm or <-FAC",4461,CDM,510,RC,11640,HCPCS,outpatient,,,113.67,85.25,,102.3,90,,,percent of total billed charges,90% of total billed charges,105.71,93,,,percent of total billed charges,93% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,43.19,38,,,percent of total billed charges,38% of total billed charges,92.53,81.4,,,percent of total billed charges,81.4% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,102.3,90,,,percent of total billed charges,90% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,43.19,38,,,percent of total billed charges,38% of total billed charges,85.25,75,,,percent of total billed charges,75% of total billed charges,96.62,85,,,percent of total billed charges,85% of total billed charges,43.19,105.71,
"Excis, Mal Lesion(sc,n,ha,fe,g);0.6-1.0cm-PRO",4466,CDM,982,RC,11641,HCPCS,outpatient,,,223.81,167.86,,211.69,130,,,fee schedule,130% of fee schedule,211.69,130,,,fee schedule,130% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,192.85,119,,,fee schedule,119% of fee schedule,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,100% of fee schedule,201.43,90,,,percent of total billed charges,90% of total billed charges,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,158.76,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,158.76,100,,,fee schedule,100% of fee schedule,158.76,287.44,
"Excis, Mal Lesion(sc,n,ha,fe,g);1.1-2.0cm-PRO",4471,CDM,982,RC,11642,HCPCS,outpatient,,,260.13,195.1,,249.48,130,,,fee schedule,130% of fee schedule,249.48,130,,,fee schedule,130% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,226.1,119,,,fee schedule,119% of fee schedule,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,100% of fee schedule,234.12,90,,,percent of total billed charges,90% of total billed charges,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,185.13,100,,,fee schedule,Pays 100% Medicare OPPS,359.3,100,,,fee schedule,100% of fee schedule,185.13,100,,,fee schedule,100% of fee schedule,185.13,359.3,
"Excis, Mal Lesion(sc,n,ha,fe,g);2.1-3.0cm-PRO",4474,CDM,982,RC,11643,HCPCS,outpatient,,,508.54,381.41,,312.72,130,,,fee schedule,130% of fee schedule,312.72,130,,,fee schedule,130% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,283.32,119,,,fee schedule,119% of fee schedule,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,100% of fee schedule,457.69,90,,,percent of total billed charges,90% of total billed charges,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,230.83,100,,,fee schedule,Pays 100% Medicare OPPS,431.16,100,,,fee schedule,100% of fee schedule,230.83,100,,,fee schedule,100% of fee schedule,230.83,457.69,
"Excis, Mal Lesion(sc,n,ha,fe,g);Over 4.0 cm-PRO",4478,CDM,982,RC,11646,HCPCS,outpatient,,,575.34,431.51,,537.47,130,,,fee schedule,130% of fee schedule,537.47,130,,,fee schedule,130% of fee schedule,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,486.54,119,,,fee schedule,119% of fee schedule,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,100% of fee schedule,517.81,90,,,percent of total billed charges,90% of total billed charges,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,393.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,393.9,100,,,fee schedule,100% of fee schedule,57.49,537.47,
Debrid. of Nail(s) Any Method(s); 1-5,4480,CDM,982,RC,11720,HCPCS,outpatient,,,60.93,45.7,,19.89,130,,,fee schedule,130% of fee schedule,19.89,130,,,fee schedule,130% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,18,119,,,fee schedule,119% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,100% of fee schedule,54.84,90,,,percent of total billed charges,90% of total billed charges,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,14.46,100,,,fee schedule,100% of fee schedule,14.46,54.84,
Debrid. of Nail(s) Any Method(s); 1-5-PRO,4483,CDM,982,RC,11720,HCPCS,outpatient,,,35.15,26.36,,19.89,130,,,fee schedule,130% of fee schedule,19.89,130,,,fee schedule,130% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,18,119,,,fee schedule,119% of fee schedule,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,100% of fee schedule,31.64,90,,,percent of total billed charges,90% of total billed charges,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,14.46,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,14.46,100,,,fee schedule,100% of fee schedule,14.46,35.93,
Debrid. of Nail;Trim. Nondys.;6 or <-PRO,4487,CDM,982,RC,11721,HCPCS,outpatient,,,39.84,29.88,,32.75,130,,,fee schedule,130% of fee schedule,32.75,130,,,fee schedule,130% of fee schedule,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,30.89,119,,,fee schedule,119% of fee schedule,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,100% of fee schedule,35.86,90,,,percent of total billed charges,90% of total billed charges,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,23.74,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,23.74,100,,,fee schedule,100% of fee schedule,23.74,35.93,
Debridement of Nail; Nail Plate-PRO,4492,CDM,982,RC,11730,HCPCS,outpatient,,,89.06,66.8,,66.83,130,,,fee schedule,130% of fee schedule,66.83,130,,,fee schedule,130% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,67.66,119,,,fee schedule,119% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,100% of fee schedule,80.15,90,,,percent of total billed charges,90% of total billed charges,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,54.11,100,,,fee schedule,100% of fee schedule,35.93,80.15,
Debrid. of Nail;Evac.;Sub.Hematoma,4498,CDM,982,RC,11740,HCPCS,outpatient,,,77.35,58.01,,42.17,130,,,fee schedule,130% of fee schedule,42.17,130,,,fee schedule,130% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,39.23,119,,,fee schedule,119% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,100% of fee schedule,69.62,90,,,percent of total billed charges,90% of total billed charges,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,32.89,100,,,fee schedule,100% of fee schedule,32.89,69.62,
"Excision:Nail/Matrix, Part/Comp.Rmv.-PRO",4507,CDM,982,RC,11750,HCPCS,outpatient,,,254.29,190.72,,227.34,130,,,fee schedule,130% of fee schedule,227.34,130,,,fee schedule,130% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,126.2,119,,,fee schedule,119% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,100% of fee schedule,228.86,90,,,percent of total billed charges,90% of total billed charges,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,102.95,100,,,fee schedule,100% of fee schedule,102.95,228.86,
Debrid. Nail;Wedge Exc.of Skin;Fold-PRO,4512,CDM,982,RC,11765,HCPCS,outpatient,,,99.59,74.69,,92.63,130,,,fee schedule,130% of fee schedule,92.63,130,,,fee schedule,130% of fee schedule,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,114.89,119,,,fee schedule,119% of fee schedule,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,100% of fee schedule,89.63,90,,,percent of total billed charges,90% of total billed charges,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,94.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,94.77,100,,,fee schedule,100% of fee schedule,89.63,143.72,
Treatment of Lesions; Inj.up to 7 Lesions-PRO,4519,CDM,982,RC,11900,HCPCS,outpatient,,,55.08,41.31,,43.1,130,,,fee schedule,130% of fee schedule,43.1,130,,,fee schedule,130% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,37.58,119,,,fee schedule,119% of fee schedule,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,100% of fee schedule,49.57,90,,,percent of total billed charges,90% of total billed charges,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,30.36,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,30.36,100,,,fee schedule,100% of fee schedule,30.36,49.57,
Removal Contraceptive-PRO,4524,CDM,982,RC,11976,HCPCS,outpatient,,,142.95,107.21,,128.48,130,,,fee schedule,130% of fee schedule,128.48,130,,,fee schedule,130% of fee schedule,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,117.05,119,,,fee schedule,119% of fee schedule,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,100% of fee schedule,128.66,90,,,percent of total billed charges,90% of total billed charges,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,93,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,93,100,,,fee schedule,100% of fee schedule,93,128.66,
"Lac Repair, PRO Supf Nonface less than 2.5cm",4530,CDM,982,RC,12001,HCPCS,outpatient,,,165.21,123.91,,59.58,130,,,fee schedule,130% of fee schedule,59.58,130,,,fee schedule,130% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,55.66,119,,,fee schedule,119% of fee schedule,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,100% of fee schedule,148.69,90,,,percent of total billed charges,90% of total billed charges,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,44.94,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,44.94,100,,,fee schedule,100% of fee schedule,44.94,148.69,
Lac Repair-PRO Supf. Nonface;2.6-7.5 cm,4535,CDM,982,RC,12002,HCPCS,outpatient,,,219.13,164.35,,78.94,130,,,fee schedule,130% of fee schedule,78.94,130,,,fee schedule,130% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,73.92,119,,,fee schedule,119% of fee schedule,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,100% of fee schedule,197.22,90,,,percent of total billed charges,90% of total billed charges,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,58.64,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,58.64,100,,,fee schedule,100% of fee schedule,58.64,197.22,
Lac Repair-PRO Supf.Nonface;7.6-12.5cm,4538,CDM,982,RC,12004,HCPCS,outpatient,,,219.13,164.35,,98.28,130,,,fee schedule,130% of fee schedule,98.28,130,,,fee schedule,130% of fee schedule,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,91.86,119,,,fee schedule,119% of fee schedule,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,100% of fee schedule,197.22,90,,,percent of total billed charges,90% of total billed charges,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,72.7,100,,,fee schedule,Pays 100% Medicare OPPS,129.35,100,,,fee schedule,100% of fee schedule,72.7,100,,,fee schedule,100% of fee schedule,72.7,197.22,
Lac Repair-PRO Supf.Nonface;12.6-20cm,4541,CDM,982,RC,12005,HCPCS,outpatient,,,241.38,181.04,,133.06,130,,,fee schedule,130% of fee schedule,133.06,130,,,fee schedule,130% of fee schedule,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,119.33,119,,,fee schedule,119% of fee schedule,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,100% of fee schedule,217.24,90,,,percent of total billed charges,90% of total billed charges,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,93.8,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,93.8,100,,,fee schedule,100% of fee schedule,93.8,217.24,
Lac Repair-PRO Supf.Nonface; 20.1-30.0cm,4544,CDM,982,RC,12006,HCPCS,outpatient,,,205.05,153.79,,163.01,130,,,fee schedule,130% of fee schedule,163.01,130,,,fee schedule,130% of fee schedule,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.25,119,,,fee schedule,119% of fee schedule,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,100% of fee schedule,184.55,90,,,percent of total billed charges,90% of total billed charges,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,115.52,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,115.52,100,,,fee schedule,100% of fee schedule,115.52,186.84,
"Suture-Sup.wounds(sc,n,ax,EG,tr,fe,ha);Over 30cm-PRO",4547,CDM,982,RC,12007,HCPCS,outpatient,,,317.55,238.16,,196.9,130,,,fee schedule,130% of fee schedule,196.9,130,,,fee schedule,130% of fee schedule,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,180.57,119,,,fee schedule,119% of fee schedule,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,100% of fee schedule,285.8,90,,,percent of total billed charges,90% of total billed charges,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,143.77,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,143.77,100,,,fee schedule,100% of fee schedule,143.77,285.8,
Lac Repair Supf. Face/Head PRO; <2.5 cm,4550,CDM,982,RC,12011,HCPCS,outpatient,,,151.15,113.36,,74.46,130,,,fee schedule,130% of fee schedule,74.46,130,,,fee schedule,130% of fee schedule,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,69.64,119,,,fee schedule,119% of fee schedule,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,100% of fee schedule,136.04,90,,,percent of total billed charges,90% of total billed charges,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,55,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,55,100,,,fee schedule,100% of fee schedule,55,136.04,
Lac Repair Supf. Face/Head PRO; 2.6-5.0cm,4553,CDM,982,RC,12013,HCPCS,outpatient,,,174.59,130.94,,82.86,130,,,fee schedule,130% of fee schedule,82.86,130,,,fee schedule,130% of fee schedule,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,73.26,119,,,fee schedule,119% of fee schedule,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,100% of fee schedule,157.13,90,,,percent of total billed charges,90% of total billed charges,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,57.9,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,57.9,100,,,fee schedule,100% of fee schedule,57.9,157.13,
Lac Repair Supf. Face/Head PRO;5.1-7.5cm,4556,CDM,982,RC,12014,HCPCS,outpatient,,,210.93,158.2,,105.74,130,,,fee schedule,130% of fee schedule,105.74,130,,,fee schedule,130% of fee schedule,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,93.72,119,,,fee schedule,119% of fee schedule,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,100% of fee schedule,189.84,90,,,percent of total billed charges,90% of total billed charges,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,74.02,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,74.02,100,,,fee schedule,100% of fee schedule,74.02,189.84,
Lac Repair Supf. Face/Head PRO;7.6-12.5cm,4559,CDM,982,RC,12015,HCPCS,outpatient,,,262.48,196.86,,130.75,130,,,fee schedule,130% of fee schedule,130.75,130,,,fee schedule,130% of fee schedule,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,118.43,119,,,fee schedule,119% of fee schedule,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,100% of fee schedule,236.23,90,,,percent of total billed charges,90% of total billed charges,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.35,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,93.35,100,,,fee schedule,100% of fee schedule,93.35,236.23,
Lac Repair Supf Head/Face PRO;20.1-30.0cm,4565,CDM,982,RC,12017,HCPCS,outpatient,,,386.67,290,,197.51,130,,,fee schedule,130% of fee schedule,197.51,130,,,fee schedule,130% of fee schedule,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,190.77,119,,,fee schedule,119% of fee schedule,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,100% of fee schedule,348,90,,,percent of total billed charges,90% of total billed charges,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,152.09,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,152.09,100,,,fee schedule,100% of fee schedule,152.09,348,
Lac Repair-PRO Supf Head/Face;< 30.0cm,4568,CDM,982,RC,12018,HCPCS,outpatient,,,465.2,348.9,,223.81,130,,,fee schedule,130% of fee schedule,223.81,130,,,fee schedule,130% of fee schedule,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,216.23,119,,,fee schedule,119% of fee schedule,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,100% of fee schedule,418.68,90,,,percent of total billed charges,90% of total billed charges,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,171.66,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,171.66,100,,,fee schedule,100% of fee schedule,171.66,418.68,
Sup. Wound Dehis Simp.-PRO,4572,CDM,982,RC,12020,HCPCS,outpatient,,,273.02,204.77,,246.96,130,,,fee schedule,130% of fee schedule,246.96,130,,,fee schedule,130% of fee schedule,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,234.74,119,,,fee schedule,119% of fee schedule,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,100% of fee schedule,245.72,90,,,percent of total billed charges,90% of total billed charges,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,192.21,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,192.21,100,,,fee schedule,100% of fee schedule,114.98,246.96,
Lac Repair-PRO Intermed. Nonface;2.5cm or <,4580,CDM,982,RC,12031,HCPCS,outpatient,,,213.26,159.95,,220.66,130,,,fee schedule,130% of fee schedule,220.66,130,,,fee schedule,130% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,189.16,119,,,fee schedule,119% of fee schedule,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,100% of fee schedule,191.93,90,,,percent of total billed charges,90% of total billed charges,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,155.27,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,155.27,100,,,fee schedule,100% of fee schedule,86.23,220.66,
Lac Repair-PRO Intermed. Nonface;2.6-7.5cm,4586,CDM,982,RC,12032,HCPCS,outpatient,,,270.67,203,,262,130,,,fee schedule,130% of fee schedule,262,130,,,fee schedule,130% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,237.17,119,,,fee schedule,119% of fee schedule,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,100% of fee schedule,243.6,90,,,percent of total billed charges,90% of total billed charges,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,194.35,100,,,fee schedule,Pays 100% Medicare OPPS,122.16,100,,,fee schedule,100% of fee schedule,194.35,100,,,fee schedule,100% of fee schedule,122.16,262,
Lac Repair-PRO Intermed. Nonface;7.6-12.5cm,4592,CDM,982,RC,12034,HCPCS,outpatient,,,189.84,142.38,,246.79,130,,,fee schedule,130% of fee schedule,246.79,130,,,fee schedule,130% of fee schedule,189.84,100,,,fee schedule,Pays 100% Medicare OPPS,189.84,100,,,fee schedule,Pays 100% Medicare OPPS,225.91,119,,,fee schedule,119% of fee schedule,189.84,100,,,fee schedule,Pays 100% Medicare OPPS,189.84,100,,,fee schedule,100% of fee schedule,170.86,90,,,percent of total billed charges,90% of total billed charges,189.84,100,,,fee schedule,Pays 100% Medicare OPPS,189.84,100,,,fee schedule,Pays 100% Medicare OPPS,189.84,100,,,fee schedule,Pays 100% Medicare OPPS,189.84,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,189.84,100,,,fee schedule,100% of fee schedule,158.09,246.79,
Lac Repair-PRO Intermed. Nonface;12.6-20.0cm,4596,CDM,982,RC,12035,HCPCS,outpatient,,,342.17,256.63,,314.35,130,,,fee schedule,130% of fee schedule,314.35,130,,,fee schedule,130% of fee schedule,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,299.51,119,,,fee schedule,119% of fee schedule,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,100% of fee schedule,307.95,90,,,percent of total billed charges,90% of total billed charges,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,244.65,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,244.65,100,,,fee schedule,100% of fee schedule,194.02,314.35,
Lac Repair-PRO Intermed. Nonface; 20.1-30cm,4601,CDM,982,RC,12036,HCPCS,outpatient,,,396.05,297.04,,359.66,130,,,fee schedule,130% of fee schedule,359.66,130,,,fee schedule,130% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,350.94,119,,,fee schedule,119% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,100% of fee schedule,356.45,90,,,percent of total billed charges,90% of total billed charges,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,284.52,100,,,fee schedule,100% of fee schedule,229.95,359.66,
Lac Repair-PRO Intermed. Nonface;< 30.0cm,4605,CDM,982,RC,12037,HCPCS,outpatient,,,462.85,347.14,,416.03,130,,,fee schedule,130% of fee schedule,416.03,130,,,fee schedule,130% of fee schedule,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,410.09,119,,,fee schedule,119% of fee schedule,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,100% of fee schedule,416.57,90,,,percent of total billed charges,90% of total billed charges,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,330.28,100,,,fee schedule,Pays 100% Medicare OPPS,265.88,100,,,fee schedule,100% of fee schedule,330.28,100,,,fee schedule,100% of fee schedule,265.88,416.57,
Lac Repair-PRO Intermed. Head/Face;2.5cm or <,4612,CDM,982,RC,12041,HCPCS,outpatient,,,230.85,173.14,,233.92,130,,,fee schedule,130% of fee schedule,233.92,130,,,fee schedule,130% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,119,,,fee schedule,119% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,100% of fee schedule,207.77,90,,,percent of total billed charges,90% of total billed charges,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,147.92,100,,,fee schedule,100% of fee schedule,100.6,233.92,
Lac Repair-PRO Intermed. Head/Face;2.6-7.5cm,4618,CDM,982,RC,12042,HCPCS,outpatient,,,270.67,203,,269.65,130,,,fee schedule,130% of fee schedule,269.65,130,,,fee schedule,130% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,244.55,119,,,fee schedule,119% of fee schedule,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,100% of fee schedule,243.6,90,,,percent of total billed charges,90% of total billed charges,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,199.46,100,,,fee schedule,Pays 100% Medicare OPPS,136.53,100,,,fee schedule,100% of fee schedule,199.46,100,,,fee schedule,100% of fee schedule,136.53,269.65,
Lac Repair-PRO Intermed. Head/Face;7.6-12.5cm,4623,CDM,982,RC,12044,HCPCS,outpatient,,,296.47,222.35,,284.87,130,,,fee schedule,130% of fee schedule,284.87,130,,,fee schedule,130% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,266.23,119,,,fee schedule,119% of fee schedule,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,100% of fee schedule,266.82,90,,,percent of total billed charges,90% of total billed charges,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,217.3,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,217.3,100,,,fee schedule,100% of fee schedule,172.46,284.87,
Lac Repair-PRO Intermed. Head/Face;12.6-20cm,4627,CDM,982,RC,12045,HCPCS,outpatient,,,355.05,266.29,,320.49,130,,,fee schedule,130% of fee schedule,320.49,130,,,fee schedule,130% of fee schedule,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,335.43,119,,,fee schedule,119% of fee schedule,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,100% of fee schedule,319.55,90,,,percent of total billed charges,90% of total billed charges,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,279.95,100,,,fee schedule,Pays 100% Medicare OPPS,208.39,100,,,fee schedule,100% of fee schedule,279.95,100,,,fee schedule,100% of fee schedule,208.39,335.43,
Lac Repair-PRO Intermed. Head/Face;20.1-30.0cm,4631,CDM,982,RC,12046,HCPCS,outpatient,,,414.8,311.1,,380.47,130,,,fee schedule,130% of fee schedule,380.47,130,,,fee schedule,130% of fee schedule,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,391.01,119,,,fee schedule,119% of fee schedule,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,100% of fee schedule,373.32,90,,,percent of total billed charges,90% of total billed charges,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,321.85,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,321.85,100,,,fee schedule,100% of fee schedule,244.32,391.01,
Lac Repair-PRO Intermed. Head/Face;< 30.0cm,4635,CDM,982,RC,12047,HCPCS,outpatient,,,462.85,347.14,,403.22,130,,,fee schedule,130% of fee schedule,403.22,130,,,fee schedule,130% of fee schedule,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,435.73,119,,,fee schedule,119% of fee schedule,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,100% of fee schedule,416.57,90,,,percent of total billed charges,90% of total billed charges,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,357.12,100,,,fee schedule,Pays 100% Medicare OPPS,280.25,100,,,fee schedule,100% of fee schedule,357.12,100,,,fee schedule,100% of fee schedule,280.25,435.73,
Lac Repair-PRO Intermed. Face;2.5cm or <,4641,CDM,982,RC,12051,HCPCS,outpatient,,,250.76,188.07,,246.43,130,,,fee schedule,130% of fee schedule,246.43,130,,,fee schedule,130% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,210.32,119,,,fee schedule,119% of fee schedule,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,100% of fee schedule,225.68,90,,,percent of total billed charges,90% of total billed charges,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,173.2,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,173.2,100,,,fee schedule,100% of fee schedule,114.98,246.43,
Lac Repair-PRO Intermed. Face;2.6-5.0cm,4647,CDM,982,RC,12052,HCPCS,outpatient,,,287.08,215.31,,295.95,130,,,fee schedule,130% of fee schedule,295.95,130,,,fee schedule,130% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,248.82,119,,,fee schedule,119% of fee schedule,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,100% of fee schedule,258.37,90,,,percent of total billed charges,90% of total billed charges,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,203.62,100,,,fee schedule,Pays 100% Medicare OPPS,158.09,100,,,fee schedule,100% of fee schedule,203.62,100,,,fee schedule,100% of fee schedule,158.09,295.95,
Lac Repair-PRO Intermed. Face;5.1-7.5cm,4652,CDM,982,RC,12053,HCPCS,outpatient,,,297.64,223.23,,291.41,130,,,fee schedule,130% of fee schedule,291.41,130,,,fee schedule,130% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,268.31,119,,,fee schedule,119% of fee schedule,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,100% of fee schedule,267.88,90,,,percent of total billed charges,90% of total billed charges,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,219.37,100,,,fee schedule,Pays 100% Medicare OPPS,201.21,100,,,fee schedule,100% of fee schedule,219.37,100,,,fee schedule,100% of fee schedule,201.21,291.41,
Lac Repair-PRO Intermed. Face;7.6-12.5cm,4657,CDM,982,RC,12054,HCPCS,outpatient,,,159.34,119.51,,207.14,130,,,fee schedule,130% of fee schedule,207.14,130,,,fee schedule,130% of fee schedule,159.34,100,,,fee schedule,Pays 100% Medicare OPPS,159.34,100,,,fee schedule,Pays 100% Medicare OPPS,189.61,119,,,fee schedule,119% of fee schedule,159.34,100,,,fee schedule,Pays 100% Medicare OPPS,159.34,100,,,fee schedule,100% of fee schedule,143.41,90,,,percent of total billed charges,90% of total billed charges,159.34,100,,,fee schedule,Pays 100% Medicare OPPS,159.34,100,,,fee schedule,Pays 100% Medicare OPPS,159.34,100,,,fee schedule,Pays 100% Medicare OPPS,159.34,100,,,fee schedule,Pays 100% Medicare OPPS,244.32,100,,,fee schedule,100% of fee schedule,159.34,100,,,fee schedule,100% of fee schedule,143.41,244.32,
Lac Repair-PRO Intermed. Face;12.6-20.0cm,4661,CDM,982,RC,12055,HCPCS,outpatient,,,321.07,240.8,,362.13,130,,,fee schedule,130% of fee schedule,362.13,130,,,fee schedule,130% of fee schedule,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,373.47,119,,,fee schedule,119% of fee schedule,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,100% of fee schedule,288.96,90,,,percent of total billed charges,90% of total billed charges,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,304.2,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,304.2,100,,,fee schedule,100% of fee schedule,287.44,373.47,
"Suture,Complex(sa,a,l);2.6-7.5cm-PRO",4672,CDM,982,RC,13121,HCPCS,outpatient,,,390.19,292.64,,441.47,130,,,fee schedule,130% of fee schedule,441.47,130,,,fee schedule,130% of fee schedule,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,324.69,119,,,fee schedule,119% of fee schedule,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,100% of fee schedule,351.17,90,,,percent of total billed charges,90% of total billed charges,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,261.25,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,261.25,100,,,fee schedule,100% of fee schedule,261.25,441.47,
"Suture,Cmplx(sa,a,l);Each Add. 5cm or <-PRO",4675,CDM,982,RC,13122,HCPCS,outpatient,,,101.95,76.46,,116.43,130,,,fee schedule,130% of fee schedule,116.43,130,,,fee schedule,130% of fee schedule,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,104.27,119,,,fee schedule,119% of fee schedule,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,100% of fee schedule,91.76,90,,,percent of total billed charges,90% of total billed charges,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,83.09,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,83.09,100,,,fee schedule,100% of fee schedule,83.09,116.43,
Burn Init. Trmt-PRO,4692,CDM,982,RC,16000,HCPCS,outpatient,,,69.14,51.86,,61.89,130,,,fee schedule,130% of fee schedule,61.89,130,,,fee schedule,130% of fee schedule,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.07,119,,,fee schedule,119% of fee schedule,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,100% of fee schedule,62.23,90,,,percent of total billed charges,90% of total billed charges,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,45.83,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,45.83,100,,,fee schedule,100% of fee schedule,35.93,62.23,
"Burn, Debride <5%-PRO",4696,CDM,982,RC,16020,HCPCS,outpatient,,,83.21,62.41,,77.14,130,,,fee schedule,130% of fee schedule,77.14,130,,,fee schedule,130% of fee schedule,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,67.59,119,,,fee schedule,119% of fee schedule,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,100% of fee schedule,74.89,90,,,percent of total billed charges,90% of total billed charges,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,56.59,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.59,100,,,fee schedule,100% of fee schedule,43.12,77.14,
Burn; Large> 10%-PRO,4703,CDM,982,RC,16030,HCPCS,outpatient,,,193.34,145.01,,176.01,130,,,fee schedule,130% of fee schedule,176.01,130,,,fee schedule,130% of fee schedule,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,165.37,119,,,fee schedule,119% of fee schedule,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,100% of fee schedule,174.01,90,,,percent of total billed charges,90% of total billed charges,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,132.52,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,132.52,100,,,fee schedule,100% of fee schedule,132.52,176.01,
Cryo-1st Lesion-PRO,4710,CDM,982,RC,17000,HCPCS,outpatient,,,96.09,72.07,,74.79,130,,,fee schedule,130% of fee schedule,74.79,130,,,fee schedule,130% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,66.68,119,,,fee schedule,119% of fee schedule,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,100% of fee schedule,86.48,90,,,percent of total billed charges,90% of total billed charges,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,56.55,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,56.55,100,,,fee schedule,100% of fee schedule,43.12,86.48,
Cryo:2-14 Lesions-PRO,4716,CDM,982,RC,17003,HCPCS,outpatient,,,11.72,8.79,,5.77,130,,,fee schedule,130% of fee schedule,5.77,130,,,fee schedule,130% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.59,119,,,fee schedule,119% of fee schedule,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,100% of fee schedule,10.55,90,,,percent of total billed charges,90% of total billed charges,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,2.07,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,2.07,100,,,fee schedule,100% of fee schedule,2.07,10.55,
Cryo Lesions 15+-PRO,4722,CDM,982,RC,17004,HCPCS,outpatient,,,336.29,252.22,,176.9,130,,,fee schedule,130% of fee schedule,176.9,130,,,fee schedule,130% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,121.17,119,,,fee schedule,119% of fee schedule,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,100% of fee schedule,302.66,90,,,percent of total billed charges,90% of total billed charges,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,101.41,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,101.41,100,,,fee schedule,100% of fee schedule,101.41,302.66,
Wart Removal;up to 14 Lesions-PRO,4728,CDM,982,RC,17110,HCPCS,outpatient,,,112.5,84.38,,92.51,130,,,fee schedule,130% of fee schedule,92.51,130,,,fee schedule,130% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,83.3,119,,,fee schedule,119% of fee schedule,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,100% of fee schedule,101.25,90,,,percent of total billed charges,90% of total billed charges,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,69.49,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,69.49,100,,,fee schedule,100% of fee schedule,28.74,101.25,
Chem. Cauterize of Gran Tissue-PRO,4734,CDM,982,RC,17250,HCPCS,outpatient,,,51.55,38.66,,48.15,130,,,fee schedule,130% of fee schedule,48.15,130,,,fee schedule,130% of fee schedule,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,46.26,119,,,fee schedule,119% of fee schedule,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,100% of fee schedule,46.4,90,,,percent of total billed charges,90% of total billed charges,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,38.04,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.04,100,,,fee schedule,100% of fee schedule,38.04,48.15,
Malignant Lesion Destruc. .5 or <;Trunk Ext.-PRO,4739,CDM,982,RC,17260,HCPCS,outpatient,,,142.95,107.21,,91.46,130,,,fee schedule,130% of fee schedule,91.46,130,,,fee schedule,130% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,86.87,119,,,fee schedule,119% of fee schedule,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,100% of fee schedule,128.66,90,,,percent of total billed charges,90% of total billed charges,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,72.4,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,72.4,100,,,fee schedule,100% of fee schedule,72.4,128.66,
Malignant Lesion Destruc. 1.1-2.0cm;Trunk Ext-PRO,4748,CDM,982,RC,17262,HCPCS,outpatient,,,216.79,162.59,,158.29,130,,,fee schedule,130% of fee schedule,158.29,130,,,fee schedule,130% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,138.39,119,,,fee schedule,119% of fee schedule,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,100% of fee schedule,195.11,90,,,percent of total billed charges,90% of total billed charges,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,112.67,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,112.67,100,,,fee schedule,100% of fee schedule,107.79,195.11,
Acne/Hair Removal Cryo.-PRO,4767,CDM,982,RC,17340,HCPCS,outpatient,,,90.22,67.67,,64.92,130,,,fee schedule,130% of fee schedule,64.92,130,,,fee schedule,130% of fee schedule,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,60.96,119,,,fee schedule,119% of fee schedule,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,100% of fee schedule,81.2,90,,,percent of total billed charges,90% of total billed charges,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,50.27,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,50.27,100,,,fee schedule,100% of fee schedule,21.56,81.2,
FB Rmv. Muscle/Tenon Sheath-PRO,4772,CDM,982,RC,20520,HCPCS,outpatient,,,237.86,178.4,,191.27,130,,,fee schedule,130% of fee schedule,191.27,130,,,fee schedule,130% of fee schedule,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,182.97,119,,,fee schedule,119% of fee schedule,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,100% of fee schedule,214.07,90,,,percent of total billed charges,90% of total billed charges,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,151.34,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,151.34,100,,,fee schedule,100% of fee schedule,86.23,214.07,
Inj. Tendon/Ligament[Package],4776,CDM,981,RC,20550,HCPCS,outpatient,,,243.73,182.8,,54.57,130,,,fee schedule,130% of fee schedule,54.57,130,,,fee schedule,130% of fee schedule,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,48.56,119,,,fee schedule,119% of fee schedule,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,100% of fee schedule,219.36,90,,,percent of total billed charges,90% of total billed charges,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,39.27,100,,,fee schedule,100% of fee schedule,28.74,219.36,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4780,CDM,450,RC,20552,HCPCS,outpatient,,,65.63,49.22,,59.07,90,,,percent of total billed charges,90% of total billed charges,61.04,93,,,percent of total billed charges,93% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,53.42,81.4,,,percent of total billed charges,81.4% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,59.07,90,,,percent of total billed charges,90% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,24.94,38,,,percent of total billed charges,38% of total billed charges,49.22,75,,,percent of total billed charges,75% of total billed charges,55.79,85,,,percent of total billed charges,85% of total billed charges,24.94,61.04,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4782,CDM,450,RC,20552,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4784,CDM,982,RC,20552,HCPCS,outpatient,,,97.26,72.95,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,87.53,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,87.53,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-PRO,4788,CDM,982,RC,20552,HCPCS,outpatient,,,97.26,72.95,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,87.53,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,87.53,
Therapeutic Inj Trigger Point(s);1or 2 Muscles-PRO,4789,CDM,982,RC,20552,HCPCS,outpatient,,,97.26,72.95,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,87.53,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,87.53,
INJ; Trig pts-3 or < muscles-PRO,4795,CDM,982,RC,20553,HCPCS,outpatient,,,352.71,264.53,,56.45,130,,,fee schedule,130% of fee schedule,56.45,130,,,fee schedule,130% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,53.9,119,,,fee schedule,119% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,100% of fee schedule,317.44,90,,,percent of total billed charges,90% of total billed charges,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,42.83,100,,,fee schedule,100% of fee schedule,42.83,317.44,
Asp/Inj-small joint (w/o ultra)-PRO,4800,CDM,982,RC,20600,HCPCS,outpatient,,,84.37,63.28,,51.1,130,,,fee schedule,130% of fee schedule,51.1,130,,,fee schedule,130% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,44.7,119,,,fee schedule,119% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,100% of fee schedule,75.93,90,,,percent of total billed charges,90% of total billed charges,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,35.66,100,,,fee schedule,100% of fee schedule,21.56,75.93,
Asp/Inj-Intermed Jnt (w/o ultra)-PRO,4809,CDM,982,RC,20605,HCPCS,outpatient,,,141.79,106.34,,53.76,130,,,fee schedule,130% of fee schedule,53.76,130,,,fee schedule,130% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,46.45,119,,,fee schedule,119% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,100% of fee schedule,127.61,90,,,percent of total billed charges,90% of total billed charges,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,37.24,100,,,fee schedule,100% of fee schedule,28.74,127.61,
Asp/Inj-Major joint (w/o ultra)-PRO,4819,CDM,982,RC,20610,HCPCS,outpatient,,,164.04,123.03,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,147.64,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,147.64,
Asp/Inj. of Ganglion-PRO,4824,CDM,982,RC,20612,HCPCS,outpatient,,,96.09,72.07,,55.09,130,,,fee schedule,130% of fee schedule,55.09,130,,,fee schedule,130% of fee schedule,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,51.3,119,,,fee schedule,119% of fee schedule,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,100% of fee schedule,86.48,90,,,percent of total billed charges,90% of total billed charges,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,41.48,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,41.48,100,,,fee schedule,100% of fee schedule,41.48,86.48,
FRX/DIS-Mandible W/O Manip.-PRO,4833,CDM,982,RC,21450,HCPCS,outpatient,,,693.7,520.28,,641.55,130,,,fee schedule,130% of fee schedule,641.55,130,,,fee schedule,130% of fee schedule,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,587.46,119,,,fee schedule,119% of fee schedule,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,100% of fee schedule,624.33,90,,,percent of total billed charges,90% of total billed charges,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,505.85,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,505.85,100,,,fee schedule,100% of fee schedule,93.42,641.55,
FXR-Sternum Closed-PRO,4839,CDM,982,RC,21820,HCPCS,outpatient,,,345.68,259.26,,188.18,130,,,fee schedule,130% of fee schedule,188.18,130,,,fee schedule,130% of fee schedule,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,180.69,119,,,fee schedule,119% of fee schedule,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,100% of fee schedule,311.11,90,,,percent of total billed charges,90% of total billed charges,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,156.43,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,156.43,100,,,fee schedule,100% of fee schedule,156.43,311.11,
Dislocate Shoulder-Sternocl.W/O Manip.-PRO,4848,CDM,982,RC,23520,HCPCS,outpatient,,,314.05,235.54,,303.98,130,,,fee schedule,130% of fee schedule,303.98,130,,,fee schedule,130% of fee schedule,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,294.56,119,,,fee schedule,119% of fee schedule,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,100% of fee schedule,282.65,90,,,percent of total billed charges,90% of total billed charges,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,253.9,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,253.9,100,,,fee schedule,100% of fee schedule,93.42,303.98,
"Disloc.-Shoulder W/ Manip,W/O anes-PRO",4855,CDM,982,RC,23650,HCPCS,outpatient,,,377.3,282.98,,359.15,130,,,fee schedule,130% of fee schedule,359.15,130,,,fee schedule,130% of fee schedule,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,362.19,119,,,fee schedule,119% of fee schedule,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,100% of fee schedule,339.57,90,,,percent of total billed charges,90% of total billed charges,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,316.15,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,316.15,100,,,fee schedule,100% of fee schedule,179.65,362.19,
FRX-humerus clsd (w/o manip)-PRO,4864,CDM,982,RC,24500,HCPCS,outpatient,,,440.58,330.44,,419.84,130,,,fee schedule,130% of fee schedule,419.84,130,,,fee schedule,130% of fee schedule,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,411.32,119,,,fee schedule,119% of fee schedule,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,100% of fee schedule,396.52,90,,,percent of total billed charges,90% of total billed charges,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,354.91,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,354.91,100,,,fee schedule,100% of fee schedule,93.42,419.84,
FX-HUM epicon W/O Manip-PRO,4870,CDM,982,RC,24560,HCPCS,outpatient,,,384.34,288.26,,371.19,130,,,fee schedule,130% of fee schedule,371.19,130,,,fee schedule,130% of fee schedule,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,365.73,119,,,fee schedule,119% of fee schedule,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,100% of fee schedule,345.91,90,,,percent of total billed charges,90% of total billed charges,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,314.27,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,314.27,100,,,fee schedule,100% of fee schedule,93.42,371.19,
"Disl-Elbow,Closed W/O Manip-PRO",4873,CDM,982,RC,24600,HCPCS,outpatient,,,471.06,353.3,,426.89,130,,,fee schedule,130% of fee schedule,426.89,130,,,fee schedule,130% of fee schedule,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,419.9,119,,,fee schedule,119% of fee schedule,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,100% of fee schedule,423.95,90,,,percent of total billed charges,90% of total billed charges,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,359.66,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,359.66,100,,,fee schedule,100% of fee schedule,143.72,426.89,
FRX/DIS-Radial Head Nursemaid W/ Manip.-PRO,4878,CDM,982,RC,24640,HCPCS,outpatient,,,214.42,160.82,,118.24,130,,,fee schedule,130% of fee schedule,118.24,130,,,fee schedule,130% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,97.98,119,,,fee schedule,119% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,100% of fee schedule,192.98,90,,,percent of total billed charges,90% of total billed charges,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,82.27,100,,,fee schedule,100% of fee schedule,82.27,192.98,
FRX/DIS-Radial Head Nursemaid W/ Manip.-FAC,4880,CDM,510,RC,24640,HCPCS,outpatient,,,141.79,106.34,,127.61,90,,,percent of total billed charges,90% of total billed charges,131.86,93,,,percent of total billed charges,93% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,53.88,38,,,percent of total billed charges,38% of total billed charges,115.42,81.4,,,percent of total billed charges,81.4% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,127.61,90,,,percent of total billed charges,90% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,53.88,38,,,percent of total billed charges,38% of total billed charges,106.34,75,,,percent of total billed charges,75% of total billed charges,120.52,85,,,percent of total billed charges,85% of total billed charges,53.88,131.86,
FRX-Radial Head W/O Manip-PRO,4883,CDM,982,RC,24650,HCPCS,outpatient,,,363.24,272.43,,309.53,130,,,fee schedule,130% of fee schedule,309.53,130,,,fee schedule,130% of fee schedule,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,303.07,119,,,fee schedule,119% of fee schedule,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,100% of fee schedule,326.92,90,,,percent of total billed charges,90% of total billed charges,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,262.41,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,262.41,100,,,fee schedule,100% of fee schedule,143.72,326.92,
FRX-radial shaft-clsd-w/o manip-PRO,4893,CDM,982,RC,25500,HCPCS,outpatient,,,369.13,276.85,,321.26,130,,,fee schedule,130% of fee schedule,321.26,130,,,fee schedule,130% of fee schedule,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,315.31,119,,,fee schedule,119% of fee schedule,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,100% of fee schedule,332.22,90,,,percent of total billed charges,90% of total billed charges,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,274.35,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,274.35,100,,,fee schedule,100% of fee schedule,93.42,332.22,
FRX-Ulnar Shaft closed w/o manip-PRO,4897,CDM,982,RC,25530,HCPCS,outpatient,,,362.07,271.55,,305.59,130,,,fee schedule,130% of fee schedule,305.59,130,,,fee schedule,130% of fee schedule,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,299.68,119,,,fee schedule,119% of fee schedule,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,100% of fee schedule,325.86,90,,,percent of total billed charges,90% of total billed charges,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,259.4,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,259.4,100,,,fee schedule,100% of fee schedule,186.84,325.86,
FRX-Radial/Ulnar Shaft w/o manip-PRO,4901,CDM,982,RC,25560,HCPCS,outpatient,,,374.97,281.23,,321.1,130,,,fee schedule,130% of fee schedule,321.1,130,,,fee schedule,130% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,317.98,119,,,fee schedule,119% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,100% of fee schedule,337.47,90,,,percent of total billed charges,90% of total billed charges,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,276.06,100,,,fee schedule,100% of fee schedule,186.84,337.47,
FRX-Radial/Ulnar Shaft w/o manip-PRO,4902,CDM,982,RC,25560,HCPCS,outpatient,,,374.97,281.23,,321.1,130,,,fee schedule,130% of fee schedule,321.1,130,,,fee schedule,130% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,317.98,119,,,fee schedule,119% of fee schedule,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,100% of fee schedule,337.47,90,,,percent of total billed charges,90% of total billed charges,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,276.06,100,,,fee schedule,Pays 100% Medicare OPPS,186.84,100,,,fee schedule,100% of fee schedule,276.06,100,,,fee schedule,100% of fee schedule,186.84,337.47,
FRX-Distal Radial W/O Manip-PRO,4907,CDM,982,RC,25600,HCPCS,outpatient,,,468.7,351.53,,346.15,130,,,fee schedule,130% of fee schedule,346.15,130,,,fee schedule,130% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,395.13,119,,,fee schedule,119% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,100% of fee schedule,421.83,90,,,percent of total billed charges,90% of total billed charges,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,346.59,100,,,fee schedule,100% of fee schedule,215.58,421.83,
FRX-Carpal Bone W/O Manip-PRO,4916,CDM,982,RC,25630,HCPCS,outpatient,,,377.3,282.98,,364.27,130,,,fee schedule,130% of fee schedule,364.27,130,,,fee schedule,130% of fee schedule,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,353.3,119,,,fee schedule,119% of fee schedule,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,100% of fee schedule,339.57,90,,,percent of total billed charges,90% of total billed charges,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,302.45,100,,,fee schedule,Pays 100% Medicare OPPS,251.51,100,,,fee schedule,100% of fee schedule,302.45,100,,,fee schedule,100% of fee schedule,251.51,364.27,
FRX-Metacarpal closed w/o manip (each)-PRO,4935,CDM,982,RC,26600,HCPCS,outpatient,,,343.33,257.5,,357.14,130,,,fee schedule,130% of fee schedule,357.14,130,,,fee schedule,130% of fee schedule,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,351.24,119,,,fee schedule,119% of fee schedule,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,100% of fee schedule,309,90,,,percent of total billed charges,90% of total billed charges,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,306.37,100,,,fee schedule,100% of fee schedule,107.79,357.14,
"FRX-Single; W/ Manip ,Each Bone-PRO",4938,CDM,982,RC,26605,HCPCS,outpatient,,,406.6,304.95,,381.15,130,,,fee schedule,130% of fee schedule,381.15,130,,,fee schedule,130% of fee schedule,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,367.5,119,,,fee schedule,119% of fee schedule,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,100% of fee schedule,365.94,90,,,percent of total billed charges,90% of total billed charges,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,316.68,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,316.68,100,,,fee schedule,100% of fee schedule,172.46,381.15,
FRX/DIS-Carpo:Thumb W/ Manip-PRO,4942,CDM,982,RC,26645,HCPCS,outpatient,,,529.65,397.24,,512.14,130,,,fee schedule,130% of fee schedule,512.14,130,,,fee schedule,130% of fee schedule,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,490.76,119,,,fee schedule,119% of fee schedule,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,100% of fee schedule,476.69,90,,,percent of total billed charges,90% of total billed charges,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,415.75,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,415.75,100,,,fee schedule,100% of fee schedule,287.44,512.14,
"DISL.-METACARP. W/ Manip, W/O Anes-PRO",4945,CDM,982,RC,26700,HCPCS,outpatient,,,401.92,301.44,,385.41,130,,,fee schedule,130% of fee schedule,385.41,130,,,fee schedule,130% of fee schedule,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,383.62,119,,,fee schedule,119% of fee schedule,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,100% of fee schedule,361.73,90,,,percent of total billed charges,90% of total billed charges,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,330.73,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,330.73,100,,,fee schedule,100% of fee schedule,51.74,385.41,
FRX/DIS-W/ Manip; W/ or W/O Skin/Skele. Tract.-PRO,4951,CDM,982,RC,26725,HCPCS,outpatient,,,430.06,322.55,,397.84,130,,,fee schedule,130% of fee schedule,397.84,130,,,fee schedule,130% of fee schedule,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,378.84,119,,,fee schedule,119% of fee schedule,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,100% of fee schedule,387.05,90,,,percent of total billed charges,90% of total billed charges,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,322.34,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,322.34,100,,,fee schedule,100% of fee schedule,114.98,397.84,
FRX-Distal phalangeal closed w/o manip-PRO,4955,CDM,982,RC,26750,HCPCS,outpatient,,,254.29,190.72,,235.04,130,,,fee schedule,130% of fee schedule,235.04,130,,,fee schedule,130% of fee schedule,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,232.92,119,,,fee schedule,119% of fee schedule,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,100% of fee schedule,228.86,90,,,percent of total billed charges,90% of total billed charges,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,202.76,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,202.76,100,,,fee schedule,100% of fee schedule,51.74,235.04,
DIS-treatment Inter. Joint W/ Manip.; W/O Anes.-PRO,4962,CDM,982,RC,26770,HCPCS,outpatient,,,380.83,285.62,,324.05,130,,,fee schedule,130% of fee schedule,324.05,130,,,fee schedule,130% of fee schedule,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,320.97,119,,,fee schedule,119% of fee schedule,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,100% of fee schedule,342.75,90,,,percent of total billed charges,90% of total billed charges,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,277.19,100,,,fee schedule,Pays 100% Medicare OPPS,51.74,100,,,fee schedule,100% of fee schedule,277.19,100,,,fee schedule,100% of fee schedule,51.74,342.75,
FRX-Treatment Coccygeal CLSD-PRO,4970,CDM,982,RC,27200,HCPCS,outpatient,,,318.73,239.05,,242.97,130,,,fee schedule,130% of fee schedule,242.97,130,,,fee schedule,130% of fee schedule,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,234.8,119,,,fee schedule,119% of fee schedule,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,100% of fee schedule,286.86,90,,,percent of total billed charges,90% of total billed charges,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,199.2,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,199.2,100,,,fee schedule,100% of fee schedule,114.98,286.86,
"DIS-Hip, Traumatic; W/O Anes.-PRO",4976,CDM,982,RC,27250,HCPCS,outpatient,,,704.24,528.18,,240.21,130,,,fee schedule,130% of fee schedule,240.21,130,,,fee schedule,130% of fee schedule,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,226.8,119,,,fee schedule,119% of fee schedule,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,100% of fee schedule,633.82,90,,,percent of total billed charges,90% of total billed charges,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,178.56,100,,,fee schedule,Pays 100% Medicare OPPS,251.51,100,,,fee schedule,100% of fee schedule,178.56,100,,,fee schedule,100% of fee schedule,178.56,633.82,
FRX-Patellar W/O Manip-PRO,4995,CDM,982,RC,27520,HCPCS,outpatient,,,453.48,340.11,,383.25,130,,,fee schedule,130% of fee schedule,383.25,130,,,fee schedule,130% of fee schedule,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,371.42,119,,,fee schedule,119% of fee schedule,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,100% of fee schedule,408.13,90,,,percent of total billed charges,90% of total billed charges,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,320.14,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,320.14,100,,,fee schedule,100% of fee schedule,194.02,408.13,
"FRX-Tibial, Proximal; W/O Mantip-PRO",4998,CDM,982,RC,27530,HCPCS,outpatient,,,568.3,426.23,,484.68,130,,,fee schedule,130% of fee schedule,484.68,130,,,fee schedule,130% of fee schedule,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,355,119,,,fee schedule,119% of fee schedule,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,100% of fee schedule,511.47,90,,,percent of total billed charges,90% of total billed charges,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,308.26,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,308.26,100,,,fee schedule,100% of fee schedule,215.58,511.47,
DIS-Treatment of Knee W/O Anes.-PRO,5001,CDM,982,RC,27550,HCPCS,outpatient,,,651.5,488.63,,602.85,130,,,fee schedule,130% of fee schedule,602.85,130,,,fee schedule,130% of fee schedule,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,604.35,119,,,fee schedule,119% of fee schedule,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,100% of fee schedule,586.35,90,,,percent of total billed charges,90% of total billed charges,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,493.76,100,,,fee schedule,Pays 100% Medicare OPPS,143.72,100,,,fee schedule,100% of fee schedule,493.76,100,,,fee schedule,100% of fee schedule,143.72,604.35,
FRX-Tibial Shaft closed w/o manip-PRO,5008,CDM,982,RC,27750,HCPCS,outpatient,,,489.8,367.35,,413.06,130,,,fee schedule,130% of fee schedule,413.06,130,,,fee schedule,130% of fee schedule,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,399.02,119,,,fee schedule,119% of fee schedule,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,100% of fee schedule,440.82,90,,,percent of total billed charges,90% of total billed charges,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,258.7,100,,,fee schedule,100% of fee schedule,342.25,100,,,fee schedule,100% of fee schedule,258.7,440.82,
FRX-Distal Fibular closed w/o manip-PRO,5022,CDM,982,RC,27786,HCPCS,outpatient,,,391.36,293.52,,372.61,130,,,fee schedule,130% of fee schedule,372.61,130,,,fee schedule,130% of fee schedule,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,358.75,119,,,fee schedule,119% of fee schedule,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,100% of fee schedule,352.22,90,,,percent of total billed charges,90% of total billed charges,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,304.95,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,304.95,100,,,fee schedule,100% of fee schedule,215.58,372.61,
FB Removal:Foot;Subcutaneous-PRO,5040,CDM,982,RC,28190,HCPCS,outpatient,,,312.87,234.65,,176.62,130,,,fee schedule,130% of fee schedule,176.62,130,,,fee schedule,130% of fee schedule,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,166.79,119,,,fee schedule,119% of fee schedule,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,100% of fee schedule,281.58,90,,,percent of total billed charges,90% of total billed charges,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,135.14,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,135.14,100,,,fee schedule,100% of fee schedule,93.42,281.58,
FB Removal: Foot; Deep -PRO,5044,CDM,982,RC,28192,HCPCS,outpatient,,,499.18,374.39,,416.87,130,,,fee schedule,130% of fee schedule,416.87,130,,,fee schedule,130% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,390.3,119,,,fee schedule,119% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,100% of fee schedule,449.26,90,,,percent of total billed charges,90% of total billed charges,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,317.35,100,,,fee schedule,100% of fee schedule,179.65,449.26,
FRX/DIS:Foot/Toe; FRX W/O Manip-PRO,5051,CDM,982,RC,28400,HCPCS,outpatient,,,358.57,268.93,,296.58,130,,,fee schedule,130% of fee schedule,296.58,130,,,fee schedule,130% of fee schedule,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,285.27,119,,,fee schedule,119% of fee schedule,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,100% of fee schedule,322.71,90,,,percent of total billed charges,90% of total billed charges,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,242.81,100,,,fee schedule,Pays 100% Medicare OPPS,194.02,100,,,fee schedule,100% of fee schedule,242.81,100,,,fee schedule,100% of fee schedule,194.02,322.71,
FRX/DIS Great Toe Closed w/o manip-PRO,5060,CDM,982,RC,28490,HCPCS,outpatient,,,198.04,148.53,,161.19,130,,,fee schedule,130% of fee schedule,161.19,130,,,fee schedule,130% of fee schedule,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,154.95,119,,,fee schedule,119% of fee schedule,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,100% of fee schedule,178.24,90,,,percent of total billed charges,90% of total billed charges,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,131.96,100,,,fee schedule,Pays 100% Medicare OPPS,64.67,100,,,fee schedule,100% of fee schedule,131.96,100,,,fee schedule,100% of fee schedule,64.67,178.24,
FRX/DIS FT/Toe Phalanx Closed w/o Manip-PRO,5064,CDM,982,RC,28510,HCPCS,outpatient,,,168.74,126.56,,155.36,130,,,fee schedule,130% of fee schedule,155.36,130,,,fee schedule,130% of fee schedule,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,148.9,119,,,fee schedule,119% of fee schedule,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,100% of fee schedule,151.87,90,,,percent of total billed charges,90% of total billed charges,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,126.88,100,,,fee schedule,Pays 100% Medicare OPPS,50.3,100,,,fee schedule,100% of fee schedule,126.88,100,,,fee schedule,100% of fee schedule,50.3,155.36,
Splint/Strap:Torso/Upper;Shldr. to Hand(long)-PRO,5086,CDM,982,RC,29105,HCPCS,outpatient,,,125.38,94.04,,78.23,130,,,fee schedule,130% of fee schedule,78.23,130,,,fee schedule,130% of fee schedule,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,51.82,119,,,fee schedule,119% of fee schedule,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,100% of fee schedule,112.84,90,,,percent of total billed charges,90% of total billed charges,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,42.15,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,42.15,100,,,fee schedule,100% of fee schedule,42.15,112.84,
Splint/Strap:Torso/Upper;Forearm to Splint(short)-PRO,5091,CDM,982,RC,29125,HCPCS,outpatient,,,98.43,73.82,,57.42,130,,,fee schedule,130% of fee schedule,57.42,130,,,fee schedule,130% of fee schedule,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,48.92,119,,,fee schedule,119% of fee schedule,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,100% of fee schedule,88.59,90,,,percent of total billed charges,90% of total billed charges,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,41.43,100,,,fee schedule,100% of fee schedule,35.93,88.59,
Application of finger splint-PRO,5093,CDM,521,RC,29130,HCPCS,outpatient,,,87.88,65.91,,79.09,90,,,percent of total billed charges,90% of total billed charges,81.73,93,,,percent of total billed charges,93% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,74.7,85,,,percent of total billed charges,85% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,71.53,81.4,,,percent of total billed charges,81.4% of total billed charges,79.09,90,,,percent of total billed charges,90% of total billed charges,79.09,90,,,percent of total billed charges,90% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,33.39,38,,,percent of total billed charges,38% of total billed charges,65.91,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,33.39,81.73,
Application of finger splint-PRO,5094,CDM,982,RC,29130,HCPCS,outpatient,,,87.88,65.91,,37.65,130,,,fee schedule,130% of fee schedule,37.65,130,,,fee schedule,130% of fee schedule,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,36.5,119,,,fee schedule,119% of fee schedule,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,100% of fee schedule,79.09,90,,,percent of total billed charges,90% of total billed charges,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,29.69,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,29.69,100,,,fee schedule,100% of fee schedule,29.69,79.09,
Casting:Legs;Below Knee to Toes(short)-PRO,5104,CDM,982,RC,29405,HCPCS,outpatient,,,216.79,162.59,,83.38,130,,,fee schedule,130% of fee schedule,83.38,130,,,fee schedule,130% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,73.17,119,,,fee schedule,119% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,100% of fee schedule,195.11,90,,,percent of total billed charges,90% of total billed charges,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,59.66,100,,,fee schedule,100% of fee schedule,57.49,195.11,
Split/Strap:Ankle/Ft to Calf(Short)-PRO,5112,CDM,982,RC,29515,HCPCS,outpatient,,,101.95,76.46,,64.97,130,,,fee schedule,130% of fee schedule,64.97,130,,,fee schedule,130% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,61.36,119,,,fee schedule,119% of fee schedule,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,100% of fee schedule,91.76,90,,,percent of total billed charges,90% of total billed charges,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,50.24,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,50.24,100,,,fee schedule,100% of fee schedule,43.12,91.76,
"Turb.Inj,FB:Nose;Intranasal-PRO",5131,CDM,982,RC,30300,HCPCS,outpatient,,,180.45,135.34,,168.71,130,,,fee schedule,130% of fee schedule,168.71,130,,,fee schedule,130% of fee schedule,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,141.03,119,,,fee schedule,119% of fee schedule,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,100% of fee schedule,162.41,90,,,percent of total billed charges,90% of total billed charges,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,130.31,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,130.31,100,,,fee schedule,100% of fee schedule,71.86,168.71,
"Control Nose Bleed,ante., simple pkg",5133,CDM,450,RC,30901,HCPCS,outpatient,,,472.23,354.17,,425.01,90,,,percent of total billed charges,90% of total billed charges,439.17,93,,,percent of total billed charges,93% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,401.4,85,,,percent of total billed charges,85% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,384.4,81.4,,,percent of total billed charges,81.4% of total billed charges,425.01,90,,,percent of total billed charges,90% of total billed charges,425.01,90,,,percent of total billed charges,90% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,179.45,38,,,percent of total billed charges,38% of total billed charges,354.17,75,,,percent of total billed charges,75% of total billed charges,401.4,85,,,percent of total billed charges,85% of total billed charges,179.45,439.17,
"Control Nose Bleed,ante., simple pkg",5134,CDM,510,RC,30901,HCPCS,outpatient,,,174.59,130.94,,157.13,90,,,percent of total billed charges,90% of total billed charges,162.37,93,,,percent of total billed charges,93% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,66.34,38,,,percent of total billed charges,38% of total billed charges,142.12,81.4,,,percent of total billed charges,81.4% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,157.13,90,,,percent of total billed charges,90% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,66.34,38,,,percent of total billed charges,38% of total billed charges,130.94,75,,,percent of total billed charges,75% of total billed charges,148.4,85,,,percent of total billed charges,85% of total billed charges,66.34,162.37,
"Control Nose Bleed,ante., simple pkg",5135,CDM,982,RC,30901,HCPCS,outpatient,,,174.59,130.94,,75.96,130,,,fee schedule,130% of fee schedule,75.96,130,,,fee schedule,130% of fee schedule,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,70.2,119,,,fee schedule,119% of fee schedule,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,100% of fee schedule,157.13,90,,,percent of total billed charges,90% of total billed charges,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,56.82,100,,,fee schedule,100% of fee schedule,56.82,157.13,
"Control Nose Bleed,ante., simple-PRO",5137,CDM,982,RC,30901,HCPCS,outpatient,,,106.63,79.97,,75.96,130,,,fee schedule,130% of fee schedule,75.96,130,,,fee schedule,130% of fee schedule,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,70.2,119,,,fee schedule,119% of fee schedule,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,100% of fee schedule,95.97,90,,,percent of total billed charges,90% of total billed charges,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,56.82,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,56.82,100,,,fee schedule,100% of fee schedule,56.82,95.97,
"Control Nose Bleed:Nasal hemo.,hemo.,ante.,Complex-PRO",5140,CDM,982,RC,30903,HCPCS,outpatient,,,119.52,89.64,,109.15,130,,,fee schedule,130% of fee schedule,109.15,130,,,fee schedule,130% of fee schedule,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,97.47,119,,,fee schedule,119% of fee schedule,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,100% of fee schedule,107.57,90,,,percent of total billed charges,90% of total billed charges,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,77.61,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,77.61,100,,,fee schedule,100% of fee schedule,77.61,109.15,
Irrag./Ins./Intro.:Vag Med./Supply:Insert Pessary-PRO,5203,CDM,982,RC,57610,HCPCS,outpatient,,,106.63,79.97,,85.3,80,,,percent of total billed charges,90% of total billed charges,85.3,80,,,percent of total billed charges,93% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,95.97,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,85.3,95.97,
"Spine Punct./Sub.-Space;Spine Punct., Lumbar, Diagnostic-PRO",5215,CDM,982,RC,62270,HCPCS,outpatient,,,227.33,170.5,,102.09,130,,,fee schedule,130% of fee schedule,102.09,130,,,fee schedule,130% of fee schedule,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,76.8,119,,,fee schedule,119% of fee schedule,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,100% of fee schedule,204.6,90,,,percent of total billed charges,90% of total billed charges,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,62.34,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,62.34,100,,,fee schedule,100% of fee schedule,62.34,204.6,
FB Removal:Eye;Conjunctival Superficial-PRO,5234,CDM,982,RC,65205,HCPCS,outpatient,,,77.35,58.01,,58.62,130,,,fee schedule,130% of fee schedule,58.62,130,,,fee schedule,130% of fee schedule,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,36.01,119,,,fee schedule,119% of fee schedule,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,100% of fee schedule,69.62,90,,,percent of total billed charges,90% of total billed charges,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,29.5,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,29.5,100,,,fee schedule,100% of fee schedule,28.74,69.62,
"FB Rmv:Eye;Conj Embedded,Sub./Scleral Nonper.-PRO",5237,CDM,982,RC,65210,HCPCS,outpatient,,,73.83,55.37,,72.46,130,,,fee schedule,130% of fee schedule,72.46,130,,,fee schedule,130% of fee schedule,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.1,119,,,fee schedule,119% of fee schedule,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,100% of fee schedule,66.45,90,,,percent of total billed charges,90% of total billed charges,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,36.44,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,36.44,100,,,fee schedule,100% of fee schedule,36.44,72.46,
"Excis. Proc:Exter. Ear/Canal;Rmv from Canal,W/O Anes.-PRO",5251,CDM,982,RC,69200,HCPCS,outpatient,,,189.84,142.38,,78.16,130,,,fee schedule,130% of fee schedule,78.16,130,,,fee schedule,130% of fee schedule,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,58.19,119,,,fee schedule,119% of fee schedule,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,100% of fee schedule,170.86,90,,,percent of total billed charges,90% of total billed charges,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,48.05,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,48.05,100,,,fee schedule,100% of fee schedule,48.05,170.86,
"Remove impacted Cerumen, 1 or both-PRO",5257,CDM,982,RC,69210,HCPCS,outpatient,,,70.31,52.73,,44.33,130,,,fee schedule,130% of fee schedule,44.33,130,,,fee schedule,130% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,41.22,119,,,fee schedule,119% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,100% of fee schedule,63.28,90,,,percent of total billed charges,90% of total billed charges,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,32.89,100,,,fee schedule,100% of fee schedule,32.89,63.28,
Office Visit New Brief -PRO,5351,CDM,982,RC,99202,HCPCS,outpatient,,,83.21,62.41,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,74.89,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,74.89,
Office Visit New Int. -PRO,5365,CDM,982,RC,99203,HCPCS,outpatient,,,139.45,104.59,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,125.51,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,125.51,
Office Visit New Ext. + -PRO,5387,CDM,982,RC,99205,HCPCS,outpatient,,,232.01,174.01,,218.79,130,,,fee schedule,130% of fee schedule,218.79,130,,,fee schedule,130% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,206.02,119,,,fee schedule,119% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,100% of fee schedule,208.81,90,,,percent of total billed charges,90% of total billed charges,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.8,100,,,fee schedule,100% of fee schedule,182.36,100,,,fee schedule,100% of fee schedule,143.8,218.79,
OFFICE CONSULT-MINOR- 15 MIN,5463,CDM,982,RC,99241,HCPCS,outpatient,,,199.21,149.41,,42.02,130,,,fee schedule,130% of fee schedule,42.02,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,40.07,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,179.29,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,53.93,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,40.07,179.29,
OFFICE CONSULT-MOD/HIGH-60 MIN,5480,CDM,982,RC,99244,HCPCS,outpatient,,,419.5,314.63,,194.19,130,,,fee schedule,130% of fee schedule,194.19,130,,,fee schedule,130% of fee schedule,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,189.98,119,,,fee schedule,119% of fee schedule,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,100% of fee schedule,377.55,90,,,percent of total billed charges,90% of total billed charges,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,136.76,100,,,fee schedule,Pays 100% Medicare OPPS,125.83,100,,,fee schedule,100% of fee schedule,136.76,100,,,fee schedule,100% of fee schedule,125.83,377.55,
OFFICE CONSULT-HIGH-HIGH-80 MIN,5485,CDM,982,RC,99245,HCPCS,outpatient,,,523.78,392.84,,241.07,130,,,fee schedule,130% of fee schedule,241.07,130,,,fee schedule,130% of fee schedule,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,234.79,119,,,fee schedule,119% of fee schedule,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,100% of fee schedule,471.4,90,,,percent of total billed charges,90% of total billed charges,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,100,,,fee schedule,Pays 100% Medicare OPPS,230.08,100,,,fee schedule,100% of fee schedule,182.75,100,,,fee schedule,100% of fee schedule,182.75,471.4,
"Nursing Facility ;Mod  SB,NH PRO",5513,CDM,982,RC,99305,HCPCS,outpatient,,,189.84,142.38,,169.73,130,,,fee schedule,130% of fee schedule,169.73,130,,,fee schedule,130% of fee schedule,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,157.88,119,,,fee schedule,119% of fee schedule,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,100% of fee schedule,170.86,90,,,percent of total billed charges,90% of total billed charges,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,134.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,134.83,100,,,fee schedule,100% of fee schedule,134.83,170.86,
Nursing Facility ;High-SB NH PRO,5516,CDM,982,RC,99306,HCPCS,outpatient,,,318.73,239.05,,216.44,130,,,fee schedule,130% of fee schedule,216.44,130,,,fee schedule,130% of fee schedule,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,203.56,119,,,fee schedule,119% of fee schedule,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,100% of fee schedule,286.86,90,,,percent of total billed charges,90% of total billed charges,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,184.2,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,184.2,100,,,fee schedule,100% of fee schedule,184.2,286.86,
*EKG Facility Charge,255,CDM,510,RC,93005,HCPCS,outpatient,,,138.27,103.7,,124.44,90,,,percent of total billed charges,90% of total billed charges,128.59,93,,,percent of total billed charges,93% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,52.54,38,,,percent of total billed charges,38% of total billed charges,112.55,81.4,,,percent of total billed charges,81.4% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,124.44,90,,,percent of total billed charges,90% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,52.54,38,,,percent of total billed charges,38% of total billed charges,103.7,75,,,percent of total billed charges,75% of total billed charges,117.53,85,,,percent of total billed charges,85% of total billed charges,52.54,128.59,
EKG-Welcome to Medicare -global,260,CDM,985,RC,G0403,HCPCS,outpatient,,,183.98,137.99,,22.91,130,,,fee schedule,130% of fee schedule,22.91,130,,,fee schedule,130% of fee schedule,14.86,100,,,fee schedule,Pays 100% Medicare OPPS,14.86,100,,,fee schedule,Pays 100% Medicare OPPS,20.93,119,,,fee schedule,119% of fee schedule,14.86,100,,,fee schedule,Pays 100% Medicare OPPS,14.86,100,,,fee schedule,100% of fee schedule,165.58,90,,,percent of total billed charges,90% of total billed charges,14.86,100,,,fee schedule,Pays 100% Medicare OPPS,14.86,100,,,fee schedule,Pays 100% Medicare OPPS,14.86,100,,,fee schedule,Pays 100% Medicare OPPS,14.86,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,14.86,100,,,fee schedule,100% of fee schedule,14.86,165.58,
I&D Abcess Simple or Single (SQ)-Fac,266,CDM,521,RC,10060,HCPCS,outpatient,,,263.65,197.74,,237.29,90,,,percent of total billed charges,90% of total billed charges,245.19,93,,,percent of total billed charges,93% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,224.1,85,,,percent of total billed charges,85% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,214.61,81.4,,,percent of total billed charges,81.4% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,237.29,90,,,percent of total billed charges,90% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,100.19,38,,,percent of total billed charges,38% of total billed charges,197.74,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,100.19,245.19,
I&D multi/complex-Fac,268,CDM,510,RC,10061,HCPCS,outpatient,,,438.24,328.68,,394.42,90,,,percent of total billed charges,90% of total billed charges,407.56,93,,,percent of total billed charges,93% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,166.53,38,,,percent of total billed charges,38% of total billed charges,356.73,81.4,,,percent of total billed charges,81.4% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,394.42,90,,,percent of total billed charges,90% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,166.53,38,,,percent of total billed charges,38% of total billed charges,328.68,75,,,percent of total billed charges,75% of total billed charges,372.5,85,,,percent of total billed charges,85% of total billed charges,166.53,407.56,
Debridement - Skin 20 Sq cm or< fac,278,CDM,521,RC,11042,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,42.79,104.73,
Debridement - Skin 20 Sq cm or< fac,279,CDM,521,RC,11042,HCPCS,outpatient,,,112.61,84.46,,101.35,90,,,percent of total billed charges,90% of total billed charges,104.73,93,,,percent of total billed charges,93% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,95.72,85,,,percent of total billed charges,85% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,91.66,81.4,,,percent of total billed charges,81.4% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,101.35,90,,,percent of total billed charges,90% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,42.79,38,,,percent of total billed charges,38% of total billed charges,84.46,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,42.79,104.73,
Debridement - Bone <20cm-FAC,282,CDM,521,RC,11044,HCPCS,outpatient,,,1013.54,760.16,,912.19,90,,,percent of total billed charges,90% of total billed charges,942.59,93,,,percent of total billed charges,93% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,861.51,85,,,percent of total billed charges,85% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,825.02,81.4,,,percent of total billed charges,81.4% of total billed charges,912.19,90,,,percent of total billed charges,90% of total billed charges,912.19,90,,,percent of total billed charges,90% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,385.15,38,,,percent of total billed charges,38% of total billed charges,760.16,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,385.15,942.59,
"Exc,Skin,Mal-(tr,a,l);0.6-1.0cm-FAC",329,CDM,510,RC,11601,HCPCS,outpatient,,,133.59,100.19,,120.23,90,,,percent of total billed charges,90% of total billed charges,124.24,93,,,percent of total billed charges,93% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,50.76,38,,,percent of total billed charges,38% of total billed charges,108.74,81.4,,,percent of total billed charges,81.4% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,120.23,90,,,percent of total billed charges,90% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,50.76,38,,,percent of total billed charges,38% of total billed charges,100.19,75,,,percent of total billed charges,75% of total billed charges,113.55,85,,,percent of total billed charges,85% of total billed charges,50.76,124.24,
Asp/Inj-Major joint (w/o ultra)-FAC,485,CDM,982,RC,20610,HCPCS,outpatient,,,270.16,202.62,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,243.14,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,243.14,
FRX-Distal Radial closed w/manip-FAC,535,CDM,360,RC,25605,HCPCS,outpatient,,,1591.28,1193.46,,1432.15,90,,,percent of total billed charges,90% of total billed charges,1479.89,93,,,percent of total billed charges,93% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,1352.59,85,,,percent of total billed charges,85% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,1295.3,81.4,,,percent of total billed charges,81.4% of total billed charges,1432.15,90,,,percent of total billed charges,90% of total billed charges,1432.15,90,,,percent of total billed charges,90% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,604.69,38,,,percent of total billed charges,38% of total billed charges,1193.46,75,,,percent of total billed charges,75% of total billed charges,1352.59,85,,,percent of total billed charges,85% of total billed charges,604.69,1479.89,
FRX-Tibial Shaft closed w/o manip-FAC,581,CDM,510,RC,27750,HCPCS,outpatient,,,496.83,372.62,,447.15,90,,,percent of total billed charges,90% of total billed charges,462.05,93,,,percent of total billed charges,93% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,188.8,38,,,percent of total billed charges,38% of total billed charges,404.42,81.4,,,percent of total billed charges,81.4% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,447.15,90,,,percent of total billed charges,90% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,188.8,38,,,percent of total billed charges,38% of total billed charges,372.62,75,,,percent of total billed charges,75% of total billed charges,422.31,85,,,percent of total billed charges,85% of total billed charges,188.8,462.05,
FB Removal From foot/deep-Fac,600,CDM,360,RC,28192,HCPCS,outpatient,,,2345.88,1759.41,,2111.29,90,,,percent of total billed charges,90% of total billed charges,2181.67,93,,,percent of total billed charges,93% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,1994,85,,,percent of total billed charges,85% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,1909.55,81.4,,,percent of total billed charges,81.4% of total billed charges,2111.29,90,,,percent of total billed charges,90% of total billed charges,2111.29,90,,,percent of total billed charges,90% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,891.43,38,,,percent of total billed charges,38% of total billed charges,1759.41,75,,,percent of total billed charges,75% of total billed charges,1994,85,,,percent of total billed charges,85% of total billed charges,891.43,2181.67,
Splint/Strap:Torso/Upper;Shldr. to Hand(long)FAC,616,CDM,510,RC,29105,HCPCS,outpatient,,,92.57,69.43,,83.31,90,,,percent of total billed charges,90% of total billed charges,86.09,93,,,percent of total billed charges,93% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,35.18,38,,,percent of total billed charges,38% of total billed charges,75.35,81.4,,,percent of total billed charges,81.4% of total billed charges,83.31,90,,,percent of total billed charges,90% of total billed charges,83.31,90,,,percent of total billed charges,90% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,35.18,38,,,percent of total billed charges,38% of total billed charges,69.43,75,,,percent of total billed charges,75% of total billed charges,78.68,85,,,percent of total billed charges,85% of total billed charges,35.18,86.09,
Application of finger splint-Fac,619,CDM,510,RC,29130,HCPCS,outpatient,,,64.44,48.33,,58,90,,,percent of total billed charges,90% of total billed charges,59.93,93,,,percent of total billed charges,93% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,24.49,38,,,percent of total billed charges,38% of total billed charges,52.45,81.4,,,percent of total billed charges,81.4% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,58,90,,,percent of total billed charges,90% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,24.49,38,,,percent of total billed charges,38% of total billed charges,48.33,75,,,percent of total billed charges,75% of total billed charges,54.77,85,,,percent of total billed charges,85% of total billed charges,24.49,59.93,
Splint/Strap:Ankle/FT-Calf(Short)-Fac,629,CDM,510,RC,29515,HCPCS,outpatient,,,186.31,139.73,,167.68,90,,,percent of total billed charges,90% of total billed charges,173.27,93,,,percent of total billed charges,93% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,70.8,38,,,percent of total billed charges,38% of total billed charges,151.66,81.4,,,percent of total billed charges,81.4% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,139.73,75,,,percent of total billed charges,75% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,173.27,
Control of nosebleed-simple anterior-Fac,637,CDM,510,RC,30901,HCPCS,outpatient,,,219.13,164.35,,197.22,90,,,percent of total billed charges,90% of total billed charges,203.79,93,,,percent of total billed charges,93% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,83.27,38,,,percent of total billed charges,38% of total billed charges,178.37,81.4,,,percent of total billed charges,81.4% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,197.22,90,,,percent of total billed charges,90% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,83.27,38,,,percent of total billed charges,38% of total billed charges,164.35,75,,,percent of total billed charges,75% of total billed charges,186.26,85,,,percent of total billed charges,85% of total billed charges,83.27,203.79,
Peritoneal lavage - FAC,677,CDM,761,RC,49084,HCPCS,outpatient,,,1674.6,1255.95,,1507.14,90,,,percent of total billed charges,90% of total billed charges,1557.38,93,,,percent of total billed charges,93% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,636.35,38,,,percent of total billed charges,38% of total billed charges,1363.12,81.4,,,percent of total billed charges,81.4% of total billed charges,1507.14,90,,,percent of total billed charges,90% of total billed charges,1507.14,90,,,percent of total billed charges,90% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,636.35,38,,,percent of total billed charges,38% of total billed charges,1255.95,75,,,percent of total billed charges,75% of total billed charges,1423.41,85,,,percent of total billed charges,85% of total billed charges,636.35,1557.38,
Insert urinary catheter straight,681,CDM,521,RC,51701,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,78.37,191.79,
Insert urinary catheter straight,682,CDM,510,RC,51701,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,191.79,
Insert Foley urinary catheter-Fac,684,CDM,510,RC,51702,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,191.79,
Insert Foley urinary catheter-Fac,685,CDM,521,RC,51702,HCPCS,outpatient,,,206.23,154.67,,185.61,90,,,percent of total billed charges,90% of total billed charges,191.79,93,,,percent of total billed charges,93% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,175.3,85,,,percent of total billed charges,85% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,167.87,81.4,,,percent of total billed charges,81.4% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,185.61,90,,,percent of total billed charges,90% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,78.37,38,,,percent of total billed charges,38% of total billed charges,154.67,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,78.37,191.79,
Bladder Scan - FAC Hospital,688,CDM,120,RC,51798,HCPCS,inpatient,,,126.12,94.59,,113.51,90,,,percent of total billed charges,90% of total billed charges,117.29,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,113.51,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,105.56,83.7,,,percent of total billed charges,83.7% of total billed charges,113.51,90,,,percent of total billed charges,90% of total billed charges,113.51,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,105.56,2506,
Defibrillation (Cardioversion)-Fac,725,CDM,120,RC,92960,HCPCS,inpatient,,,421.83,316.37,,379.65,90,,,percent of total billed charges,90% of total billed charges,392.3,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,379.65,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,353.07,83.7,,,percent of total billed charges,83.7% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,353.07,2506,
Defibrillation (Cardioversion)-Fac,726,CDM,761,RC,92960,HCPCS,outpatient,,,421.83,316.37,,379.65,90,,,percent of total billed charges,90% of total billed charges,392.3,93,,,percent of total billed charges,93% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,160.3,38,,,percent of total billed charges,38% of total billed charges,343.37,81.4,,,percent of total billed charges,81.4% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,379.65,90,,,percent of total billed charges,90% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,160.3,38,,,percent of total billed charges,38% of total billed charges,316.37,75,,,percent of total billed charges,75% of total billed charges,358.56,85,,,percent of total billed charges,85% of total billed charges,160.3,392.3,
"IV infusion hydration, ea add hr up to 8-Fac",733,CDM,761,RC,96361,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
"IV infusion hydration, ea add hr up to 8-Fac",734,CDM,761,RC,96361,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
"IV infusion hydration, ea add hr up to 8-Fac",735,CDM,510,RC,96361,HCPCS,outpatient,,,85.54,64.16,,76.99,90,,,percent of total billed charges,90% of total billed charges,79.55,93,,,percent of total billed charges,93% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,32.51,38,,,percent of total billed charges,38% of total billed charges,69.63,81.4,,,percent of total billed charges,81.4% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,76.99,90,,,percent of total billed charges,90% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,32.51,38,,,percent of total billed charges,38% of total billed charges,64.16,75,,,percent of total billed charges,75% of total billed charges,72.71,85,,,percent of total billed charges,85% of total billed charges,32.51,79.55,
"IV infusion therapy, 1 hour",740,CDM,521,RC,96365,HCPCS,outpatient,,,276.53,207.4,,248.88,90,,,percent of total billed charges,90% of total billed charges,257.17,93,,,percent of total billed charges,93% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,235.05,85,,,percent of total billed charges,85% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,225.1,81.4,,,percent of total billed charges,81.4% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,248.88,90,,,percent of total billed charges,90% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,105.08,38,,,percent of total billed charges,38% of total billed charges,207.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,105.08,257.17,
IM injection/SQ injection-Fac,745,CDM,761,RC,96372,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
IM injection/SQ injection-Fac,746,CDM,521,RC,96372,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,16.92,41.41,
IM injection/SQ injection-Fac,747,CDM,710,RC,96372,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
IM injection/SQ injection-Fac,748,CDM,510,RC,96372,HCPCS,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
Debridement - Skin 20 Sq cm or< PRO,3804,CDM,981,RC,11042,HCPCS,outpatient,,,406.06,304.55,,67.16,130,,,fee schedule,130% of fee schedule,67.16,130,,,fee schedule,130% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,75.54,119,,,fee schedule,119% of fee schedule,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,100% of fee schedule,365.45,90,,,percent of total billed charges,90% of total billed charges,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,60.41,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,60.41,100,,,fee schedule,100% of fee schedule,60.41,365.45,
Debridement - Skin 20 Sq cm or< PRO,3806,CDM,521,RC,11042,HCPCS,outpatient,,,406.06,304.55,,365.45,90,,,percent of total billed charges,90% of total billed charges,377.64,93,,,percent of total billed charges,93% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,345.15,85,,,percent of total billed charges,85% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,330.53,81.4,,,percent of total billed charges,81.4% of total billed charges,365.45,90,,,percent of total billed charges,90% of total billed charges,365.45,90,,,percent of total billed charges,90% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,304.55,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,154.3,377.64,
Debridement - Skin 20 Sq cm or< PRO,3807,CDM,521,RC,11042,HCPCS,outpatient,,,406.06,304.55,,365.45,90,,,percent of total billed charges,90% of total billed charges,377.64,93,,,percent of total billed charges,93% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,345.15,85,,,percent of total billed charges,85% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,330.53,81.4,,,percent of total billed charges,81.4% of total billed charges,365.45,90,,,percent of total billed charges,90% of total billed charges,365.45,90,,,percent of total billed charges,90% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,154.3,38,,,percent of total billed charges,38% of total billed charges,304.55,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,154.3,377.64,
WC remove devit tis 20cm< Pro,3894,CDM,521,RC,97597,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,20.98,51.34,
Anes for cardioversion,3910,CDM,120,RC,410,HCPCS,inpatient,,,57.43,43.07,,51.69,90,,,percent of total billed charges,90% of total billed charges,53.41,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,51.69,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,48.07,83.7,,,percent of total billed charges,83.7% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,51.69,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,48.07,2506,
Biopsy tangential ea add FAC,3918,CDM,450,RC,11103,HCPCS,outpatient,,,55.2,41.4,,49.68,90,,,percent of total billed charges,90% of total billed charges,51.34,93,,,percent of total billed charges,93% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,44.93,81.4,,,percent of total billed charges,81.4% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,20.98,38,,,percent of total billed charges,38% of total billed charges,41.4,75,,,percent of total billed charges,75% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,20.98,51.34,
Biopsy Punch-Fac,3920,CDM,450,RC,11104,HCPCS,outpatient,,,242.9,182.18,,218.61,90,,,percent of total billed charges,90% of total billed charges,225.9,93,,,percent of total billed charges,93% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,206.47,85,,,percent of total billed charges,85% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,197.72,81.4,,,percent of total billed charges,81.4% of total billed charges,218.61,90,,,percent of total billed charges,90% of total billed charges,218.61,90,,,percent of total billed charges,90% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,92.3,38,,,percent of total billed charges,38% of total billed charges,182.18,75,,,percent of total billed charges,75% of total billed charges,206.47,85,,,percent of total billed charges,85% of total billed charges,92.3,225.9,
Biopsy Punch each add Pro,3922,CDM,981,RC,11105,HCPCS,outpatient,,,69.56,52.17,,55.65,80,,,percent of total billed charges,90% of total billed charges,55.65,80,,,percent of total billed charges,93% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,32.8,119,,,fee schedule,119% of fee schedule,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,100% of fee schedule,62.6,90,,,percent of total billed charges,90% of total billed charges,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,25.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.84,100,,,fee schedule,100% of fee schedule,25.84,62.6,
Biopsy punch each add Fac,3924,CDM,450,RC,11105,HCPCS,outpatient,,,88.32,66.24,,79.49,90,,,percent of total billed charges,90% of total billed charges,82.14,93,,,percent of total billed charges,93% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,75.07,85,,,percent of total billed charges,85% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,71.89,81.4,,,percent of total billed charges,81.4% of total billed charges,79.49,90,,,percent of total billed charges,90% of total billed charges,79.49,90,,,percent of total billed charges,90% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,33.56,38,,,percent of total billed charges,38% of total billed charges,66.24,75,,,percent of total billed charges,75% of total billed charges,75.07,85,,,percent of total billed charges,85% of total billed charges,33.56,82.14,
Biopsy Incisional Facility,3926,CDM,450,RC,11106,HCPCS,outpatient,,,331.22,248.42,,298.1,90,,,percent of total billed charges,90% of total billed charges,308.03,93,,,percent of total billed charges,93% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,281.54,85,,,percent of total billed charges,85% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,269.61,81.4,,,percent of total billed charges,81.4% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,298.1,90,,,percent of total billed charges,90% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,125.86,38,,,percent of total billed charges,38% of total billed charges,248.42,75,,,percent of total billed charges,75% of total billed charges,281.54,85,,,percent of total billed charges,85% of total billed charges,125.86,308.03,
Biopsy incisional ea add FAC,3928,CDM,450,RC,11107,HCPCS,outpatient,,,165.61,124.21,,149.05,90,,,percent of total billed charges,90% of total billed charges,154.02,93,,,percent of total billed charges,93% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,134.81,81.4,,,percent of total billed charges,81.4% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,149.05,90,,,percent of total billed charges,90% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,62.93,38,,,percent of total billed charges,38% of total billed charges,124.21,75,,,percent of total billed charges,75% of total billed charges,140.77,85,,,percent of total billed charges,85% of total billed charges,62.93,154.02,
"Asp./Inj Joint; Major(s,h,k) BILATERAL -Facility",3934,CDM,450,RC,20610,HCPCS,outpatient,,,208.57,156.43,,187.71,90,,,percent of total billed charges,90% of total billed charges,193.97,93,,,percent of total billed charges,93% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,177.28,85,,,percent of total billed charges,85% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,169.78,81.4,,,percent of total billed charges,81.4% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,187.71,90,,,percent of total billed charges,90% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,79.26,38,,,percent of total billed charges,38% of total billed charges,156.43,75,,,percent of total billed charges,75% of total billed charges,177.28,85,,,percent of total billed charges,85% of total billed charges,79.26,193.97,
FRX/Dislocation-Finger/Thumb; W manip-FAC,3937,CDM,450,RC,26755,HCPCS,outpatient,,,591.74,443.81,,532.57,90,,,percent of total billed charges,90% of total billed charges,550.32,93,,,percent of total billed charges,93% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,481.68,81.4,,,percent of total billed charges,81.4% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,532.57,90,,,percent of total billed charges,90% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,224.86,38,,,percent of total billed charges,38% of total billed charges,443.81,75,,,percent of total billed charges,75% of total billed charges,502.98,85,,,percent of total billed charges,85% of total billed charges,224.86,550.32,
Office Visit Est. Brief-FAC,3954,CDM,761,RC,99212,HCPCS,outpatient,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
PM INJECT TRIGGER POINTS 3/> FAC,3967,CDM,988,RC,20553,HCPCS,outpatient,,,97.42,73.07,,56.45,130,,,fee schedule,130% of fee schedule,56.45,130,,,fee schedule,130% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,53.9,119,,,fee schedule,119% of fee schedule,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,100% of fee schedule,87.68,90,,,percent of total billed charges,90% of total billed charges,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,42.83,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,42.83,100,,,fee schedule,100% of fee schedule,42.83,87.68,
I&D Abcess Simple or Single[Package],4196,CDM,982,RC,10060,HCPCS,outpatient,,,225,168.75,,125.29,130,,,fee schedule,130% of fee schedule,125.29,130,,,fee schedule,130% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,124.88,119,,,fee schedule,119% of fee schedule,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,100% of fee schedule,202.5,90,,,percent of total billed charges,90% of total billed charges,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,108.83,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,108.83,100,,,fee schedule,100% of fee schedule,57.49,202.5,
I&D Abcess Simple or Single (SQ)-PRO,4202,CDM,521,RC,10060,HCPCS,outpatient,,,255.45,191.59,,229.91,90,,,percent of total billed charges,90% of total billed charges,237.57,93,,,percent of total billed charges,93% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,217.13,85,,,percent of total billed charges,85% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,207.94,81.4,,,percent of total billed charges,81.4% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,229.91,90,,,percent of total billed charges,90% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,97.07,38,,,percent of total billed charges,38% of total billed charges,191.59,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,97.07,237.57,
I&D Complicated or Multiple[Package],4205,CDM,982,RC,10061,HCPCS,outpatient,,,397.24,297.93,,212.82,130,,,fee schedule,130% of fee schedule,212.82,130,,,fee schedule,130% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,225.9,119,,,fee schedule,119% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,100% of fee schedule,357.52,90,,,percent of total billed charges,90% of total billed charges,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,188.32,100,,,fee schedule,100% of fee schedule,114.98,357.52,
I&D Complicated or Multiple[Package],4206,CDM,510,RC,10061,HCPCS,outpatient,,,397.24,297.93,,357.52,90,,,percent of total billed charges,90% of total billed charges,369.43,93,,,percent of total billed charges,93% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,150.95,38,,,percent of total billed charges,38% of total billed charges,323.35,81.4,,,percent of total billed charges,81.4% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,357.52,90,,,percent of total billed charges,90% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,150.95,38,,,percent of total billed charges,38% of total billed charges,297.93,75,,,percent of total billed charges,75% of total billed charges,337.65,85,,,percent of total billed charges,85% of total billed charges,150.95,369.43,
I&D multi/complex-PRO,4210,CDM,982,RC,10061,HCPCS,outpatient,,,263.65,197.74,,212.82,130,,,fee schedule,130% of fee schedule,212.82,130,,,fee schedule,130% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,225.9,119,,,fee schedule,119% of fee schedule,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,100% of fee schedule,237.29,90,,,percent of total billed charges,90% of total billed charges,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,188.32,100,,,fee schedule,Pays 100% Medicare OPPS,114.98,100,,,fee schedule,100% of fee schedule,188.32,100,,,fee schedule,100% of fee schedule,114.98,237.29,
FB Removal/Incision[Package],4214,CDM,982,RC,10120,HCPCS,outpatient,,,223.81,167.86,,122.29,130,,,fee schedule,130% of fee schedule,122.29,130,,,fee schedule,130% of fee schedule,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,127.98,119,,,fee schedule,119% of fee schedule,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,100% of fee schedule,201.43,90,,,percent of total billed charges,90% of total billed charges,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,108.4,100,,,fee schedule,Pays 100% Medicare OPPS,71.86,100,,,fee schedule,100% of fee schedule,108.4,100,,,fee schedule,100% of fee schedule,71.86,201.43,
I&D hematoma/fluid [Package],4221,CDM,982,RC,10140,HCPCS,outpatient,,,2404.49,1803.37,,154.88,130,,,fee schedule,130% of fee schedule,154.88,130,,,fee schedule,130% of fee schedule,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,147.82,119,,,fee schedule,119% of fee schedule,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,100% of fee schedule,2164.04,90,,,percent of total billed charges,90% of total billed charges,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,120.76,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,120.76,100,,,fee schedule,100% of fee schedule,28.74,2164.04,
Debridement - Skin 20 Sq cm or<[Package],4238,CDM,120,RC,11042,HCPCS,inpatient,,,518.68,389.01,,466.81,90,,,percent of total billed charges,90% of total billed charges,482.37,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,466.81,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,434.14,83.7,,,percent of total billed charges,83.7% of total billed charges,466.81,90,,,percent of total billed charges,90% of total billed charges,466.81,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,434.14,2506,
Debridement - Bone <20cm-PRO,4247,CDM,982,RC,11044,HCPCS,outpatient,,,675.69,506.77,,276.35,130,,,fee schedule,130% of fee schedule,276.35,130,,,fee schedule,130% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,281.7,119,,,fee schedule,119% of fee schedule,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,100% of fee schedule,608.12,90,,,percent of total billed charges,90% of total billed charges,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,225.5,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,225.5,100,,,fee schedule,100% of fee schedule,225.5,608.12,
Debridement skin addtn 20 sq cm-PRO,4251,CDM,450,RC,11045,HCPCS,outpatient,,,99.93,74.95,,89.94,90,,,percent of total billed charges,90% of total billed charges,92.93,93,,,percent of total billed charges,93% of total billed charges,37.97,38,,,percent of total billed charges,38% of total billed charges,37.97,38,,,percent of total billed charges,38% of total billed charges,84.94,85,,,percent of total billed charges,85% of total billed charges,37.97,38,,,percent of total billed charges,38% of total billed charges,81.34,81.4,,,percent of total billed charges,81.4% of total billed charges,89.94,90,,,percent of total billed charges,90% of total billed charges,89.94,90,,,percent of total billed charges,90% of total billed charges,37.97,38,,,percent of total billed charges,38% of total billed charges,37.97,38,,,percent of total billed charges,38% of total billed charges,37.97,38,,,percent of total billed charges,38% of total billed charges,74.95,75,,,percent of total billed charges,75% of total billed charges,84.94,85,,,percent of total billed charges,85% of total billed charges,37.97,92.93,
Debridement skin addtn 20 sq cm-PRO,4252,CDM,981,RC,11045,HCPCS,outpatient,,,99.93,74.95,,23.3,130,,,fee schedule,130% of fee schedule,23.3,130,,,fee schedule,130% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,32.95,119,,,fee schedule,119% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,100% of fee schedule,89.94,90,,,percent of total billed charges,90% of total billed charges,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.23,100,,,fee schedule,100% of fee schedule,23.3,89.94,
Deb bone add-on [Package],4257,CDM,120,RC,11047,HCPCS,inpatient,,,1809.94,1357.46,,1628.95,90,,,percent of total billed charges,90% of total billed charges,1683.24,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1628.95,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1514.92,83.7,,,percent of total billed charges,83.7% of total billed charges,1628.95,90,,,percent of total billed charges,90% of total billed charges,1628.95,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,2506,
BIOPSY-tangential (scrape-PRO,4273,CDM,981,RC,11102,HCPCS,outpatient,,,112.61,84.46,,90.09,80,,,percent of total billed charges,90% of total billed charges,90.09,80,,,percent of total billed charges,93% of total billed charges,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,48.3,119,,,fee schedule,119% of fee schedule,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,100% of fee schedule,101.35,90,,,percent of total billed charges,90% of total billed charges,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,38.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,38.24,100,,,fee schedule,100% of fee schedule,38.24,101.35,
Biopsy tangential ea add PRO,4278,CDM,981,RC,11103,HCPCS,outpatient,,,60.72,45.54,,48.58,80,,,percent of total billed charges,90% of total billed charges,48.58,80,,,percent of total billed charges,93% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,28.01,119,,,fee schedule,119% of fee schedule,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,100% of fee schedule,54.65,90,,,percent of total billed charges,90% of total billed charges,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,21.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,21.84,100,,,fee schedule,100% of fee schedule,21.84,54.65,
Biopsy Punch-PRO,4285,CDM,981,RC,11104,HCPCS,outpatient,,,141.32,105.99,,113.06,80,,,percent of total billed charges,90% of total billed charges,113.06,80,,,percent of total billed charges,93% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,60.43,119,,,fee schedule,119% of fee schedule,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,100% of fee schedule,127.19,90,,,percent of total billed charges,90% of total billed charges,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,47.33,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,47.33,100,,,fee schedule,100% of fee schedule,47.33,127.19,
Biopsy Incisional-PRO,4292,CDM,981,RC,11106,HCPCS,outpatient,,,220.81,165.61,,176.65,80,,,percent of total billed charges,90% of total billed charges,176.65,80,,,percent of total billed charges,93% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,73.04,119,,,fee schedule,119% of fee schedule,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,100% of fee schedule,198.73,90,,,percent of total billed charges,90% of total billed charges,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,56.85,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,56.85,100,,,fee schedule,100% of fee schedule,56.85,198.73,
Biopsy Incisional ea add PRO,4296,CDM,981,RC,11107,HCPCS,outpatient,,,81.7,61.28,,65.36,80,,,percent of total billed charges,90% of total billed charges,65.36,80,,,percent of total billed charges,93% of total billed charges,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,39.33,119,,,fee schedule,119% of fee schedule,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,100% of fee schedule,73.53,90,,,percent of total billed charges,90% of total billed charges,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,30.95,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,30.95,100,,,fee schedule,100% of fee schedule,30.95,73.53,
"Shaving,Benign(tr, a, l)=<0.5cm",4308,CDM,510,RC,11300,HCPCS,outpatient,,,127.72,95.79,,114.95,90,,,percent of total billed charges,90% of total billed charges,118.78,93,,,percent of total billed charges,93% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,48.53,38,,,percent of total billed charges,38% of total billed charges,103.96,81.4,,,percent of total billed charges,81.4% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,114.95,90,,,percent of total billed charges,90% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,48.53,38,,,percent of total billed charges,38% of total billed charges,95.79,75,,,percent of total billed charges,75% of total billed charges,108.56,85,,,percent of total billed charges,85% of total billed charges,48.53,118.78,
Debridement of Nail; Nail Plate,4489,CDM,982,RC,11730,HCPCS,outpatient,,,146.47,109.85,,66.83,130,,,fee schedule,130% of fee schedule,66.83,130,,,fee schedule,130% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,67.66,119,,,fee schedule,119% of fee schedule,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,100% of fee schedule,131.82,90,,,percent of total billed charges,90% of total billed charges,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,54.11,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,54.11,100,,,fee schedule,100% of fee schedule,35.93,131.82,
Debrid. of Nail;Evac.;Sub.Hematoma,4496,CDM,982,RC,11740,HCPCS,outpatient,,,77.35,58.01,,42.17,130,,,fee schedule,130% of fee schedule,42.17,130,,,fee schedule,130% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,39.23,119,,,fee schedule,119% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,100% of fee schedule,69.62,90,,,percent of total billed charges,90% of total billed charges,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,32.89,100,,,fee schedule,100% of fee schedule,32.89,69.62,
Debrid. of Nail;Evac.;Sub.Hematoma,4497,CDM,982,RC,11740,HCPCS,outpatient,,,77.35,58.01,,42.17,130,,,fee schedule,130% of fee schedule,42.17,130,,,fee schedule,130% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,39.23,119,,,fee schedule,119% of fee schedule,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,100% of fee schedule,69.62,90,,,percent of total billed charges,90% of total billed charges,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,32.89,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,32.89,100,,,fee schedule,100% of fee schedule,32.89,69.62,
"Excision:Nail/Matrix, Part/Comp.Rmv.",4502,CDM,982,RC,11750,HCPCS,outpatient,,,425.37,319.03,,227.34,130,,,fee schedule,130% of fee schedule,227.34,130,,,fee schedule,130% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,126.2,119,,,fee schedule,119% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,100% of fee schedule,382.83,90,,,percent of total billed charges,90% of total billed charges,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,102.95,100,,,fee schedule,100% of fee schedule,102.95,382.83,
"Excision:Nail/Matrix, Part/Comp.Rmv.",4503,CDM,982,RC,11750,HCPCS,outpatient,,,425.37,319.03,,227.34,130,,,fee schedule,130% of fee schedule,227.34,130,,,fee schedule,130% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,126.2,119,,,fee schedule,119% of fee schedule,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,100% of fee schedule,382.83,90,,,percent of total billed charges,90% of total billed charges,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,102.95,100,,,fee schedule,Pays 100% Medicare OPPS,172.46,100,,,fee schedule,100% of fee schedule,102.95,100,,,fee schedule,100% of fee schedule,102.95,382.83,
Treatment of Lesions; Inj.up to 7 Lesions,4515,CDM,450,RC,11900,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
Lac Repair-PRO Intermed. Nonface; 20.1-30cm,4600,CDM,982,RC,12036,HCPCS,outpatient,,,987.8,740.85,,359.66,130,,,fee schedule,130% of fee schedule,359.66,130,,,fee schedule,130% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,350.94,119,,,fee schedule,119% of fee schedule,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,100% of fee schedule,889.02,90,,,percent of total billed charges,90% of total billed charges,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,284.52,100,,,fee schedule,Pays 100% Medicare OPPS,229.95,100,,,fee schedule,100% of fee schedule,284.52,100,,,fee schedule,100% of fee schedule,229.95,889.02,
Lac Repair-PRO Intermed. Head/Face;2.5cm or <,4611,CDM,982,RC,12041,HCPCS,outpatient,,,569.49,427.12,,233.92,130,,,fee schedule,130% of fee schedule,233.92,130,,,fee schedule,130% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,182.75,119,,,fee schedule,119% of fee schedule,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,100% of fee schedule,512.54,90,,,percent of total billed charges,90% of total billed charges,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,147.92,100,,,fee schedule,Pays 100% Medicare OPPS,100.6,100,,,fee schedule,100% of fee schedule,147.92,100,,,fee schedule,100% of fee schedule,100.6,512.54,
PRO LACERATION COMPLEX HAND/DDD EA ADD 5 CM OR LESS,4680,CDM,981,RC,13133,HCPCS,outpatient,,,315.21,236.41,,180.13,130,,,fee schedule,130% of fee schedule,180.13,130,,,fee schedule,130% of fee schedule,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,159.1,119,,,fee schedule,119% of fee schedule,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,100% of fee schedule,283.69,90,,,percent of total billed charges,90% of total billed charges,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,125.64,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,125.64,100,,,fee schedule,100% of fee schedule,125.64,283.69,
Inj. Tendon/Ligament[Package],4775,CDM,982,RC,20550,HCPCS,outpatient,,,140.62,105.47,,54.57,130,,,fee schedule,130% of fee schedule,54.57,130,,,fee schedule,130% of fee schedule,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,48.56,119,,,fee schedule,119% of fee schedule,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,100% of fee schedule,126.56,90,,,percent of total billed charges,90% of total billed charges,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,39.27,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,39.27,100,,,fee schedule,100% of fee schedule,28.74,126.56,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4781,CDM,982,RC,20552,HCPCS,outpatient,,,174.59,130.94,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,157.13,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,157.13,
Therapeutic Inj Trigger Point(s);1or 2 Muscles[Package],4783,CDM,982,RC,20552,HCPCS,outpatient,,,174.59,130.94,,50.19,130,,,fee schedule,130% of fee schedule,50.19,130,,,fee schedule,130% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,47.8,119,,,fee schedule,119% of fee schedule,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,100% of fee schedule,157.13,90,,,percent of total billed charges,90% of total billed charges,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,37.44,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,37.44,100,,,fee schedule,100% of fee schedule,37.44,157.13,
Asp/Inj.; Joint small joint,4797,CDM,982,RC,20600,HCPCS,outpatient,,,148.81,111.61,,51.1,130,,,fee schedule,130% of fee schedule,51.1,130,,,fee schedule,130% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,44.7,119,,,fee schedule,119% of fee schedule,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,100% of fee schedule,133.93,90,,,percent of total billed charges,90% of total billed charges,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,35.66,100,,,fee schedule,Pays 100% Medicare OPPS,21.56,100,,,fee schedule,100% of fee schedule,35.66,100,,,fee schedule,100% of fee schedule,21.56,133.93,
"Asp./Inj joint; Inter.(w,el,an)",4803,CDM,982,RC,20605,HCPCS,outpatient,,,237.86,178.4,,53.76,130,,,fee schedule,130% of fee schedule,53.76,130,,,fee schedule,130% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,46.45,119,,,fee schedule,119% of fee schedule,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,100% of fee schedule,214.07,90,,,percent of total billed charges,90% of total billed charges,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,37.24,100,,,fee schedule,Pays 100% Medicare OPPS,28.74,100,,,fee schedule,100% of fee schedule,37.24,100,,,fee schedule,100% of fee schedule,28.74,214.07,
"Asp./Inj Joint; Major(s,h,k)",4812,CDM,982,RC,20610,HCPCS,outpatient,,,268.34,201.26,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,241.51,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,241.51,
"Asp./Inj Joint; Major(s,h,k) BILATERAL PRO",4815,CDM,981,RC,20610,HCPCS,outpatient,,,328.09,246.07,,66.14,130,,,fee schedule,130% of fee schedule,66.14,130,,,fee schedule,130% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,56.77,119,,,fee schedule,119% of fee schedule,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,100% of fee schedule,295.28,90,,,percent of total billed charges,90% of total billed charges,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,45.44,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,45.44,100,,,fee schedule,100% of fee schedule,43.12,295.28,
FRX/DIS-Radial Head Nursemaid W/ Manip.-PRO,4877,CDM,982,RC,24640,HCPCS,outpatient,,,214.42,160.82,,118.24,130,,,fee schedule,130% of fee schedule,118.24,130,,,fee schedule,130% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,97.98,119,,,fee schedule,119% of fee schedule,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,100% of fee schedule,192.98,90,,,percent of total billed charges,90% of total billed charges,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,82.27,100,,,fee schedule,Pays 100% Medicare OPPS,93.42,100,,,fee schedule,100% of fee schedule,82.27,100,,,fee schedule,100% of fee schedule,82.27,192.98,
FRX-Distal Radial W/O Manip,4905,CDM,982,RC,25600,HCPCS,outpatient,,,686.66,515,,346.15,130,,,fee schedule,130% of fee schedule,346.15,130,,,fee schedule,130% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,395.13,119,,,fee schedule,119% of fee schedule,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,100% of fee schedule,617.99,90,,,percent of total billed charges,90% of total billed charges,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,346.59,100,,,fee schedule,Pays 100% Medicare OPPS,215.58,100,,,fee schedule,100% of fee schedule,346.59,100,,,fee schedule,100% of fee schedule,215.58,617.99,
PRO TENDON REPAIR EXT FINGER,4931,CDM,981,RC,26418,HCPCS,outpatient,,,1584.24,1188.18,,739.86,130,,,fee schedule,130% of fee schedule,739.86,130,,,fee schedule,130% of fee schedule,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,744.73,119,,,fee schedule,119% of fee schedule,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,100% of fee schedule,1425.82,90,,,percent of total billed charges,90% of total billed charges,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,663.98,100,,,fee schedule,Pays 100% Medicare OPPS,287.44,100,,,fee schedule,100% of fee schedule,663.98,100,,,fee schedule,100% of fee schedule,287.44,1425.82,
"FRX-HAND Single; W/O Manip, Each Bone{package}",4933,CDM,982,RC,26600,HCPCS,outpatient,,,570.65,427.99,,357.14,130,,,fee schedule,130% of fee schedule,357.14,130,,,fee schedule,130% of fee schedule,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,351.24,119,,,fee schedule,119% of fee schedule,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,100% of fee schedule,513.59,90,,,percent of total billed charges,90% of total billed charges,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,306.37,100,,,fee schedule,Pays 100% Medicare OPPS,107.79,100,,,fee schedule,100% of fee schedule,306.37,100,,,fee schedule,100% of fee schedule,107.79,513.59,
FRX/Dislocation-Finger/Thumb; W Manip-PRO,4958,CDM,981,RC,26755,HCPCS,outpatient,,,769.86,577.4,,353.77,130,,,fee schedule,130% of fee schedule,353.77,130,,,fee schedule,130% of fee schedule,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,341.26,119,,,fee schedule,119% of fee schedule,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,100% of fee schedule,692.87,90,,,percent of total billed charges,90% of total billed charges,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,290.96,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,290.96,100,,,fee schedule,100% of fee schedule,57.49,692.87,
Dislocation-interphalangeal closed w anes[Package],4964,CDM,982,RC,26775,HCPCS,outpatient,,,1538.55,1153.91,,449.41,130,,,fee schedule,130% of fee schedule,449.41,130,,,fee schedule,130% of fee schedule,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,432.65,119,,,fee schedule,119% of fee schedule,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,100% of fee schedule,1384.7,90,,,percent of total billed charges,90% of total billed charges,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,375.98,100,,,fee schedule,Pays 100% Medicare OPPS,86.23,100,,,fee schedule,100% of fee schedule,375.98,100,,,fee schedule,100% of fee schedule,86.23,1384.7,
FRX(Lower Leg&Ankle)-Tibial Shaft W/O Manip,5006,CDM,983,RC,27750,HCPCS,outpatient,,,816.71,612.53,,413.06,130,,,fee schedule,130% of fee schedule,413.06,130,,,fee schedule,130% of fee schedule,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,399.02,119,,,fee schedule,119% of fee schedule,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,100% of fee schedule,735.04,90,,,percent of total billed charges,90% of total billed charges,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,342.25,100,,,fee schedule,Pays 100% Medicare OPPS,258.7,100,,,fee schedule,100% of fee schedule,342.25,100,,,fee schedule,100% of fee schedule,258.7,735.04,
FB Removal: Foot; Deep -PRO,5043,CDM,975,RC,28192,HCPCS,outpatient,,,872.96,654.72,,416.87,130,,,fee schedule,130% of fee schedule,416.87,130,,,fee schedule,130% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,390.3,119,,,fee schedule,119% of fee schedule,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,100% of fee schedule,785.66,90,,,percent of total billed charges,90% of total billed charges,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,317.35,100,,,fee schedule,Pays 100% Medicare OPPS,179.65,100,,,fee schedule,100% of fee schedule,317.35,100,,,fee schedule,100% of fee schedule,179.65,785.66,
APPLY CAST LONG ARM-PRO,5076,CDM,981,RC,29065,HCPCS,outpatient,,,217.95,163.46,,89.99,130,,,fee schedule,130% of fee schedule,89.99,130,,,fee schedule,130% of fee schedule,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,84.39,119,,,fee schedule,119% of fee schedule,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,100% of fee schedule,196.16,90,,,percent of total billed charges,90% of total billed charges,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,69.71,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,69.71,100,,,fee schedule,100% of fee schedule,57.49,196.16,
Casting:Arm/Shldr/ Torso;Elbow to Finger,5078,CDM,982,RC,29075,HCPCS,outpatient,,,173.41,130.06,,82.03,130,,,fee schedule,130% of fee schedule,82.03,130,,,fee schedule,130% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,76.27,119,,,fee schedule,119% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,100% of fee schedule,156.07,90,,,percent of total billed charges,90% of total billed charges,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,64.26,100,,,fee schedule,100% of fee schedule,43.12,156.07,
Casting:Arm/Shldr/ Torso;Elbow to Finger,5079,CDM,982,RC,29075,HCPCS,outpatient,,,173.41,130.06,,82.03,130,,,fee schedule,130% of fee schedule,82.03,130,,,fee schedule,130% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,76.27,119,,,fee schedule,119% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,100% of fee schedule,156.07,90,,,percent of total billed charges,90% of total billed charges,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,64.26,100,,,fee schedule,100% of fee schedule,43.12,156.07,
Casting:Arm/Shldr/Torso'Elbow to Finger-PRO,5081,CDM,981,RC,29075,HCPCS,outpatient,,,183.98,137.99,,82.03,130,,,fee schedule,130% of fee schedule,82.03,130,,,fee schedule,130% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,76.27,119,,,fee schedule,119% of fee schedule,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,100% of fee schedule,165.58,90,,,percent of total billed charges,90% of total billed charges,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,64.26,100,,,fee schedule,Pays 100% Medicare OPPS,43.12,100,,,fee schedule,100% of fee schedule,64.26,100,,,fee schedule,100% of fee schedule,43.12,165.58,
Splint/Strap:Torso/Upper;Forearm to Splint(short),5088,CDM,510,RC,29125,HCPCS,outpatient,,,161.71,121.28,,145.54,90,,,percent of total billed charges,90% of total billed charges,150.39,93,,,percent of total billed charges,93% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,61.45,38,,,percent of total billed charges,38% of total billed charges,131.63,81.4,,,percent of total billed charges,81.4% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,145.54,90,,,percent of total billed charges,90% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,61.45,38,,,percent of total billed charges,38% of total billed charges,121.28,75,,,percent of total billed charges,75% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,61.45,150.39,
Splint/Strap:Torso/Upper;Forearm to Splint(short),5089,CDM,983,RC,29125,HCPCS,outpatient,,,161.71,121.28,,57.42,130,,,fee schedule,130% of fee schedule,57.42,130,,,fee schedule,130% of fee schedule,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,48.92,119,,,fee schedule,119% of fee schedule,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,100% of fee schedule,145.54,90,,,percent of total billed charges,90% of total billed charges,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,41.43,100,,,fee schedule,Pays 100% Medicare OPPS,35.93,100,,,fee schedule,100% of fee schedule,41.43,100,,,fee schedule,100% of fee schedule,35.93,145.54,
Casting:Legs;Below Knee  to Toes(short),5101,CDM,982,RC,29405,HCPCS,outpatient,,,216.79,162.59,,83.38,130,,,fee schedule,130% of fee schedule,83.38,130,,,fee schedule,130% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,73.17,119,,,fee schedule,119% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,100% of fee schedule,195.11,90,,,percent of total billed charges,90% of total billed charges,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,59.66,100,,,fee schedule,100% of fee schedule,57.49,195.11,
Casting:Legs;Below Knee to Toes(short)-PRO,5103,CDM,981,RC,29405,HCPCS,outpatient,,,226.16,169.62,,83.38,130,,,fee schedule,130% of fee schedule,83.38,130,,,fee schedule,130% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,73.17,119,,,fee schedule,119% of fee schedule,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,100% of fee schedule,203.54,90,,,percent of total billed charges,90% of total billed charges,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,59.66,100,,,fee schedule,Pays 100% Medicare OPPS,57.49,100,,,fee schedule,100% of fee schedule,59.66,100,,,fee schedule,100% of fee schedule,57.49,203.54,
AND Physical (DSS),5181,CDM,510,RC,46651,HCPCS,outpatient,,,42.17,31.63,,37.95,90,,,percent of total billed charges,90% of total billed charges,39.22,93,,,percent of total billed charges,93% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,16.02,38,,,percent of total billed charges,38% of total billed charges,34.33,81.4,,,percent of total billed charges,81.4% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,37.95,90,,,percent of total billed charges,90% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,16.02,38,,,percent of total billed charges,38% of total billed charges,31.63,75,,,percent of total billed charges,75% of total billed charges,35.84,85,,,percent of total billed charges,85% of total billed charges,16.02,39.22,
Occipital (greater) Block [Package],5217,CDM,120,RC,64405,HCPCS,inpatient,,,737.63,553.22,,663.87,90,,,percent of total billed charges,90% of total billed charges,686,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,663.87,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,617.4,83.7,,,percent of total billed charges,83.7% of total billed charges,663.87,90,,,percent of total billed charges,90% of total billed charges,663.87,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,617.4,2506,
Sports Physical,5259,CDM,510,RC,,,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
Insurance Physical,5261,CDM,510,RC,,,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,117.69,
College Physical (Includes nursing),5263,CDM,510,RC,,,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,117.69,
Employment Physical,5265,CDM,510,RC,,,outpatient,,,126.55,94.91,,113.9,90,,,percent of total billed charges,90% of total billed charges,117.69,93,,,percent of total billed charges,93% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,48.09,38,,,percent of total billed charges,38% of total billed charges,103.01,81.4,,,percent of total billed charges,81.4% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,113.9,90,,,percent of total billed charges,90% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,48.09,38,,,percent of total billed charges,38% of total billed charges,94.91,75,,,percent of total billed charges,75% of total billed charges,107.57,85,,,percent of total billed charges,85% of total billed charges,48.09,117.69,
Brief Physical,5267,CDM,510,RC,,,outpatient,,,46.87,35.15,,42.18,90,,,percent of total billed charges,90% of total billed charges,43.59,93,,,percent of total billed charges,93% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,17.81,38,,,percent of total billed charges,38% of total billed charges,38.15,81.4,,,percent of total billed charges,81.4% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,35.15,75,,,percent of total billed charges,75% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,43.59,
Grimmway Farms Physical,5269,CDM,510,RC,,,outpatient,,,101.95,76.46,,91.76,90,,,percent of total billed charges,90% of total billed charges,94.81,93,,,percent of total billed charges,93% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,38.74,38,,,percent of total billed charges,38% of total billed charges,82.99,81.4,,,percent of total billed charges,81.4% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,76.46,75,,,percent of total billed charges,75% of total billed charges,86.66,85,,,percent of total billed charges,85% of total billed charges,38.74,94.81,
Portamedic,5271,CDM,510,RC,,,outpatient,,,101.95,76.46,,91.76,90,,,percent of total billed charges,90% of total billed charges,94.81,93,,,percent of total billed charges,93% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,38.74,38,,,percent of total billed charges,38% of total billed charges,82.99,81.4,,,percent of total billed charges,81.4% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,91.76,90,,,percent of total billed charges,90% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,38.74,38,,,percent of total billed charges,38% of total billed charges,76.46,75,,,percent of total billed charges,75% of total billed charges,86.66,85,,,percent of total billed charges,85% of total billed charges,38.74,94.81,
Admin Vaccine;Oral/Intranasal,5288,CDM,510,RC,90473,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
CPR-PRO,5291,CDM,120,RC,92950,HCPCS,inpatient,,,648,486,,583.2,90,,,percent of total billed charges,90% of total billed charges,602.64,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,583.2,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,542.38,83.7,,,percent of total billed charges,83.7% of total billed charges,583.2,90,,,percent of total billed charges,90% of total billed charges,583.2,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,542.38,2506,
Defibrillation - Cardioversion-PRO,5294,CDM,761,RC,92960,HCPCS,outpatient,,,515.59,386.69,,464.03,90,,,percent of total billed charges,90% of total billed charges,479.5,93,,,percent of total billed charges,93% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,195.92,38,,,percent of total billed charges,38% of total billed charges,419.69,81.4,,,percent of total billed charges,81.4% of total billed charges,464.03,90,,,percent of total billed charges,90% of total billed charges,464.03,90,,,percent of total billed charges,90% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,195.92,38,,,percent of total billed charges,38% of total billed charges,386.69,75,,,percent of total billed charges,75% of total billed charges,438.25,85,,,percent of total billed charges,85% of total billed charges,195.92,479.5,
"Allergy Immuno.:Allergen,not Includ. Provision;Single Inj.",5315,CDM,510,RC,95115,HCPCS,outpatient,,,26.96,20.22,,24.26,90,,,percent of total billed charges,90% of total billed charges,25.07,93,,,percent of total billed charges,93% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,10.24,38,,,percent of total billed charges,38% of total billed charges,21.95,81.4,,,percent of total billed charges,81.4% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,20.22,75,,,percent of total billed charges,75% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,25.07,
"Allergy Immuno.:Allergen,not Includ. Provision;2> Injections",5317,CDM,510,RC,95117,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
FOLLOW UP VISIT - NO CHARGE,5330,CDM,982,RC,99024,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.36,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.36,32.36,
FOLLOW UP VISIT - NO CHARGE,5331,CDM,521,RC,99024,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,
FOLLOW UP VISIT - NO CHARGE,5332,CDM,982,RC,99024,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.36,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.36,32.36,
Office Visit New Min,5337,CDM,982,RC,99201,HCPCS,outpatient,,,108.97,81.73,,34.66,130,,,fee schedule,130% of fee schedule,34.66,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.31,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,98.07,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,35.95,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.31,98.07,
Office Visit New Min,5338,CDM,982,RC,99201,HCPCS,outpatient,,,108.97,81.73,,34.66,130,,,fee schedule,130% of fee schedule,34.66,130,,,fee schedule,130% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,32.31,119,,,fee schedule,119% of fee schedule,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,98.07,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,35.95,100,,,fee schedule,100% of fee schedule,,,,,other,Not reimbursable per contract,32.31,98.07,
Office Visit New Brief,5342,CDM,982,RC,99202,HCPCS,outpatient,,,175.77,131.83,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,158.19,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,158.19,
Office Visit New Brief,5343,CDM,982,RC,99202,HCPCS,outpatient,,,175.77,131.83,,66.22,130,,,fee schedule,130% of fee schedule,66.22,130,,,fee schedule,130% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,61.62,119,,,fee schedule,119% of fee schedule,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,100% of fee schedule,158.19,90,,,percent of total billed charges,90% of total billed charges,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,48.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,48.42,100,,,fee schedule,100% of fee schedule,48.42,158.19,
Office Visit New Int.,5353,CDM,982,RC,99203,HCPCS,outpatient,,,234.37,175.78,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,210.93,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,210.93,
Office Visit New Int.,5354,CDM,982,RC,99203,HCPCS,outpatient,,,234.37,175.78,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,210.93,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,210.93,
Office Visit New Int.,5355,CDM,982,RC,99203,HCPCS,outpatient,,,234.37,175.78,,101.17,130,,,fee schedule,130% of fee schedule,101.17,130,,,fee schedule,130% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,92.2,119,,,fee schedule,119% of fee schedule,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,100% of fee schedule,210.93,90,,,percent of total billed charges,90% of total billed charges,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,83.27,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,83.27,100,,,fee schedule,100% of fee schedule,83.27,210.93,
Office Visit New Ext.,5367,CDM,982,RC,99204,HCPCS,outpatient,,,332.79,249.59,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,299.51,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,299.51,
Office Visit New Ext.,5368,CDM,982,RC,99204,HCPCS,outpatient,,,332.79,249.59,,171.28,130,,,fee schedule,130% of fee schedule,171.28,130,,,fee schedule,130% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,157.71,119,,,fee schedule,119% of fee schedule,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,100% of fee schedule,299.51,90,,,percent of total billed charges,90% of total billed charges,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,134.25,100,,,fee schedule,Pays 100% Medicare OPPS,118.64,100,,,fee schedule,100% of fee schedule,134.25,100,,,fee schedule,100% of fee schedule,118.64,299.51,
Office Visit New Ext. +,5380,CDM,982,RC,99205,HCPCS,outpatient,,,385.51,289.13,,218.79,130,,,fee schedule,130% of fee schedule,218.79,130,,,fee schedule,130% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,206.02,119,,,fee schedule,119% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,100% of fee schedule,346.96,90,,,percent of total billed charges,90% of total billed charges,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.8,100,,,fee schedule,100% of fee schedule,182.36,100,,,fee schedule,100% of fee schedule,143.8,346.96,
Office Visit New Ext. +,5381,CDM,982,RC,99205,HCPCS,outpatient,,,385.51,289.13,,218.79,130,,,fee schedule,130% of fee schedule,218.79,130,,,fee schedule,130% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,206.02,119,,,fee schedule,119% of fee schedule,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,100% of fee schedule,346.96,90,,,percent of total billed charges,90% of total billed charges,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,182.36,100,,,fee schedule,Pays 100% Medicare OPPS,143.8,100,,,fee schedule,100% of fee schedule,182.36,100,,,fee schedule,100% of fee schedule,143.8,346.96,
Office/Outpatient;Est. 5min.Visit,5389,CDM,761,RC,99211,HCPCS,outpatient,,,57.41,43.06,,51.67,90,,,percent of total billed charges,90% of total billed charges,53.39,93,,,percent of total billed charges,93% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,21.82,38,,,percent of total billed charges,38% of total billed charges,46.73,81.4,,,percent of total billed charges,81.4% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,51.67,90,,,percent of total billed charges,90% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,21.82,38,,,percent of total billed charges,38% of total billed charges,43.06,75,,,percent of total billed charges,75% of total billed charges,48.8,85,,,percent of total billed charges,85% of total billed charges,21.82,53.39,
Office Visit Est. Brief[Package],5392,CDM,982,RC,99212,HCPCS,outpatient,,,93.74,70.31,,33.75,130,,,fee schedule,130% of fee schedule,33.75,130,,,fee schedule,130% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,31.43,119,,,fee schedule,119% of fee schedule,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,100% of fee schedule,84.37,90,,,percent of total billed charges,90% of total billed charges,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.77,100,,,fee schedule,Pays 100% Medicare OPPS,35.95,100,,,fee schedule,100% of fee schedule,35.77,100,,,fee schedule,100% of fee schedule,31.43,84.37,
Office Visit Est. Int.,5406,CDM,982,RC,99213,HCPCS,outpatient,,,126.55,94.91,,67.08,130,,,fee schedule,130% of fee schedule,67.08,130,,,fee schedule,130% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.51,119,,,fee schedule,119% of fee schedule,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,100% of fee schedule,113.9,90,,,percent of total billed charges,90% of total billed charges,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,66.54,100,,,fee schedule,Pays 100% Medicare OPPS,62.91,100,,,fee schedule,100% of fee schedule,66.54,100,,,fee schedule,100% of fee schedule,62.51,113.9,
Office Visit Est. Ext.,5422,CDM,982,RC,99214,HCPCS,outpatient,,,194.51,145.88,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,175.06,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,175.06,
Office Visit Est. Ext.,5423,CDM,982,RC,99214,HCPCS,outpatient,,,194.51,145.88,,102.64,130,,,fee schedule,130% of fee schedule,102.64,130,,,fee schedule,130% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,96.2,119,,,fee schedule,119% of fee schedule,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,100% of fee schedule,175.06,90,,,percent of total billed charges,90% of total billed charges,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.34,100,,,fee schedule,Pays 100% Medicare OPPS,98.5,100,,,fee schedule,100% of fee schedule,98.34,100,,,fee schedule,100% of fee schedule,96.2,175.06,
Office Visit Est. Ext. +,5437,CDM,982,RC,99215,HCPCS,outpatient,,,294.11,220.58,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,264.7,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,264.7,
Office Visit Est. Ext. +,5438,CDM,982,RC,99215,HCPCS,outpatient,,,294.11,220.58,,144.42,130,,,fee schedule,130% of fee schedule,144.42,130,,,fee schedule,130% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,135.92,119,,,fee schedule,119% of fee schedule,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,100% of fee schedule,264.7,90,,,percent of total billed charges,90% of total billed charges,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,144.52,100,,,fee schedule,Pays 100% Medicare OPPS,146.32,100,,,fee schedule,100% of fee schedule,144.52,100,,,fee schedule,100% of fee schedule,135.92,264.7,
OFFICE CONSULT-LOW-30 MIN[Package],5468,CDM,982,RC,99242,HCPCS,outpatient,,,248.42,186.32,,88.05,130,,,fee schedule,130% of fee schedule,88.05,130,,,fee schedule,130% of fee schedule,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,84.44,119,,,fee schedule,119% of fee schedule,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,100% of fee schedule,223.58,90,,,percent of total billed charges,90% of total billed charges,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,56.81,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,56.81,100,,,fee schedule,100% of fee schedule,56.81,223.58,
OFFICE CONSULT-MODERATE-40 MIN,5475,CDM,982,RC,99243,HCPCS,outpatient,,,316.38,237.29,,122.62,130,,,fee schedule,130% of fee schedule,122.62,130,,,fee schedule,130% of fee schedule,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,118.06,119,,,fee schedule,119% of fee schedule,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,100% of fee schedule,284.74,90,,,percent of total billed charges,90% of total billed charges,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,89.53,100,,,fee schedule,Pays 100% Medicare OPPS,107.85,100,,,fee schedule,100% of fee schedule,89.53,100,,,fee schedule,100% of fee schedule,89.53,284.74,
Nursing Facility ;Low SB. NH-PRO,5510,CDM,982,RC,99304,HCPCS,outpatient,,,171.07,128.3,,120.91,130,,,fee schedule,130% of fee schedule,120.91,130,,,fee schedule,130% of fee schedule,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,110.19,119,,,fee schedule,119% of fee schedule,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,100% of fee schedule,153.96,90,,,percent of total billed charges,90% of total billed charges,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,81.45,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,81.45,100,,,fee schedule,100% of fee schedule,81.45,153.96,
Nursing Facility Subset:Low stable SB NH-PRO,5521,CDM,982,RC,99307,HCPCS,outpatient,,,108.97,81.73,,57.51,130,,,fee schedule,130% of fee schedule,57.51,130,,,fee schedule,130% of fee schedule,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,53.66,119,,,fee schedule,119% of fee schedule,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,100% of fee schedule,98.07,90,,,percent of total billed charges,90% of total billed charges,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,40.22,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,40.22,100,,,fee schedule,100% of fee schedule,40.22,98.07,
Nursing facility Subsequent Visit SB NH (minor mod),5525,CDM,982,RC,99308,HCPCS,outpatient,,,153.5,115.13,,88.7,130,,,fee schedule,130% of fee schedule,88.7,130,,,fee schedule,130% of fee schedule,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,84.42,119,,,fee schedule,119% of fee schedule,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,100% of fee schedule,138.15,90,,,percent of total billed charges,90% of total billed charges,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,75.43,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,75.43,100,,,fee schedule,100% of fee schedule,75.43,138.15,
"Nursing fac Subsequent Visit SB, NH (new problem)pro",5529,CDM,982,RC,99309,HCPCS,outpatient,,,205.05,153.79,,116.82,130,,,fee schedule,130% of fee schedule,116.82,130,,,fee schedule,130% of fee schedule,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,111.31,119,,,fee schedule,119% of fee schedule,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,100% of fee schedule,184.55,90,,,percent of total billed charges,90% of total billed charges,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,108.12,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,108.12,100,,,fee schedule,100% of fee schedule,108.12,184.55,
"Nursing fac Subsequent SB,NH (immed)pro",5532,CDM,982,RC,99310,HCPCS,outpatient,,,258.96,194.22,,173.72,130,,,fee schedule,130% of fee schedule,173.72,130,,,fee schedule,130% of fee schedule,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,164.09,119,,,fee schedule,119% of fee schedule,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,100% of fee schedule,233.06,90,,,percent of total billed charges,90% of total billed charges,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,155.28,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,155.28,100,,,fee schedule,100% of fee schedule,155.28,233.06,
Nursing facility Assess-Pro,5538,CDM,521,RC,99318,HCPCS,outpatient,,,196.87,147.65,,177.18,90,,,percent of total billed charges,90% of total billed charges,183.09,93,,,percent of total billed charges,93% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,167.34,85,,,percent of total billed charges,85% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,160.25,81.4,,,percent of total billed charges,81.4% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,147.65,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,74.81,183.09,
Nursing facility Assess-Pro,5539,CDM,521,RC,99318,HCPCS,outpatient,,,196.87,147.65,,177.18,90,,,percent of total billed charges,90% of total billed charges,183.09,93,,,percent of total billed charges,93% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,167.34,85,,,percent of total billed charges,85% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,160.25,81.4,,,percent of total billed charges,81.4% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,177.18,90,,,percent of total billed charges,90% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,74.81,38,,,percent of total billed charges,38% of total billed charges,147.65,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,74.81,183.09,
Prev New < 1yr.,5546,CDM,982,RC,99381,HCPCS,outpatient,,,154.67,116,,79.48,130,,,fee schedule,130% of fee schedule,79.48,130,,,fee schedule,130% of fee schedule,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,94.41,119,,,fee schedule,119% of fee schedule,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,100% of fee schedule,139.2,90,,,percent of total billed charges,90% of total billed charges,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,74.42,100,,,fee schedule,100% of fee schedule,53.93,139.2,
Prev. New 1-4 yrs.,5548,CDM,982,RC,99382,HCPCS,outpatient,,,154.67,116,,90.64,130,,,fee schedule,130% of fee schedule,90.64,130,,,fee schedule,130% of fee schedule,79.25,100,,,fee schedule,Pays 100% Medicare OPPS,79.25,100,,,fee schedule,Pays 100% Medicare OPPS,100.88,119,,,fee schedule,119% of fee schedule,79.25,100,,,fee schedule,Pays 100% Medicare OPPS,79.25,100,,,fee schedule,100% of fee schedule,139.2,90,,,percent of total billed charges,90% of total billed charges,79.25,100,,,fee schedule,Pays 100% Medicare OPPS,79.25,100,,,fee schedule,Pays 100% Medicare OPPS,79.25,100,,,fee schedule,Pays 100% Medicare OPPS,79.25,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,79.25,100,,,fee schedule,100% of fee schedule,53.93,139.2,
Prev. New 5-11 yrs.,5550,CDM,982,RC,99383,HCPCS,outpatient,,,243.73,182.8,,90.64,130,,,fee schedule,130% of fee schedule,90.64,130,,,fee schedule,130% of fee schedule,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,106.9,119,,,fee schedule,119% of fee schedule,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,100% of fee schedule,219.36,90,,,percent of total billed charges,90% of total billed charges,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,84.08,100,,,fee schedule,100% of fee schedule,53.93,219.36,
Prev New;12-17yrs.,5552,CDM,982,RC,99384,HCPCS,outpatient,,,258.96,194.22,,102.14,130,,,fee schedule,130% of fee schedule,102.14,130,,,fee schedule,130% of fee schedule,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.27,119,,,fee schedule,119% of fee schedule,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,100% of fee schedule,233.06,90,,,percent of total billed charges,90% of total billed charges,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,53.93,100,,,fee schedule,100% of fee schedule,98.75,100,,,fee schedule,100% of fee schedule,53.93,233.06,
CDL Physical- Age 18-39,5555,CDM,983,RC,99385,HCPCS,outpatient,,,121.86,91.4,,102.14,130,,,fee schedule,130% of fee schedule,102.14,130,,,fee schedule,130% of fee schedule,94.96,100,,,fee schedule,Pays 100% Medicare OPPS,94.96,100,,,fee schedule,Pays 100% Medicare OPPS,121.11,119,,,fee schedule,119% of fee schedule,94.96,100,,,fee schedule,Pays 100% Medicare OPPS,94.96,100,,,fee schedule,100% of fee schedule,109.67,90,,,percent of total billed charges,90% of total billed charges,94.96,100,,,fee schedule,Pays 100% Medicare OPPS,94.96,100,,,fee schedule,Pays 100% Medicare OPPS,94.96,100,,,fee schedule,Pays 100% Medicare OPPS,94.96,100,,,fee schedule,Pays 100% Medicare OPPS,86.28,100,,,fee schedule,100% of fee schedule,94.96,100,,,fee schedule,100% of fee schedule,86.28,121.11,
Prev. New;40-64yrs.,5557,CDM,982,RC,99386,HCPCS,outpatient,,,379.65,284.74,,125.24,130,,,fee schedule,130% of fee schedule,125.24,130,,,fee schedule,130% of fee schedule,115.15,100,,,fee schedule,Pays 100% Medicare OPPS,115.15,100,,,fee schedule,Pays 100% Medicare OPPS,146.99,119,,,fee schedule,119% of fee schedule,115.15,100,,,fee schedule,Pays 100% Medicare OPPS,115.15,100,,,fee schedule,100% of fee schedule,341.69,90,,,percent of total billed charges,90% of total billed charges,115.15,100,,,fee schedule,Pays 100% Medicare OPPS,115.15,100,,,fee schedule,Pays 100% Medicare OPPS,115.15,100,,,fee schedule,Pays 100% Medicare OPPS,115.15,100,,,fee schedule,Pays 100% Medicare OPPS,86.28,100,,,fee schedule,100% of fee schedule,115.15,100,,,fee schedule,100% of fee schedule,86.28,341.69,
Prev.New;65 and >,5560,CDM,982,RC,99387,HCPCS,outpatient,,,434.73,326.05,,137.64,130,,,fee schedule,130% of fee schedule,137.64,130,,,fee schedule,130% of fee schedule,123.89,100,,,fee schedule,Pays 100% Medicare OPPS,123.89,100,,,fee schedule,Pays 100% Medicare OPPS,158.12,119,,,fee schedule,119% of fee schedule,123.89,100,,,fee schedule,Pays 100% Medicare OPPS,123.89,100,,,fee schedule,100% of fee schedule,391.26,90,,,percent of total billed charges,90% of total billed charges,123.89,100,,,fee schedule,Pays 100% Medicare OPPS,123.89,100,,,fee schedule,Pays 100% Medicare OPPS,123.89,100,,,fee schedule,Pays 100% Medicare OPPS,123.89,100,,,fee schedule,Pays 100% Medicare OPPS,86.28,100,,,fee schedule,100% of fee schedule,123.89,100,,,fee schedule,100% of fee schedule,86.28,391.26,
Prev. Est;< 1yr.,5563,CDM,982,RC,99391,HCPCS,outpatient,,,105.47,79.1,,68.38,130,,,fee schedule,130% of fee schedule,68.38,130,,,fee schedule,130% of fee schedule,67.67,100,,,fee schedule,Pays 100% Medicare OPPS,67.67,100,,,fee schedule,Pays 100% Medicare OPPS,86.62,119,,,fee schedule,119% of fee schedule,67.67,100,,,fee schedule,Pays 100% Medicare OPPS,67.67,100,,,fee schedule,100% of fee schedule,94.92,90,,,percent of total billed charges,90% of total billed charges,67.67,100,,,fee schedule,Pays 100% Medicare OPPS,67.67,100,,,fee schedule,Pays 100% Medicare OPPS,67.67,100,,,fee schedule,Pays 100% Medicare OPPS,67.67,100,,,fee schedule,Pays 100% Medicare OPPS,43.14,100,,,fee schedule,100% of fee schedule,67.67,100,,,fee schedule,100% of fee schedule,43.14,94.92,
Prev. Est.;1-4yrs.,5565,CDM,982,RC,99392,HCPCS,outpatient,,,105.47,79.1,,79.48,130,,,fee schedule,130% of fee schedule,79.48,130,,,fee schedule,130% of fee schedule,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,94.41,119,,,fee schedule,119% of fee schedule,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,100% of fee schedule,94.92,90,,,percent of total billed charges,90% of total billed charges,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,43.14,100,,,fee schedule,100% of fee schedule,74.42,100,,,fee schedule,100% of fee schedule,43.14,94.92,
Prev. Est.;5-11yrs,5567,CDM,982,RC,99393,HCPCS,outpatient,,,200.38,150.29,,79.48,130,,,fee schedule,130% of fee schedule,79.48,130,,,fee schedule,130% of fee schedule,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,94.41,119,,,fee schedule,119% of fee schedule,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,100% of fee schedule,180.34,90,,,percent of total billed charges,90% of total billed charges,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,74.42,100,,,fee schedule,Pays 100% Medicare OPPS,43.14,100,,,fee schedule,100% of fee schedule,74.42,100,,,fee schedule,100% of fee schedule,43.14,180.34,
Prev. Est.;12-17 yrs.,5569,CDM,982,RC,99394,HCPCS,outpatient,,,217.95,163.46,,90.64,130,,,fee schedule,130% of fee schedule,90.64,130,,,fee schedule,130% of fee schedule,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,106.9,119,,,fee schedule,119% of fee schedule,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,100% of fee schedule,196.16,90,,,percent of total billed charges,90% of total billed charges,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,84.08,100,,,fee schedule,Pays 100% Medicare OPPS,43.14,100,,,fee schedule,100% of fee schedule,84.08,100,,,fee schedule,100% of fee schedule,43.14,196.16,
Prev. Est.;18-39yrs.,5571,CDM,982,RC,99395,HCPCS,outpatient,,,291.77,218.83,,90.64,130,,,fee schedule,130% of fee schedule,90.64,130,,,fee schedule,130% of fee schedule,86.76,100,,,fee schedule,Pays 100% Medicare OPPS,86.76,100,,,fee schedule,Pays 100% Medicare OPPS,109.93,119,,,fee schedule,119% of fee schedule,86.76,100,,,fee schedule,Pays 100% Medicare OPPS,86.76,100,,,fee schedule,100% of fee schedule,262.59,90,,,percent of total billed charges,90% of total billed charges,86.76,100,,,fee schedule,Pays 100% Medicare OPPS,86.76,100,,,fee schedule,Pays 100% Medicare OPPS,86.76,100,,,fee schedule,Pays 100% Medicare OPPS,86.76,100,,,fee schedule,Pays 100% Medicare OPPS,61.12,100,,,fee schedule,100% of fee schedule,86.76,100,,,fee schedule,100% of fee schedule,61.12,262.59,
Prev. Est.;40-64 yrs.,5574,CDM,982,RC,99396,HCPCS,outpatient,,,333.95,250.46,,102.14,130,,,fee schedule,130% of fee schedule,102.14,130,,,fee schedule,130% of fee schedule,94,100,,,fee schedule,Pays 100% Medicare OPPS,94,100,,,fee schedule,Pays 100% Medicare OPPS,119.81,119,,,fee schedule,119% of fee schedule,94,100,,,fee schedule,Pays 100% Medicare OPPS,94,100,,,fee schedule,100% of fee schedule,300.56,90,,,percent of total billed charges,90% of total billed charges,94,100,,,fee schedule,Pays 100% Medicare OPPS,94,100,,,fee schedule,Pays 100% Medicare OPPS,94,100,,,fee schedule,Pays 100% Medicare OPPS,94,100,,,fee schedule,Pays 100% Medicare OPPS,137.54,100,,,fee schedule,100% of fee schedule,94,100,,,fee schedule,100% of fee schedule,94,300.56,
Prev. Est.;65 and up,5576,CDM,982,RC,99397,HCPCS,outpatient,,,363.24,272.43,,114.14,130,,,fee schedule,130% of fee schedule,114.14,130,,,fee schedule,130% of fee schedule,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,126.27,119,,,fee schedule,119% of fee schedule,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,100% of fee schedule,326.92,90,,,percent of total billed charges,90% of total billed charges,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,98.75,100,,,fee schedule,Pays 100% Medicare OPPS,61.12,100,,,fee schedule,100% of fee schedule,98.75,100,,,fee schedule,100% of fee schedule,61.12,326.92,
Smoking/tobacco cessation-3-10min clinic,5578,CDM,982,RC,99406,HCPCS,outpatient,,,29.28,21.96,,15.56,130,,,fee schedule,130% of fee schedule,15.56,130,,,fee schedule,130% of fee schedule,11.91,100,,,fee schedule,Pays 100% Medicare OPPS,11.91,100,,,fee schedule,Pays 100% Medicare OPPS,15.07,119,,,fee schedule,119% of fee schedule,11.91,100,,,fee schedule,Pays 100% Medicare OPPS,11.91,100,,,fee schedule,100% of fee schedule,26.35,90,,,percent of total billed charges,90% of total billed charges,11.91,100,,,fee schedule,Pays 100% Medicare OPPS,11.91,100,,,fee schedule,Pays 100% Medicare OPPS,11.91,100,,,fee schedule,Pays 100% Medicare OPPS,11.91,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,11.91,100,,,fee schedule,100% of fee schedule,11.91,26.35,
Smoking Counseling,5580,CDM,982,RC,99407,HCPCS,outpatient,,,59.76,44.82,,33.32,130,,,fee schedule,130% of fee schedule,33.32,130,,,fee schedule,130% of fee schedule,25.22,100,,,fee schedule,Pays 100% Medicare OPPS,25.22,100,,,fee schedule,Pays 100% Medicare OPPS,31.84,119,,,fee schedule,119% of fee schedule,25.22,100,,,fee schedule,Pays 100% Medicare OPPS,25.22,100,,,fee schedule,100% of fee schedule,53.78,90,,,percent of total billed charges,90% of total billed charges,25.22,100,,,fee schedule,Pays 100% Medicare OPPS,25.22,100,,,fee schedule,Pays 100% Medicare OPPS,25.22,100,,,fee schedule,Pays 100% Medicare OPPS,25.22,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.22,100,,,fee schedule,100% of fee schedule,25.22,53.78,
Advanced Care Planning 30 minutes,5586,CDM,983,RC,99497,HCPCS,outpatient,,,142.8,107.1,,114.24,80,,,percent of total billed charges,90% of total billed charges,114.24,80,,,percent of total billed charges,93% of total billed charges,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,96.31,119,,,fee schedule,119% of fee schedule,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,100% of fee schedule,128.52,90,,,percent of total billed charges,90% of total billed charges,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,76.2,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,76.2,100,,,fee schedule,100% of fee schedule,76.2,128.52,
Advanced Care planning addt 30 min,5588,CDM,983,RC,99498,HCPCS,outpatient,,,127.5,95.63,,102,80,,,percent of total billed charges,90% of total billed charges,102,80,,,percent of total billed charges,93% of total billed charges,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,90.68,119,,,fee schedule,119% of fee schedule,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,100% of fee schedule,114.75,90,,,percent of total billed charges,90% of total billed charges,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,72.08,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,72.08,100,,,fee schedule,100% of fee schedule,72.08,114.75,
Oral eval with counseling less than 3 yo,5592,CDM,510,RC,D0145,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
Oral eval with counselling age 3-4 yr,5594,CDM,510,RC,D0190,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
Floride Varnish Administation,5596,CDM,982,RC,D1206,HCPCS,outpatient,,,22.08,16.56,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,19.87,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,19.87,19.87,
Screening PAP/Breast-Medicare annual,5602,CDM,982,RC,G0101,HCPCS,outpatient,,,141.79,106.34,,35.67,130,,,fee schedule,130% of fee schedule,35.67,130,,,fee schedule,130% of fee schedule,27.89,100,,,fee schedule,Pays 100% Medicare OPPS,27.89,100,,,fee schedule,Pays 100% Medicare OPPS,34.86,119,,,fee schedule,119% of fee schedule,27.89,100,,,fee schedule,Pays 100% Medicare OPPS,27.89,100,,,fee schedule,100% of fee schedule,127.61,90,,,percent of total billed charges,90% of total billed charges,27.89,100,,,fee schedule,Pays 100% Medicare OPPS,27.89,100,,,fee schedule,Pays 100% Medicare OPPS,27.89,100,,,fee schedule,Pays 100% Medicare OPPS,27.89,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,27.89,100,,,fee schedule,100% of fee schedule,27.89,127.61,
Welcome to Medicare Exam,5607,CDM,982,RC,G0402,HCPCS,outpatient,,,402.67,302,,164.59,130,,,fee schedule,130% of fee schedule,164.59,130,,,fee schedule,130% of fee schedule,132.54,100,,,fee schedule,Pays 100% Medicare OPPS,132.54,100,,,fee schedule,Pays 100% Medicare OPPS,154.65,119,,,fee schedule,119% of fee schedule,132.54,100,,,fee schedule,Pays 100% Medicare OPPS,132.54,100,,,fee schedule,100% of fee schedule,362.4,90,,,percent of total billed charges,90% of total billed charges,132.54,100,,,fee schedule,Pays 100% Medicare OPPS,132.54,100,,,fee schedule,Pays 100% Medicare OPPS,132.54,100,,,fee schedule,Pays 100% Medicare OPPS,132.54,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,132.54,100,,,fee schedule,100% of fee schedule,132.54,362.4,
Medicare Annual Wellness,5613,CDM,983,RC,G0438,HCPCS,outpatient,,,332.79,249.59,,212.04,130,,,fee schedule,130% of fee schedule,212.04,130,,,fee schedule,130% of fee schedule,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,208.33,119,,,fee schedule,119% of fee schedule,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,100% of fee schedule,299.51,90,,,percent of total billed charges,90% of total billed charges,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,169.19,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,169.19,100,,,fee schedule,100% of fee schedule,169.19,299.51,
Medicare Annual Wellness- subsequent,5615,CDM,982,RC,G0439,HCPCS,outpatient,,,265.2,198.9,,141.82,130,,,fee schedule,130% of fee schedule,141.82,130,,,fee schedule,130% of fee schedule,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,141.55,119,,,fee schedule,119% of fee schedule,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,100% of fee schedule,238.68,90,,,percent of total billed charges,90% of total billed charges,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,132.67,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,132.67,100,,,fee schedule,100% of fee schedule,132.67,238.68,
depression annual screening Medicare,5617,CDM,983,RC,G0444,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,11.66,119,,,fee schedule,119% of fee schedule,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,9.24,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,9.24,100,,,fee schedule,100% of fee schedule,9.24,36.72,
Telehealth Facility Charge,5621,CDM,780,RC,Q3014,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
Exc/debride subq add 20sq c[Package],5819,CDM,120,RC,11045,HCPCS,inpatient,,,157.38,118.04,,141.64,90,,,percent of total billed charges,90% of total billed charges,146.36,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,141.64,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,131.73,83.7,,,percent of total billed charges,83.7% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,131.73,2506,
Exc/debride subq add 20sq c[Package],5820,CDM,510,RC,11045,HCPCS,outpatient,,,157.38,118.04,,141.64,90,,,percent of total billed charges,90% of total billed charges,146.36,93,,,percent of total billed charges,93% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,59.8,38,,,percent of total billed charges,38% of total billed charges,128.11,81.4,,,percent of total billed charges,81.4% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,141.64,90,,,percent of total billed charges,90% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,59.8,38,,,percent of total billed charges,38% of total billed charges,118.04,75,,,percent of total billed charges,75% of total billed charges,133.77,85,,,percent of total billed charges,85% of total billed charges,59.8,146.36,
Exc/debride subq add 20sq c[Package],5821,CDM,982,RC,11045,HCPCS,outpatient,,,157.38,118.04,,23.3,130,,,fee schedule,130% of fee schedule,23.3,130,,,fee schedule,130% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,32.95,119,,,fee schedule,119% of fee schedule,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,100% of fee schedule,141.64,90,,,percent of total billed charges,90% of total billed charges,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,25.23,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,25.23,100,,,fee schedule,100% of fee schedule,23.3,141.64,
EXC - paring or cutting benign lesion -single[Package],5824,CDM,510,RC,11055,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
EXC - paring or cutting benign lesion -single[Package],5825,CDM,982,RC,11055,HCPCS,outpatient,,,94.91,71.18,,26.12,130,,,fee schedule,130% of fee schedule,26.12,130,,,fee schedule,130% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,19.74,119,,,fee schedule,119% of fee schedule,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,100% of fee schedule,85.42,90,,,percent of total billed charges,90% of total billed charges,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,15.84,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,15.84,100,,,fee schedule,100% of fee schedule,15.84,85.42,
BIOPSY-tangential (scrape) FAC,5828,CDM,450,RC,11102,HCPCS,outpatient,,,220.81,165.61,,198.73,90,,,percent of total billed charges,90% of total billed charges,205.35,93,,,percent of total billed charges,93% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,187.69,85,,,percent of total billed charges,85% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,179.74,81.4,,,percent of total billed charges,81.4% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,198.73,90,,,percent of total billed charges,90% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,83.91,38,,,percent of total billed charges,38% of total billed charges,165.61,75,,,percent of total billed charges,75% of total billed charges,187.69,85,,,percent of total billed charges,85% of total billed charges,83.91,205.35,
Skin Graft app trnk/arm/leg up to 100sq cm[Package],5835,CDM,120,RC,15271,HCPCS,inpatient,,,3418.23,2563.67,,3076.41,90,,,percent of total billed charges,90% of total billed charges,3178.95,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,3076.41,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,2861.06,83.7,,,percent of total billed charges,83.7% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,1326,3178.95,
Skin Graft app trnk/arm/leg up to 100sq cm[Package],5836,CDM,510,RC,15271,HCPCS,outpatient,,,3418.23,2563.67,,3076.41,90,,,percent of total billed charges,90% of total billed charges,3178.95,93,,,percent of total billed charges,93% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,1298.93,38,,,percent of total billed charges,38% of total billed charges,2782.44,81.4,,,percent of total billed charges,81.4% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,3076.41,90,,,percent of total billed charges,90% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,1298.93,38,,,percent of total billed charges,38% of total billed charges,2563.67,75,,,percent of total billed charges,75% of total billed charges,2905.5,85,,,percent of total billed charges,85% of total billed charges,1298.93,3178.95,
Skin Graft app trnk/arm/leg up to 100sq cm[Package],5837,CDM,982,RC,15271,HCPCS,outpatient,,,3418.23,2563.67,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,105.29,119,,,fee schedule,119% of fee schedule,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,100% of fee schedule,3076.41,90,,,percent of total billed charges,90% of total billed charges,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,83.71,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,83.71,100,,,fee schedule,100% of fee schedule,83.71,3076.41,
Apply rigid leg (TCC)[Package],5849,CDM,510,RC,29445,HCPCS,outpatient,,,697.77,523.33,,627.99,90,,,percent of total billed charges,90% of total billed charges,648.93,93,,,percent of total billed charges,93% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,,,,,other,Not reimbursable per contract,265.15,38,,,percent of total billed charges,38% of total billed charges,567.98,81.4,,,percent of total billed charges,81.4% of total billed charges,627.99,90,,,percent of total billed charges,90% of total billed charges,627.99,90,,,percent of total billed charges,90% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,265.15,38,,,percent of total billed charges,38% of total billed charges,523.33,75,,,percent of total billed charges,75% of total billed charges,593.1,85,,,percent of total billed charges,85% of total billed charges,265.15,648.93,
Apply rigid leg (TCC)[Package],5850,CDM,982,RC,29445,HCPCS,outpatient,,,697.77,523.33,,142.51,130,,,fee schedule,130% of fee schedule,142.51,130,,,fee schedule,130% of fee schedule,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,126.69,119,,,fee schedule,119% of fee schedule,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,100% of fee schedule,627.99,90,,,percent of total billed charges,90% of total billed charges,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,99.19,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,99.19,100,,,fee schedule,100% of fee schedule,99.19,627.99,
Apply strapping lower ext multi-layer cast[Package],5853,CDM,120,RC,29581,HCPCS,inpatient,,,250.27,187.7,,225.24,90,,,percent of total billed charges,90% of total billed charges,232.75,93,,,percent of total billed charges,93% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,225.24,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,209.48,83.7,,,percent of total billed charges,83.7% of total billed charges,225.24,90,,,percent of total billed charges,90% of total billed charges,225.24,90,,,percent of total billed charges,90% of total billed charges,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,1326,100,,,per diem,Pays 100% medicare per diem,,,,,other,Not reimbursable per contract,2506,100,,,per diem,100% of IP per diem,209.48,2506,
dentoalveolar block-PRO,5855,CDM,981,RC,64400,HCPCS,outpatient,,,344.6,258.45,,91.81,130,,,fee schedule,130% of fee schedule,91.81,130,,,fee schedule,130% of fee schedule,50.59,100,,,fee schedule,Pays 100% Medicare OPPS,50.59,100,,,fee schedule,Pays 100% Medicare OPPS,61.82,119,,,fee schedule,119% of fee schedule,50.59,100,,,fee schedule,Pays 100% Medicare OPPS,50.59,100,,,fee schedule,100% of fee schedule,310.14,90,,,percent of total billed charges,90% of total billed charges,50.59,100,,,fee schedule,Pays 100% Medicare OPPS,50.59,100,,,fee schedule,Pays 100% Medicare OPPS,50.59,100,,,fee schedule,Pays 100% Medicare OPPS,50.59,100,,,fee schedule,Pays 100% Medicare OPPS,165.28,100,,,fee schedule,100% of fee schedule,50.59,100,,,fee schedule,100% of fee schedule,50.59,310.14,
Clinic Spirometry,5861,CDM,982,RC,94010,HCPCS,outpatient,,,110.4,82.8,,46.18,130,,,fee schedule,130% of fee schedule,46.18,130,,,fee schedule,130% of fee schedule,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,33.65,119,,,fee schedule,119% of fee schedule,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,100% of fee schedule,99.36,90,,,percent of total billed charges,90% of total billed charges,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,28.03,100,,,fee schedule,Pays 100% Medicare OPPS,71.9,100,,,fee schedule,100% of fee schedule,28.03,100,,,fee schedule,100% of fee schedule,28.03,99.36,
Clinic Pre and Post PFT,5863,CDM,982,RC,94060,HCPCS,outpatient,,,176.65,132.49,,79.73,130,,,fee schedule,130% of fee schedule,79.73,130,,,fee schedule,130% of fee schedule,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,57.56,119,,,fee schedule,119% of fee schedule,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,100% of fee schedule,158.99,90,,,percent of total billed charges,90% of total billed charges,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,40.41,100,,,fee schedule,Pays 100% Medicare OPPS,89.88,100,,,fee schedule,100% of fee schedule,40.41,100,,,fee schedule,100% of fee schedule,40.41,158.99,
Diagnostic screening w symptoms,5865,CDM,983,RC,96127,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,4.89,100,,,fee schedule,Pays 100% Medicare OPPS,4.89,100,,,fee schedule,Pays 100% Medicare OPPS,6.15,119,,,fee schedule,119% of fee schedule,4.89,100,,,fee schedule,Pays 100% Medicare OPPS,4.89,100,,,fee schedule,100% of fee schedule,36.72,90,,,percent of total billed charges,90% of total billed charges,4.89,100,,,fee schedule,Pays 100% Medicare OPPS,4.89,100,,,fee schedule,Pays 100% Medicare OPPS,4.89,100,,,fee schedule,Pays 100% Medicare OPPS,4.89,100,,,fee schedule,Pays 100% Medicare OPPS,,,,,other,Not reimbursable per contract,4.89,100,,,fee schedule,100% of fee schedule,4.89,36.72,
Administration of patient-focused health risk assessment instrument,5868,CDM,521,RC,96160,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
Administration of caregiver-focused health risk assessment instrument,5871,CDM,521,RC,96161,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
"Depression screening, pos w plan  Medicaid",5885,CDM,521,RC,G8431,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
"Depression screening-neg, no FU Medicaid",5887,CDM,983,RC,G851-,HCPCS,outpatient,,,40.8,30.6,,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,90,,,percent of total billed charges,90% of total billed charges,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,36.72,36.72,
Depression screening neg,5890,CDM,521,RC,G8510,HCPCS,outpatient,,,40.8,30.6,,36.72,90,,,percent of total billed charges,90% of total billed charges,37.94,93,,,percent of total billed charges,93% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,33.21,81.4,,,percent of total billed charges,81.4% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,15.5,38,,,percent of total billed charges,38% of total billed charges,30.6,75,,,percent of total billed charges,75% of total billed charges,,,,,other,Not reimbursable per contract,15.5,37.94,
FAC Lac Complex Hand 5cm,5913,CDM,450,RC,13133,HCPCS,outpatient,,,294.11,220.58,,264.7,90,,,percent of total billed charges,90% of total billed charges,273.52,93,,,percent of total billed charges,93% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,249.99,85,,,percent of total billed charges,85% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,239.41,81.4,,,percent of total billed charges,81.4% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,264.7,90,,,percent of total billed charges,90% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,111.76,38,,,percent of total billed charges,38% of total billed charges,220.58,75,,,percent of total billed charges,75% of total billed charges,249.99,85,,,percent of total billed charges,85% of total billed charges,111.76,273.52,
Repair Extensor Tendon-Hand-FAC,5946,CDM,450,RC,26410,HCPCS,outpatient,,,2450.17,1837.63,,2205.15,90,,,percent of total billed charges,90% of total billed charges,2278.66,93,,,percent of total billed charges,93% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,2082.64,85,,,percent of total billed charges,85% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,1994.44,81.4,,,percent of total billed charges,81.4% of total billed charges,2205.15,90,,,percent of total billed charges,90% of total billed charges,2205.15,90,,,percent of total billed charges,90% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,931.06,38,,,percent of total billed charges,38% of total billed charges,1837.63,75,,,percent of total billed charges,75% of total billed charges,2082.64,85,,,percent of total billed charges,85% of total billed charges,931.06,2278.66,
FAC Tendon Rep Ext Fing,5948,CDM,450,RC,26418,HCPCS,outpatient,,,2444.33,1833.25,,2199.9,90,,,percent of total billed charges,90% of total billed charges,2273.23,93,,,percent of total billed charges,93% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,2077.68,85,,,percent of total billed charges,85% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,1989.68,81.4,,,percent of total billed charges,81.4% of total billed charges,2199.9,90,,,percent of total billed charges,90% of total billed charges,2199.9,90,,,percent of total billed charges,90% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,928.85,38,,,percent of total billed charges,38% of total billed charges,1833.25,75,,,percent of total billed charges,75% of total billed charges,2077.68,85,,,percent of total billed charges,85% of total billed charges,928.85,2273.23,
z* Vitamin B12 340B,340003,CDM,636,RC,J3420,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
z* Vitamin B12 340B,340003,CDM,250,RC,J3420,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
z* Diphenhydramine 50mg/ml 340B,340005,CDM,636,RC,J1200,HCPCS,outpatient,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
z* Diphenhydramine 50mg/ml 340B,340005,CDM,250,RC,J1200,HCPCS,outpatient,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
z* Depo-Testosterone SDV 340B,340006,CDM,636,RC,J1080,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
z* Depo-Testosterone SDV 340B,340006,CDM,250,RC,J1080,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
z* Erythromycin opth (340),430044-340,CDM,250,RC,,,outpatient,,,38.66,29,,34.79,90,,,percent of total billed charges,90% of total billed charges,35.95,93,,,percent of total billed charges,93% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,31.47,81.4,,,percent of total billed charges,81.4% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,34.79,90,,,percent of total billed charges,90% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,14.69,38,,,percent of total billed charges,38% of total billed charges,29,75,,,percent of total billed charges,75% of total billed charges,32.86,85,,,percent of total billed charges,85% of total billed charges,14.69,35.95,
z* Ethyl Chloride AccuStream,444141,CDM,250,RC,,,outpatient,,,46.24,34.68,,41.62,90,,,percent of total billed charges,90% of total billed charges,43,93,,,percent of total billed charges,93% of total billed charges,17.57,38,,,percent of total billed charges,38% of total billed charges,17.57,38,,,percent of total billed charges,38% of total billed charges,39.3,85,,,percent of total billed charges,85% of total billed charges,17.57,38,,,percent of total billed charges,38% of total billed charges,37.64,81.4,,,percent of total billed charges,81.4% of total billed charges,41.62,90,,,percent of total billed charges,90% of total billed charges,41.62,90,,,percent of total billed charges,90% of total billed charges,17.57,38,,,percent of total billed charges,38% of total billed charges,17.57,38,,,percent of total billed charges,38% of total billed charges,17.57,38,,,percent of total billed charges,38% of total billed charges,34.68,75,,,percent of total billed charges,75% of total billed charges,39.3,85,,,percent of total billed charges,85% of total billed charges,17.57,43,
z* acetaminophen 325mg po,460014,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
z* Aspirin 81mg Chew,460449,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
z* Premarin 25mg inj,460519,CDM,250,RC,J1410,HCPCS,outpatient,,,424.32,318.24,,381.89,90,,,percent of total billed charges,90% of total billed charges,394.62,93,,,percent of total billed charges,93% of total billed charges,161.24,38,,,percent of total billed charges,38% of total billed charges,161.24,38,,,percent of total billed charges,38% of total billed charges,360.67,85,,,percent of total billed charges,85% of total billed charges,161.24,38,,,percent of total billed charges,38% of total billed charges,345.4,81.4,,,percent of total billed charges,81.4% of total billed charges,381.89,90,,,percent of total billed charges,90% of total billed charges,381.89,90,,,percent of total billed charges,90% of total billed charges,161.24,38,,,percent of total billed charges,38% of total billed charges,161.24,38,,,percent of total billed charges,38% of total billed charges,161.24,38,,,percent of total billed charges,38% of total billed charges,318.24,75,,,percent of total billed charges,75% of total billed charges,360.67,85,,,percent of total billed charges,85% of total billed charges,161.24,394.62,
z* acetaminophen 160mg/5ml,460816,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
z* Dexamethasone 4mg inj,461558,CDM,250,RC,,,outpatient,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
z* Depo-Medrol 40mg inj,461655,CDM,636,RC,J1010,HCPCS,outpatient,,,51.55,38.66,,46.4,90,,,percent of total billed charges,90% of total billed charges,47.94,93,,,percent of total billed charges,93% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,41.96,81.4,,,percent of total billed charges,81.4% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,38.66,75,,,percent of total billed charges,75% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,47.94,
z* Depo-Medrol 40mg inj,461655,CDM,250,RC,J1010,HCPCS,outpatient,,,51.55,38.66,,46.4,90,,,percent of total billed charges,90% of total billed charges,47.94,93,,,percent of total billed charges,93% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,41.96,81.4,,,percent of total billed charges,81.4% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,46.4,90,,,percent of total billed charges,90% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,19.59,38,,,percent of total billed charges,38% of total billed charges,38.66,75,,,percent of total billed charges,75% of total billed charges,43.82,85,,,percent of total billed charges,85% of total billed charges,19.59,47.94,
z* Depo-Medrol 80mg inj,461659,CDM,636,RC,J1010,HCPCS,outpatient,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,201.61,
z* Depo-Medrol 80mg inj,461659,CDM,250,RC,J1010,HCPCS,outpatient,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,201.61,
z* TNKase,465878,CDM,636,RC,J3101,HCPCS,outpatient,,,9289.43,6967.07,,8360.49,90,,,percent of total billed charges,90% of total billed charges,8639.17,93,,,percent of total billed charges,93% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,7896.02,85,,,percent of total billed charges,85% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,7561.6,81.4,,,percent of total billed charges,81.4% of total billed charges,8360.49,90,,,percent of total billed charges,90% of total billed charges,8360.49,90,,,percent of total billed charges,90% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,6967.07,75,,,percent of total billed charges,75% of total billed charges,7896.02,85,,,percent of total billed charges,85% of total billed charges,3529.98,8639.17,
z* TNKase,465878,CDM,250,RC,J3101,HCPCS,outpatient,,,9289.43,6967.07,,8360.49,90,,,percent of total billed charges,90% of total billed charges,8639.17,93,,,percent of total billed charges,93% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,7896.02,85,,,percent of total billed charges,85% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,7561.6,81.4,,,percent of total billed charges,81.4% of total billed charges,8360.49,90,,,percent of total billed charges,90% of total billed charges,8360.49,90,,,percent of total billed charges,90% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,3529.98,38,,,percent of total billed charges,38% of total billed charges,6967.07,75,,,percent of total billed charges,75% of total billed charges,7896.02,85,,,percent of total billed charges,85% of total billed charges,3529.98,8639.17,
z* Ketorolac (Toradol) 60mg vial,466409,CDM,250,RC,,,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
z* dextrose 5%/500ml IV,467076-1,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
z* Bupivacaine 0.50% 50ml 340B,467545-340,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
z* Lidocaine 1% w/ epi 340B,468058-340,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
z* diphenhydramine 12.5mg/5ml,468444,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
z* Kenalog 40mg/ml (340),468850-340,CDM,250,RC,J3301,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
z* TB test 340B,469494-340,CDM,250,RC,73718-2,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
z* Depo-Provera,469841,CDM,250,RC,00144-P,HCPCS,outpatient,,,178.11,133.58,,160.3,90,,,percent of total billed charges,90% of total billed charges,165.64,93,,,percent of total billed charges,93% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,144.98,81.4,,,percent of total billed charges,81.4% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,133.58,75,,,percent of total billed charges,75% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,165.64,
z* Depo-Provera,469841,CDM,250,RC,J1050,HCPCS,outpatient,,,178.11,133.58,,160.3,90,,,percent of total billed charges,90% of total billed charges,165.64,93,,,percent of total billed charges,93% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,144.98,81.4,,,percent of total billed charges,81.4% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,133.58,75,,,percent of total billed charges,75% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,165.64,
z* Depo-Provera,469841,CDM,250,RC,144,HCPCS,outpatient,,,178.11,133.58,,160.3,90,,,percent of total billed charges,90% of total billed charges,165.64,93,,,percent of total billed charges,93% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,144.98,81.4,,,percent of total billed charges,81.4% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,133.58,75,,,percent of total billed charges,75% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,165.64,
z* Depo-Provera,469841,CDM,250,RC,J1050,HCPCS,outpatient,,,178.11,133.58,,160.3,90,,,percent of total billed charges,90% of total billed charges,165.64,93,,,percent of total billed charges,93% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,144.98,81.4,,,percent of total billed charges,81.4% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,160.3,90,,,percent of total billed charges,90% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,67.68,38,,,percent of total billed charges,38% of total billed charges,133.58,75,,,percent of total billed charges,75% of total billed charges,151.39,85,,,percent of total billed charges,85% of total billed charges,67.68,165.64,
z* Lidocaine Jelly,470278,CDM,250,RC,,,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
z* acetaminophen 500mg po,470971,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
z* lidocaine 1% MDV 340B,497931-340,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
z* Lidocaine 2% 340B,497932-340,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
z* Lidocaine 2% w/ epi 340B,497933-340,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
z* Drysol,499952,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
acetaminophen 325 mg oral tablet,ACE1003030,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
acetaminophen 500 mg oral tablet,ACE1003031,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
acetaminophen 120 mg rectal suppository,ACE1003032,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
acetaminophen 325 mg rectal suppository,ACE1003033,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
acetaminophen 650 mg rectal suppository,ACE1003034,CDM,637,RC,A9270,HCPCS,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
acetaminophen 160 mg/5 mL oral suspension,ACE1003035,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
z* acetaZOLAMIDE 250 mg oral tablet,ACE1003094,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Acetylcysteine 20% IV solution,ACE1003234,CDM,636,RC,J0132,HCPCS,outpatient,,,304.66,228.5,,274.19,90,,,percent of total billed charges,90% of total billed charges,283.33,93,,,percent of total billed charges,93% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,247.99,81.4,,,percent of total billed charges,81.4% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,228.5,75,,,percent of total billed charges,75% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,283.33,
Acetylcysteine 20% IV solution,ACE1003234,CDM,250,RC,J0132,HCPCS,outpatient,,,304.66,228.5,,274.19,90,,,percent of total billed charges,90% of total billed charges,283.33,93,,,percent of total billed charges,93% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,247.99,81.4,,,percent of total billed charges,81.4% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,274.19,90,,,percent of total billed charges,90% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,115.77,38,,,percent of total billed charges,38% of total billed charges,228.5,75,,,percent of total billed charges,75% of total billed charges,258.96,85,,,percent of total billed charges,85% of total billed charges,115.77,283.33,
HYDROcodone-acetaminophen 5mg/325 mg oral tablet,ACE11074,CDM,637,RC,,,outpatient,,,2.31,1.73,,2.08,90,,,percent of total billed charges,90% of total billed charges,2.15,93,,,percent of total billed charges,93% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,1.96,85,,,percent of total billed charges,85% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,1.88,81.4,,,percent of total billed charges,81.4% of total billed charges,2.08,90,,,percent of total billed charges,90% of total billed charges,2.08,90,,,percent of total billed charges,90% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,1.73,75,,,percent of total billed charges,75% of total billed charges,1.96,85,,,percent of total billed charges,85% of total billed charges,0.88,2.15,
HYDROcodone/Acetaminophen 7.5 mg-325mg/15 mL oral solution,ACE11083,CDM,250,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
HYDROcodone/Acetaminophen 7.5 mg-325mg/15 mL oral solution,ACE11083,CDM,637,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
acetylcysteine 20% inhalation solution,ACE4856,CDM,250,RC,,,outpatient,,,33.98,25.49,,30.58,90,,,percent of total billed charges,90% of total billed charges,31.6,93,,,percent of total billed charges,93% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,28.88,85,,,percent of total billed charges,85% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,27.66,81.4,,,percent of total billed charges,81.4% of total billed charges,30.58,90,,,percent of total billed charges,90% of total billed charges,30.58,90,,,percent of total billed charges,90% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,12.91,38,,,percent of total billed charges,38% of total billed charges,25.49,75,,,percent of total billed charges,75% of total billed charges,28.88,85,,,percent of total billed charges,85% of total billed charges,12.91,31.6,
acetylcysteine 600 mg oral capsule,ACE4857,CDM,250,RC,,,outpatient,,,0.12,0.09,,0.11,90,,,percent of total billed charges,90% of total billed charges,0.11,93,,,percent of total billed charges,93% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.1,85,,,percent of total billed charges,85% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.1,81.4,,,percent of total billed charges,81.4% of total billed charges,0.11,90,,,percent of total billed charges,90% of total billed charges,0.11,90,,,percent of total billed charges,90% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.09,75,,,percent of total billed charges,75% of total billed charges,0.1,85,,,percent of total billed charges,85% of total billed charges,0.05,0.11,
Acidophilus probiotic oral capsule,ACI11651,CDM,637,RC,A9270,HCPCS,outpatient,,,2.2,1.65,,1.98,90,,,percent of total billed charges,90% of total billed charges,2.05,93,,,percent of total billed charges,93% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,1.87,85,,,percent of total billed charges,85% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,1.79,81.4,,,percent of total billed charges,81.4% of total billed charges,1.98,90,,,percent of total billed charges,90% of total billed charges,1.98,90,,,percent of total billed charges,90% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,1.65,75,,,percent of total billed charges,75% of total billed charges,1.87,85,,,percent of total billed charges,85% of total billed charges,0.84,2.05,
Alteplase 100 mg IV injection,ACT1003205,CDM,636,RC,J2997,HCPCS,outpatient,,,13280.9,9960.68,,11952.81,90,,,percent of total billed charges,90% of total billed charges,12351.24,93,,,percent of total billed charges,93% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,11288.77,85,,,percent of total billed charges,85% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,10810.65,81.4,,,percent of total billed charges,81.4% of total billed charges,11952.81,90,,,percent of total billed charges,90% of total billed charges,11952.81,90,,,percent of total billed charges,90% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,9960.68,75,,,percent of total billed charges,75% of total billed charges,11288.77,85,,,percent of total billed charges,85% of total billed charges,5046.74,12351.24,
Alteplase 100 mg IV injection,ACT1003205,CDM,250,RC,J2997,HCPCS,outpatient,,,13280.9,9960.68,,11952.81,90,,,percent of total billed charges,90% of total billed charges,12351.24,93,,,percent of total billed charges,93% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,11288.77,85,,,percent of total billed charges,85% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,10810.65,81.4,,,percent of total billed charges,81.4% of total billed charges,11952.81,90,,,percent of total billed charges,90% of total billed charges,11952.81,90,,,percent of total billed charges,90% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,5046.74,38,,,percent of total billed charges,38% of total billed charges,9960.68,75,,,percent of total billed charges,75% of total billed charges,11288.77,85,,,percent of total billed charges,85% of total billed charges,5046.74,12351.24,
Activated Charcoal Plus Sorbitol 25 g oral suspension,ACT1003418,CDM,250,RC,A9270,HCPCS,outpatient,,,53.92,40.44,,48.53,90,,,percent of total billed charges,90% of total billed charges,50.15,93,,,percent of total billed charges,93% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,43.89,81.4,,,percent of total billed charges,81.4% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,48.53,90,,,percent of total billed charges,90% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,20.49,38,,,percent of total billed charges,38% of total billed charges,40.44,75,,,percent of total billed charges,75% of total billed charges,45.83,85,,,percent of total billed charges,85% of total billed charges,20.49,50.15,
ActHIB intramuscular injection,ACT16971,CDM,250,RC,90648,HCPCS,outpatient,,,43.35,32.51,,39.02,90,,,percent of total billed charges,90% of total billed charges,40.32,93,,,percent of total billed charges,93% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,35.29,81.4,,,percent of total billed charges,81.4% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,39.02,90,,,percent of total billed charges,90% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,16.47,38,,,percent of total billed charges,38% of total billed charges,32.51,75,,,percent of total billed charges,75% of total billed charges,36.85,85,,,percent of total billed charges,85% of total billed charges,16.47,40.32,
Actemra 20 mg/mL (400mg) intravenous solution,ACT18402,CDM,636,RC,J3262,HCPCS,outpatient,,,9.16,6.87,,8.24,90,,,percent of total billed charges,90% of total billed charges,8.52,93,,,percent of total billed charges,93% of total billed charges,3.48,38,,,percent of total billed charges,38% of total billed charges,3.48,38,,,percent of total billed charges,38% of total billed charges,7.79,85,,,percent of total billed charges,85% of total billed charges,3.48,38,,,percent of total billed charges,38% of total billed charges,7.46,81.4,,,percent of total billed charges,81.4% of total billed charges,8.24,90,,,percent of total billed charges,90% of total billed charges,8.24,90,,,percent of total billed charges,90% of total billed charges,3.48,38,,,percent of total billed charges,38% of total billed charges,3.48,38,,,percent of total billed charges,38% of total billed charges,3.48,38,,,percent of total billed charges,38% of total billed charges,6.87,75,,,percent of total billed charges,75% of total billed charges,7.79,85,,,percent of total billed charges,85% of total billed charges,3.48,8.52,
acyclovir 200 mg oral capsule,ACY1002985,CDM,637,RC,A9270,HCPCS,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
acyclovir 500mg IV,ACY1002986,CDM,636,RC,J0133,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
acyclovir 500mg IV,ACY1002986,CDM,250,RC,J0133,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
acyclovir 800 mg oral tablet,ACY123,CDM,250,RC,,,outpatient,,,4.59,3.44,,4.13,90,,,percent of total billed charges,90% of total billed charges,4.27,93,,,percent of total billed charges,93% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,3.9,85,,,percent of total billed charges,85% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,3.74,81.4,,,percent of total billed charges,81.4% of total billed charges,4.13,90,,,percent of total billed charges,90% of total billed charges,4.13,90,,,percent of total billed charges,90% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,3.44,75,,,percent of total billed charges,75% of total billed charges,3.9,85,,,percent of total billed charges,85% of total billed charges,1.74,4.27,
acyclovir 50 mg/mL intravenous solution,ACY127,CDM,636,RC,J0133,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
Tdap IM suspension,ADA17575,CDM,636,RC,90715,HCPCS,outpatient,,,52.72,39.54,,47.45,90,,,percent of total billed charges,90% of total billed charges,49.03,93,,,percent of total billed charges,93% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,42.91,81.4,,,percent of total billed charges,81.4% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,47.45,90,,,percent of total billed charges,90% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,20.03,38,,,percent of total billed charges,38% of total billed charges,39.54,75,,,percent of total billed charges,75% of total billed charges,44.81,85,,,percent of total billed charges,85% of total billed charges,20.03,49.03,
adenosine 3 mg/mL intravenous solution,ADE1003096,CDM,250,RC,J0153,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
adenosine 3 mg/mL intravenous solution,ADE1003096,CDM,636,RC,J0153,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
Fluticasone-salmeterol 500/50 mcg inhalation powder,ADV1003409,CDM,259,RC,,,outpatient,,,358.38,268.79,,322.54,90,,,percent of total billed charges,90% of total billed charges,333.29,93,,,percent of total billed charges,93% of total billed charges,136.18,38,,,percent of total billed charges,38% of total billed charges,136.18,38,,,percent of total billed charges,38% of total billed charges,304.62,85,,,percent of total billed charges,85% of total billed charges,136.18,38,,,percent of total billed charges,38% of total billed charges,291.72,81.4,,,percent of total billed charges,81.4% of total billed charges,322.54,90,,,percent of total billed charges,90% of total billed charges,322.54,90,,,percent of total billed charges,90% of total billed charges,136.18,38,,,percent of total billed charges,38% of total billed charges,136.18,38,,,percent of total billed charges,38% of total billed charges,136.18,38,,,percent of total billed charges,38% of total billed charges,268.79,75,,,percent of total billed charges,75% of total billed charges,304.62,85,,,percent of total billed charges,85% of total billed charges,136.18,333.29,
Fluticasone-salmeterol 250/50 mcg inhalation powder,ADV1003410,CDM,259,RC,,,outpatient,,,220.56,165.42,,198.5,90,,,percent of total billed charges,90% of total billed charges,205.12,93,,,percent of total billed charges,93% of total billed charges,83.81,38,,,percent of total billed charges,38% of total billed charges,83.81,38,,,percent of total billed charges,38% of total billed charges,187.48,85,,,percent of total billed charges,85% of total billed charges,83.81,38,,,percent of total billed charges,38% of total billed charges,179.54,81.4,,,percent of total billed charges,81.4% of total billed charges,198.5,90,,,percent of total billed charges,90% of total billed charges,198.5,90,,,percent of total billed charges,90% of total billed charges,83.81,38,,,percent of total billed charges,38% of total billed charges,83.81,38,,,percent of total billed charges,38% of total billed charges,83.81,38,,,percent of total billed charges,38% of total billed charges,165.42,75,,,percent of total billed charges,75% of total billed charges,187.48,85,,,percent of total billed charges,85% of total billed charges,83.81,205.12,
Phenylephrine 10% ophthalmic solution,AK 1003380,CDM,250,RC,,,outpatient,,,66.05,49.54,,59.45,90,,,percent of total billed charges,90% of total billed charges,61.43,93,,,percent of total billed charges,93% of total billed charges,25.1,38,,,percent of total billed charges,38% of total billed charges,25.1,38,,,percent of total billed charges,38% of total billed charges,56.14,85,,,percent of total billed charges,85% of total billed charges,25.1,38,,,percent of total billed charges,38% of total billed charges,53.76,81.4,,,percent of total billed charges,81.4% of total billed charges,59.45,90,,,percent of total billed charges,90% of total billed charges,59.45,90,,,percent of total billed charges,90% of total billed charges,25.1,38,,,percent of total billed charges,38% of total billed charges,25.1,38,,,percent of total billed charges,38% of total billed charges,25.1,38,,,percent of total billed charges,38% of total billed charges,49.54,75,,,percent of total billed charges,75% of total billed charges,56.14,85,,,percent of total billed charges,85% of total billed charges,25.1,61.43,
Phenylephrine 2.5% ophthalmic solution,AK 1003381,CDM,250,RC,,,outpatient,,,53.65,40.24,,48.29,90,,,percent of total billed charges,90% of total billed charges,49.89,93,,,percent of total billed charges,93% of total billed charges,20.39,38,,,percent of total billed charges,38% of total billed charges,20.39,38,,,percent of total billed charges,38% of total billed charges,45.6,85,,,percent of total billed charges,85% of total billed charges,20.39,38,,,percent of total billed charges,38% of total billed charges,43.67,81.4,,,percent of total billed charges,81.4% of total billed charges,48.29,90,,,percent of total billed charges,90% of total billed charges,48.29,90,,,percent of total billed charges,90% of total billed charges,20.39,38,,,percent of total billed charges,38% of total billed charges,20.39,38,,,percent of total billed charges,38% of total billed charges,20.39,38,,,percent of total billed charges,38% of total billed charges,40.24,75,,,percent of total billed charges,75% of total billed charges,45.6,85,,,percent of total billed charges,85% of total billed charges,20.39,49.89,
albuterol 2.5 mg/3 mL (0.083%) inhalation solution,ALB1003229,CDM,250,RC,J7613,HCPCS,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
albumin human 25% intravenous solution,ALB1003284,CDM,250,RC,P9047,HCPCS,outpatient,,,300.21,225.16,,270.19,90,,,percent of total billed charges,90% of total billed charges,279.2,93,,,percent of total billed charges,93% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,255.18,85,,,percent of total billed charges,85% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,244.37,81.4,,,percent of total billed charges,81.4% of total billed charges,270.19,90,,,percent of total billed charges,90% of total billed charges,270.19,90,,,percent of total billed charges,90% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,225.16,75,,,percent of total billed charges,75% of total billed charges,255.18,85,,,percent of total billed charges,85% of total billed charges,114.08,279.2,
albumin human 25% intravenous solution,ALB1003284,CDM,636,RC,P9047,HCPCS,outpatient,,,300.21,225.16,,270.19,90,,,percent of total billed charges,90% of total billed charges,279.2,93,,,percent of total billed charges,93% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,255.18,85,,,percent of total billed charges,85% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,244.37,81.4,,,percent of total billed charges,81.4% of total billed charges,270.19,90,,,percent of total billed charges,90% of total billed charges,270.19,90,,,percent of total billed charges,90% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,114.08,38,,,percent of total billed charges,38% of total billed charges,225.16,75,,,percent of total billed charges,75% of total billed charges,255.18,85,,,percent of total billed charges,85% of total billed charges,114.08,279.2,
albuterol 1.25 mg/3 mL (0.042%) inhalation solution,ALB4817,CDM,636,RC,J7613,HCPCS,outpatient,,,23.75,17.81,,21.38,90,,,percent of total billed charges,90% of total billed charges,22.09,93,,,percent of total billed charges,93% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,20.19,85,,,percent of total billed charges,85% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,19.33,81.4,,,percent of total billed charges,81.4% of total billed charges,21.38,90,,,percent of total billed charges,90% of total billed charges,21.38,90,,,percent of total billed charges,90% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,17.81,75,,,percent of total billed charges,75% of total billed charges,20.19,85,,,percent of total billed charges,85% of total billed charges,9.03,22.09,
albuterol 0.63 mg/3 mL (0.021%) inhalation solution,ALB4818,CDM,636,RC,J7613,HCPCS,outpatient,,,38.09,28.57,,34.28,90,,,percent of total billed charges,90% of total billed charges,35.42,93,,,percent of total billed charges,93% of total billed charges,14.47,38,,,percent of total billed charges,38% of total billed charges,14.47,38,,,percent of total billed charges,38% of total billed charges,32.38,85,,,percent of total billed charges,85% of total billed charges,14.47,38,,,percent of total billed charges,38% of total billed charges,31.01,81.4,,,percent of total billed charges,81.4% of total billed charges,34.28,90,,,percent of total billed charges,90% of total billed charges,34.28,90,,,percent of total billed charges,90% of total billed charges,14.47,38,,,percent of total billed charges,38% of total billed charges,14.47,38,,,percent of total billed charges,38% of total billed charges,14.47,38,,,percent of total billed charges,38% of total billed charges,28.57,75,,,percent of total billed charges,75% of total billed charges,32.38,85,,,percent of total billed charges,85% of total billed charges,14.47,35.42,
Spironolactone 25 mg oral tablet,ALD1003182,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
allopurinol 100 mg oral tablet,ALL1003012,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
ALPRAZolam 1 mg oral tablet,ALP1701,CDM,637,RC,,,outpatient,,,3.3,2.48,,2.97,90,,,percent of total billed charges,90% of total billed charges,3.07,93,,,percent of total billed charges,93% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,2.81,85,,,percent of total billed charges,85% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,2.69,81.4,,,percent of total billed charges,81.4% of total billed charges,2.97,90,,,percent of total billed charges,90% of total billed charges,2.97,90,,,percent of total billed charges,90% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,2.48,75,,,percent of total billed charges,75% of total billed charges,2.81,85,,,percent of total billed charges,85% of total billed charges,1.25,3.07,
Zolpidem 5 mg oral tablet,AMB1003247,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
amiodarone 200 mg oral tablet,AMI1002987,CDM,637,RC,A9270,HCPCS,outpatient,,,21.09,15.82,,18.98,90,,,percent of total billed charges,90% of total billed charges,19.61,93,,,percent of total billed charges,93% of total billed charges,8.01,38,,,percent of total billed charges,38% of total billed charges,8.01,38,,,percent of total billed charges,38% of total billed charges,17.93,85,,,percent of total billed charges,85% of total billed charges,8.01,38,,,percent of total billed charges,38% of total billed charges,17.17,81.4,,,percent of total billed charges,81.4% of total billed charges,18.98,90,,,percent of total billed charges,90% of total billed charges,18.98,90,,,percent of total billed charges,90% of total billed charges,8.01,38,,,percent of total billed charges,38% of total billed charges,8.01,38,,,percent of total billed charges,38% of total billed charges,8.01,38,,,percent of total billed charges,38% of total billed charges,15.82,75,,,percent of total billed charges,75% of total billed charges,17.93,85,,,percent of total billed charges,85% of total billed charges,8.01,19.61,
amiodarone 150 mg/3mL intravenous solution,AMI1002988,CDM,250,RC,J0282,HCPCS,outpatient,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
amitriptyline 50 mg oral tablet,AMI1003089,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
amLODIPine 5 mg oral tablet,AML1003217,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
ammonium lactate 12% topical lotion,AMM13839,CDM,250,RC,,,outpatient,,,10.2,7.65,,9.18,90,,,percent of total billed charges,90% of total billed charges,9.49,93,,,percent of total billed charges,93% of total billed charges,3.88,38,,,percent of total billed charges,38% of total billed charges,3.88,38,,,percent of total billed charges,38% of total billed charges,8.67,85,,,percent of total billed charges,85% of total billed charges,3.88,38,,,percent of total billed charges,38% of total billed charges,8.3,81.4,,,percent of total billed charges,81.4% of total billed charges,9.18,90,,,percent of total billed charges,90% of total billed charges,9.18,90,,,percent of total billed charges,90% of total billed charges,3.88,38,,,percent of total billed charges,38% of total billed charges,3.88,38,,,percent of total billed charges,38% of total billed charges,3.88,38,,,percent of total billed charges,38% of total billed charges,7.65,75,,,percent of total billed charges,75% of total billed charges,8.67,85,,,percent of total billed charges,85% of total billed charges,3.88,9.49,
amoxicillin 500 mg oral capsule,AMO1003059,CDM,637,RC,A9270,HCPCS,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
amoxicillin 400 mg/5 mL oral liquid,AMO1003061,CDM,637,RC,A9270,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid,AMO1229,CDM,250,RC,G9315,HCPCS,outpatient,,,77.45,58.09,,69.71,90,,,percent of total billed charges,90% of total billed charges,72.03,93,,,percent of total billed charges,93% of total billed charges,29.43,38,,,percent of total billed charges,38% of total billed charges,29.43,38,,,percent of total billed charges,38% of total billed charges,65.83,85,,,percent of total billed charges,85% of total billed charges,29.43,38,,,percent of total billed charges,38% of total billed charges,63.04,81.4,,,percent of total billed charges,81.4% of total billed charges,69.71,90,,,percent of total billed charges,90% of total billed charges,69.71,90,,,percent of total billed charges,90% of total billed charges,29.43,38,,,percent of total billed charges,38% of total billed charges,29.43,38,,,percent of total billed charges,38% of total billed charges,29.43,38,,,percent of total billed charges,38% of total billed charges,58.09,75,,,percent of total billed charges,75% of total billed charges,65.83,85,,,percent of total billed charges,85% of total billed charges,29.43,72.03,
apixaban (Eliquis) 2.5 mg oral tablet,API19728,CDM,250,RC,,,outpatient,,,10.33,7.75,,9.3,90,,,percent of total billed charges,90% of total billed charges,9.61,93,,,percent of total billed charges,93% of total billed charges,3.93,38,,,percent of total billed charges,38% of total billed charges,3.93,38,,,percent of total billed charges,38% of total billed charges,8.78,85,,,percent of total billed charges,85% of total billed charges,3.93,38,,,percent of total billed charges,38% of total billed charges,8.41,81.4,,,percent of total billed charges,81.4% of total billed charges,9.3,90,,,percent of total billed charges,90% of total billed charges,9.3,90,,,percent of total billed charges,90% of total billed charges,3.93,38,,,percent of total billed charges,38% of total billed charges,3.93,38,,,percent of total billed charges,38% of total billed charges,3.93,38,,,percent of total billed charges,38% of total billed charges,7.75,75,,,percent of total billed charges,75% of total billed charges,8.78,85,,,percent of total billed charges,85% of total billed charges,3.93,9.61,
Aranesp 60mcg/0.3mL injection,ARA16084,CDM,636,RC,J0881,HCPCS,outpatient,,,680.1,510.08,,612.09,90,,,percent of total billed charges,90% of total billed charges,632.49,93,,,percent of total billed charges,93% of total billed charges,258.44,38,,,percent of total billed charges,38% of total billed charges,258.44,38,,,percent of total billed charges,38% of total billed charges,578.09,85,,,percent of total billed charges,85% of total billed charges,258.44,38,,,percent of total billed charges,38% of total billed charges,553.6,81.4,,,percent of total billed charges,81.4% of total billed charges,612.09,90,,,percent of total billed charges,90% of total billed charges,612.09,90,,,percent of total billed charges,90% of total billed charges,258.44,38,,,percent of total billed charges,38% of total billed charges,258.44,38,,,percent of total billed charges,38% of total billed charges,258.44,38,,,percent of total billed charges,38% of total billed charges,510.08,75,,,percent of total billed charges,75% of total billed charges,578.09,85,,,percent of total billed charges,85% of total billed charges,258.44,632.49,
ascorbic acid 500 mg/mL injectable solution,ASC1003194,CDM,636,RC,J3490,HCPCS,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
ascorbic acid 500 mg/mL injectable solution,ASC1003194,CDM,250,RC,J3490,HCPCS,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
z* aspirin 325 mg oral tablet,ASP1003099,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
aspirin 325 mg oral delayed release tablet,ASP1003100,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Aspirin 81 oral delayed release tablet,ASP1003101,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
"aspirin 81 mg oral tablet, chewable",ASP1742,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
atenolol 25 mg oral tablet,ATE1002990,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
atenolol 50 mg oral tablet,ATE1002991,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
Lorazepam 0.5 mg oral tablet,ATI1003092,CDM,637,RC,A9270,HCPCS,outpatient,,,3.24,2.43,,2.92,90,,,percent of total billed charges,90% of total billed charges,3.01,93,,,percent of total billed charges,93% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.64,81.4,,,percent of total billed charges,81.4% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.43,75,,,percent of total billed charges,75% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,3.01,
Lorazepam 2 mg/mL injectable solution,ATI1003093,CDM,636,RC,J2060,HCPCS,outpatient,,,22.74,17.06,,20.47,90,,,percent of total billed charges,90% of total billed charges,21.15,93,,,percent of total billed charges,93% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,18.51,81.4,,,percent of total billed charges,81.4% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,17.06,75,,,percent of total billed charges,75% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,21.15,
Lorazepam 2 mg/mL injectable solution,ATI1003093,CDM,250,RC,J2060,HCPCS,outpatient,,,22.74,17.06,,20.47,90,,,percent of total billed charges,90% of total billed charges,21.15,93,,,percent of total billed charges,93% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,18.51,81.4,,,percent of total billed charges,81.4% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,17.06,75,,,percent of total billed charges,75% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,21.15,
Lorazepam 1 mg oral tablet,ATI3182013,CDM,637,RC,A9270,HCPCS,outpatient,,,3.24,2.43,,2.92,90,,,percent of total billed charges,90% of total billed charges,3.01,93,,,percent of total billed charges,93% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.64,81.4,,,percent of total billed charges,81.4% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.43,75,,,percent of total billed charges,75% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,3.01,
atorvastatin 40 mg oral tablet,ATO14075,CDM,250,RC,,,outpatient,,,2.16,1.62,,1.94,90,,,percent of total billed charges,90% of total billed charges,2.01,93,,,percent of total billed charges,93% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,1.84,85,,,percent of total billed charges,85% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,1.76,81.4,,,percent of total billed charges,81.4% of total billed charges,1.94,90,,,percent of total billed charges,90% of total billed charges,1.94,90,,,percent of total billed charges,90% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,1.62,75,,,percent of total billed charges,75% of total billed charges,1.84,85,,,percent of total billed charges,85% of total billed charges,0.82,2.01,
atorvastatin 40 mg oral tablet,ATO14075,CDM,637,RC,,,outpatient,,,2.16,1.62,,1.94,90,,,percent of total billed charges,90% of total billed charges,2.01,93,,,percent of total billed charges,93% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,1.84,85,,,percent of total billed charges,85% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,1.76,81.4,,,percent of total billed charges,81.4% of total billed charges,1.94,90,,,percent of total billed charges,90% of total billed charges,1.94,90,,,percent of total billed charges,90% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,0.82,38,,,percent of total billed charges,38% of total billed charges,1.62,75,,,percent of total billed charges,75% of total billed charges,1.84,85,,,percent of total billed charges,85% of total billed charges,0.82,2.01,
atorvastatin 80 mg oral tablet,ATO14076,CDM,250,RC,,,outpatient,,,3.44,2.58,,3.1,90,,,percent of total billed charges,90% of total billed charges,3.2,93,,,percent of total billed charges,93% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.8,81.4,,,percent of total billed charges,81.4% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.58,75,,,percent of total billed charges,75% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,3.2,
atropine 0.1 mg/mL injectable solution,ATR1003103,CDM,636,RC,J0461,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
atropine 0.1 mg/mL injectable solution,ATR1003103,CDM,250,RC,J0461,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
atropine 1% ophthalmic solution,ATR1003312,CDM,250,RC,,,outpatient,,,40.63,30.47,,36.57,90,,,percent of total billed charges,90% of total billed charges,37.79,93,,,percent of total billed charges,93% of total billed charges,15.44,38,,,percent of total billed charges,38% of total billed charges,15.44,38,,,percent of total billed charges,38% of total billed charges,34.54,85,,,percent of total billed charges,85% of total billed charges,15.44,38,,,percent of total billed charges,38% of total billed charges,33.07,81.4,,,percent of total billed charges,81.4% of total billed charges,36.57,90,,,percent of total billed charges,90% of total billed charges,36.57,90,,,percent of total billed charges,90% of total billed charges,15.44,38,,,percent of total billed charges,38% of total billed charges,15.44,38,,,percent of total billed charges,38% of total billed charges,15.44,38,,,percent of total billed charges,38% of total billed charges,30.47,75,,,percent of total billed charges,75% of total billed charges,34.54,85,,,percent of total billed charges,85% of total billed charges,15.44,37.79,
Amoxicillin-clavulanate 875/125 mg oral tablet,AUG1003062,CDM,637,RC,A9270,HCPCS,outpatient,,,5.8,4.35,,5.22,90,,,percent of total billed charges,90% of total billed charges,5.39,93,,,percent of total billed charges,93% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,4.93,85,,,percent of total billed charges,85% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,4.72,81.4,,,percent of total billed charges,81.4% of total billed charges,5.22,90,,,percent of total billed charges,90% of total billed charges,5.22,90,,,percent of total billed charges,90% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,4.35,75,,,percent of total billed charges,75% of total billed charges,4.93,85,,,percent of total billed charges,85% of total billed charges,2.2,5.39,
Amoxicillin-clavulante 500/125 mg oral tablet,AUG1219,CDM,250,RC,,,outpatient,,,5.8,4.35,,5.22,90,,,percent of total billed charges,90% of total billed charges,5.39,93,,,percent of total billed charges,93% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,4.93,85,,,percent of total billed charges,85% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,4.72,81.4,,,percent of total billed charges,81.4% of total billed charges,5.22,90,,,percent of total billed charges,90% of total billed charges,5.22,90,,,percent of total billed charges,90% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,4.35,75,,,percent of total billed charges,75% of total billed charges,4.93,85,,,percent of total billed charges,85% of total billed charges,2.2,5.39,
Avycaz 2.5 g intravenous injection,AVY22727,CDM,636,RC,J0714,HCPCS,outpatient,,,515.15,386.36,,463.64,90,,,percent of total billed charges,90% of total billed charges,479.09,93,,,percent of total billed charges,93% of total billed charges,195.76,38,,,percent of total billed charges,38% of total billed charges,195.76,38,,,percent of total billed charges,38% of total billed charges,437.88,85,,,percent of total billed charges,85% of total billed charges,195.76,38,,,percent of total billed charges,38% of total billed charges,419.33,81.4,,,percent of total billed charges,81.4% of total billed charges,463.64,90,,,percent of total billed charges,90% of total billed charges,463.64,90,,,percent of total billed charges,90% of total billed charges,195.76,38,,,percent of total billed charges,38% of total billed charges,195.76,38,,,percent of total billed charges,38% of total billed charges,195.76,38,,,percent of total billed charges,38% of total billed charges,386.36,75,,,percent of total billed charges,75% of total billed charges,437.88,85,,,percent of total billed charges,85% of total billed charges,195.76,479.09,
Ayr Saline 0.65% nasal gel,AYR14747,CDM,250,RC,,,outpatient,,,9.27,6.95,,8.34,90,,,percent of total billed charges,90% of total billed charges,8.62,93,,,percent of total billed charges,93% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,7.88,85,,,percent of total billed charges,85% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,7.55,81.4,,,percent of total billed charges,81.4% of total billed charges,8.34,90,,,percent of total billed charges,90% of total billed charges,8.34,90,,,percent of total billed charges,90% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,6.95,75,,,percent of total billed charges,75% of total billed charges,7.88,85,,,percent of total billed charges,85% of total billed charges,3.52,8.62,
Ayr Saline 0.65% nasal gel,AYR14747,CDM,637,RC,,,outpatient,,,9.27,6.95,,8.34,90,,,percent of total billed charges,90% of total billed charges,8.62,93,,,percent of total billed charges,93% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,7.88,85,,,percent of total billed charges,85% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,7.55,81.4,,,percent of total billed charges,81.4% of total billed charges,8.34,90,,,percent of total billed charges,90% of total billed charges,8.34,90,,,percent of total billed charges,90% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,3.52,38,,,percent of total billed charges,38% of total billed charges,6.95,75,,,percent of total billed charges,75% of total billed charges,7.88,85,,,percent of total billed charges,85% of total billed charges,3.52,8.62,
Ayr Saline No-Drip Spray 0.65% nasal gel,AYR14756,CDM,250,RC,,,outpatient,,,6.41,4.81,,5.77,90,,,percent of total billed charges,90% of total billed charges,5.96,93,,,percent of total billed charges,93% of total billed charges,2.44,38,,,percent of total billed charges,38% of total billed charges,2.44,38,,,percent of total billed charges,38% of total billed charges,5.45,85,,,percent of total billed charges,85% of total billed charges,2.44,38,,,percent of total billed charges,38% of total billed charges,5.22,81.4,,,percent of total billed charges,81.4% of total billed charges,5.77,90,,,percent of total billed charges,90% of total billed charges,5.77,90,,,percent of total billed charges,90% of total billed charges,2.44,38,,,percent of total billed charges,38% of total billed charges,2.44,38,,,percent of total billed charges,38% of total billed charges,2.44,38,,,percent of total billed charges,38% of total billed charges,4.81,75,,,percent of total billed charges,75% of total billed charges,5.45,85,,,percent of total billed charges,85% of total billed charges,2.44,5.96,
azithromycin 200 mg/5 mL oral liquid,AZI1249,CDM,250,RC,A9270,HCPCS,outpatient,,,40.91,30.68,,36.82,90,,,percent of total billed charges,90% of total billed charges,38.05,93,,,percent of total billed charges,93% of total billed charges,15.55,38,,,percent of total billed charges,38% of total billed charges,15.55,38,,,percent of total billed charges,38% of total billed charges,34.77,85,,,percent of total billed charges,85% of total billed charges,15.55,38,,,percent of total billed charges,38% of total billed charges,33.3,81.4,,,percent of total billed charges,81.4% of total billed charges,36.82,90,,,percent of total billed charges,90% of total billed charges,36.82,90,,,percent of total billed charges,90% of total billed charges,15.55,38,,,percent of total billed charges,38% of total billed charges,15.55,38,,,percent of total billed charges,38% of total billed charges,15.55,38,,,percent of total billed charges,38% of total billed charges,30.68,75,,,percent of total billed charges,75% of total billed charges,34.77,85,,,percent of total billed charges,85% of total billed charges,15.55,38.05,
Sulfamethoxazole-trimethoprim DS 800/160 mg oral tablet,BAC1003076,CDM,637,RC,A9270,HCPCS,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
bacitracin 500 units/g topical ointment,BAC1003338,CDM,637,RC,A9270,HCPCS,outpatient,,,0.15,0.11,,0.14,90,,,percent of total billed charges,90% of total billed charges,0.14,93,,,percent of total billed charges,93% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.13,85,,,percent of total billed charges,85% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.12,81.4,,,percent of total billed charges,81.4% of total billed charges,0.14,90,,,percent of total billed charges,90% of total billed charges,0.14,90,,,percent of total billed charges,90% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.11,75,,,percent of total billed charges,75% of total billed charges,0.13,85,,,percent of total billed charges,85% of total billed charges,0.06,0.14,
bacitracin zinc 500 units/g topical ointment,BAC12182,CDM,250,RC,A9270,HCPCS,outpatient,,,0.15,0.11,,0.14,90,,,percent of total billed charges,90% of total billed charges,0.14,93,,,percent of total billed charges,93% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.13,85,,,percent of total billed charges,85% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.12,81.4,,,percent of total billed charges,81.4% of total billed charges,0.14,90,,,percent of total billed charges,90% of total billed charges,0.14,90,,,percent of total billed charges,90% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.06,38,,,percent of total billed charges,38% of total billed charges,0.11,75,,,percent of total billed charges,75% of total billed charges,0.13,85,,,percent of total billed charges,85% of total billed charges,0.06,0.14,
Bacitracin Oint 14 gram tube,baci14g,CDM,637,RC,,,outpatient,,,5.63,4.22,,5.07,90,,,percent of total billed charges,90% of total billed charges,5.24,93,,,percent of total billed charges,93% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,4.79,85,,,percent of total billed charges,85% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,4.58,81.4,,,percent of total billed charges,81.4% of total billed charges,5.07,90,,,percent of total billed charges,90% of total billed charges,5.07,90,,,percent of total billed charges,90% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,2.14,38,,,percent of total billed charges,38% of total billed charges,4.22,75,,,percent of total billed charges,75% of total billed charges,4.79,85,,,percent of total billed charges,85% of total billed charges,2.14,5.24,
Menthol (Bengay) topical cream,BEN11835,CDM,637,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
benztropine 0.5 mg oral tablet,BEN1804,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Dicyclomine 10 mg oral capsule,BEN5694,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Terbutaline 1 mg/mL injectable solution,BRE1003231,CDM,636,RC,J3105,HCPCS,outpatient,,,16.24,12.18,,14.62,90,,,percent of total billed charges,90% of total billed charges,15.1,93,,,percent of total billed charges,93% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.22,81.4,,,percent of total billed charges,81.4% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,12.18,75,,,percent of total billed charges,75% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,15.1,
Terbutaline 1 mg/mL injectable solution,BRE1003231,CDM,250,RC,J3105,HCPCS,outpatient,,,16.24,12.18,,14.62,90,,,percent of total billed charges,90% of total billed charges,15.1,93,,,percent of total billed charges,93% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.22,81.4,,,percent of total billed charges,81.4% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,12.18,75,,,percent of total billed charges,75% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,15.1,
brimonidine 0.2% ophthalmic solution,BRI1003365,CDM,250,RC,,,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Brilinta (ticagrelor) 90 mg oral tablet,BRI22490,CDM,250,RC,,,outpatient,,,10.13,7.6,,9.12,90,,,percent of total billed charges,90% of total billed charges,9.42,93,,,percent of total billed charges,93% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,8.61,85,,,percent of total billed charges,85% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,8.25,81.4,,,percent of total billed charges,81.4% of total billed charges,9.12,90,,,percent of total billed charges,90% of total billed charges,9.12,90,,,percent of total billed charges,90% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,7.6,75,,,percent of total billed charges,75% of total billed charges,8.61,85,,,percent of total billed charges,85% of total billed charges,3.85,9.42,
Brilinta (ticagrelor) 90 mg oral tablet,BRI22490,CDM,637,RC,,,outpatient,,,10.13,7.6,,9.12,90,,,percent of total billed charges,90% of total billed charges,9.42,93,,,percent of total billed charges,93% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,8.61,85,,,percent of total billed charges,85% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,8.25,81.4,,,percent of total billed charges,81.4% of total billed charges,9.12,90,,,percent of total billed charges,90% of total billed charges,9.12,90,,,percent of total billed charges,90% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,3.85,38,,,percent of total billed charges,38% of total billed charges,7.6,75,,,percent of total billed charges,75% of total billed charges,8.61,85,,,percent of total billed charges,85% of total billed charges,3.85,9.42,
bumetanide 1 mg oral tablet,BUM1003106,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
bumetanide 0.25 mg/mL injectable solution,BUM1823,CDM,250,RC,,,outpatient,,,46.87,35.15,,42.18,90,,,percent of total billed charges,90% of total billed charges,43.59,93,,,percent of total billed charges,93% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,38.15,81.4,,,percent of total billed charges,81.4% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,42.18,90,,,percent of total billed charges,90% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,17.81,38,,,percent of total billed charges,38% of total billed charges,35.15,75,,,percent of total billed charges,75% of total billed charges,39.84,85,,,percent of total billed charges,85% of total billed charges,17.81,43.59,
"bupivacaine-EPINEPHrine 0.5%-1:200,000 injectable solution",BUP12755,CDM,258,RC,,,outpatient,,,24,18,,21.6,90,,,percent of total billed charges,90% of total billed charges,22.32,93,,,percent of total billed charges,93% of total billed charges,9.12,38,,,percent of total billed charges,38% of total billed charges,9.12,38,,,percent of total billed charges,38% of total billed charges,20.4,85,,,percent of total billed charges,85% of total billed charges,9.12,38,,,percent of total billed charges,38% of total billed charges,19.54,81.4,,,percent of total billed charges,81.4% of total billed charges,21.6,90,,,percent of total billed charges,90% of total billed charges,21.6,90,,,percent of total billed charges,90% of total billed charges,9.12,38,,,percent of total billed charges,38% of total billed charges,9.12,38,,,percent of total billed charges,38% of total billed charges,9.12,38,,,percent of total billed charges,38% of total billed charges,18,75,,,percent of total billed charges,75% of total billed charges,20.4,85,,,percent of total billed charges,85% of total billed charges,9.12,22.32,
"bupivacaine-EPINEPHrine 0.25%-1:200,000 preservative-free injectable solution",BUP12761,CDM,250,RC,A9270,HCPCS,outpatient,,,21.98,16.49,,19.78,90,,,percent of total billed charges,90% of total billed charges,20.44,93,,,percent of total billed charges,93% of total billed charges,8.35,38,,,percent of total billed charges,38% of total billed charges,8.35,38,,,percent of total billed charges,38% of total billed charges,18.68,85,,,percent of total billed charges,85% of total billed charges,8.35,38,,,percent of total billed charges,38% of total billed charges,17.89,81.4,,,percent of total billed charges,81.4% of total billed charges,19.78,90,,,percent of total billed charges,90% of total billed charges,19.78,90,,,percent of total billed charges,90% of total billed charges,8.35,38,,,percent of total billed charges,38% of total billed charges,8.35,38,,,percent of total billed charges,38% of total billed charges,8.35,38,,,percent of total billed charges,38% of total billed charges,16.49,75,,,percent of total billed charges,75% of total billed charges,18.68,85,,,percent of total billed charges,85% of total billed charges,8.35,20.44,
buprenorphine-naloxone 8 mg-2 mg sublingual film,BUP16287,CDM,637,RC,,,outpatient,,,31.83,23.87,,28.65,90,,,percent of total billed charges,90% of total billed charges,29.6,93,,,percent of total billed charges,93% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,27.06,85,,,percent of total billed charges,85% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,25.91,81.4,,,percent of total billed charges,81.4% of total billed charges,28.65,90,,,percent of total billed charges,90% of total billed charges,28.65,90,,,percent of total billed charges,90% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,12.1,38,,,percent of total billed charges,38% of total billed charges,23.87,75,,,percent of total billed charges,75% of total billed charges,27.06,85,,,percent of total billed charges,85% of total billed charges,12.1,29.6,
bupivacaine 0.25% preservative-free injectable solution,BUP1836,CDM,258,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
z* bupivacaine 0.75% SDPF 10mL vial,BUP1840,CDM,250,RC,J0665,HCPCS,outpatient,,,6.1,4.58,,5.49,90,,,percent of total billed charges,90% of total billed charges,5.67,93,,,percent of total billed charges,93% of total billed charges,2.32,38,,,percent of total billed charges,38% of total billed charges,2.32,38,,,percent of total billed charges,38% of total billed charges,5.19,85,,,percent of total billed charges,85% of total billed charges,2.32,38,,,percent of total billed charges,38% of total billed charges,4.97,81.4,,,percent of total billed charges,81.4% of total billed charges,5.49,90,,,percent of total billed charges,90% of total billed charges,5.49,90,,,percent of total billed charges,90% of total billed charges,2.32,38,,,percent of total billed charges,38% of total billed charges,2.32,38,,,percent of total billed charges,38% of total billed charges,2.32,38,,,percent of total billed charges,38% of total billed charges,4.58,75,,,percent of total billed charges,75% of total billed charges,5.19,85,,,percent of total billed charges,85% of total billed charges,2.32,5.67,
"buPROPion 150 mg/12 hours (SR) oral tablet, extended release",BUP1853,CDM,250,RC,A9270,HCPCS,outpatient,,,2.26,1.7,,2.03,90,,,percent of total billed charges,90% of total billed charges,2.1,93,,,percent of total billed charges,93% of total billed charges,0.86,38,,,percent of total billed charges,38% of total billed charges,0.86,38,,,percent of total billed charges,38% of total billed charges,1.92,85,,,percent of total billed charges,85% of total billed charges,0.86,38,,,percent of total billed charges,38% of total billed charges,1.84,81.4,,,percent of total billed charges,81.4% of total billed charges,2.03,90,,,percent of total billed charges,90% of total billed charges,2.03,90,,,percent of total billed charges,90% of total billed charges,0.86,38,,,percent of total billed charges,38% of total billed charges,0.86,38,,,percent of total billed charges,38% of total billed charges,0.86,38,,,percent of total billed charges,38% of total billed charges,1.7,75,,,percent of total billed charges,75% of total billed charges,1.92,85,,,percent of total billed charges,85% of total billed charges,0.86,2.1,
busPIRone 15 mg oral tablet,BUS1875,CDM,250,RC,,,outpatient,,,1.15,0.86,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.07,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.98,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.86,75,,,percent of total billed charges,75% of total billed charges,0.98,85,,,percent of total billed charges,85% of total billed charges,0.44,1.07,
calcium chloride 100 mg/mL injectable solution,CAL1003345,CDM,259,RC,,,outpatient,,,63.28,47.46,,56.95,90,,,percent of total billed charges,90% of total billed charges,58.85,93,,,percent of total billed charges,93% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,53.79,85,,,percent of total billed charges,85% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,51.51,81.4,,,percent of total billed charges,81.4% of total billed charges,56.95,90,,,percent of total billed charges,90% of total billed charges,56.95,90,,,percent of total billed charges,90% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,24.05,38,,,percent of total billed charges,38% of total billed charges,47.46,75,,,percent of total billed charges,75% of total billed charges,53.79,85,,,percent of total billed charges,85% of total billed charges,24.05,58.85,
calcium gluconate 1 g/50 mL-NaCl 0.9% injectable solution,CAL19618,CDM,636,RC,J0613,HCPCS,outpatient,,,28.36,21.27,,25.52,90,,,percent of total billed charges,90% of total billed charges,26.37,93,,,percent of total billed charges,93% of total billed charges,10.78,38,,,percent of total billed charges,38% of total billed charges,10.78,38,,,percent of total billed charges,38% of total billed charges,24.11,85,,,percent of total billed charges,85% of total billed charges,10.78,38,,,percent of total billed charges,38% of total billed charges,23.09,81.4,,,percent of total billed charges,81.4% of total billed charges,25.52,90,,,percent of total billed charges,90% of total billed charges,25.52,90,,,percent of total billed charges,90% of total billed charges,10.78,38,,,percent of total billed charges,38% of total billed charges,10.78,38,,,percent of total billed charges,38% of total billed charges,10.78,38,,,percent of total billed charges,38% of total billed charges,21.27,75,,,percent of total billed charges,75% of total billed charges,24.11,85,,,percent of total billed charges,85% of total billed charges,10.78,26.37,
calcitonin 200 intl units/mL IV,CAL4342,CDM,636,RC,J0630,HCPCS,outpatient,,,3213.66,2410.25,,2892.29,90,,,percent of total billed charges,90% of total billed charges,2988.7,93,,,percent of total billed charges,93% of total billed charges,1221.19,38,,,percent of total billed charges,38% of total billed charges,1221.19,38,,,percent of total billed charges,38% of total billed charges,2731.61,85,,,percent of total billed charges,85% of total billed charges,1221.19,38,,,percent of total billed charges,38% of total billed charges,2615.92,81.4,,,percent of total billed charges,81.4% of total billed charges,2892.29,90,,,percent of total billed charges,90% of total billed charges,2892.29,90,,,percent of total billed charges,90% of total billed charges,1221.19,38,,,percent of total billed charges,38% of total billed charges,1221.19,38,,,percent of total billed charges,38% of total billed charges,1221.19,38,,,percent of total billed charges,38% of total billed charges,2410.25,75,,,percent of total billed charges,75% of total billed charges,2731.61,85,,,percent of total billed charges,85% of total billed charges,1221.19,2988.7,
calcitonin 200 intl units/inh NASAL,CAL4343,CDM,637,RC,,,outpatient,,,157.78,118.34,,142,90,,,percent of total billed charges,90% of total billed charges,146.74,93,,,percent of total billed charges,93% of total billed charges,59.96,38,,,percent of total billed charges,38% of total billed charges,59.96,38,,,percent of total billed charges,38% of total billed charges,134.11,85,,,percent of total billed charges,85% of total billed charges,59.96,38,,,percent of total billed charges,38% of total billed charges,128.43,81.4,,,percent of total billed charges,81.4% of total billed charges,142,90,,,percent of total billed charges,90% of total billed charges,142,90,,,percent of total billed charges,90% of total billed charges,59.96,38,,,percent of total billed charges,38% of total billed charges,59.96,38,,,percent of total billed charges,38% of total billed charges,59.96,38,,,percent of total billed charges,38% of total billed charges,118.34,75,,,percent of total billed charges,75% of total billed charges,134.11,85,,,percent of total billed charges,85% of total billed charges,59.96,146.74,
calcium (as carbonate)-vitamin D 600 mg-400 intl units oral tablet,CAL7915,CDM,637,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Diltiazem 30 mg oral tablet,CAR1003022,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Sucralfate 1 g oral tablet,CAR1003184,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Doxazosin 2 mg oral tablet,CAR1003221,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
carvedilol 6.25 mg oral tablet,CAR13161,CDM,637,RC,A9270,HCPCS,outpatient,,,3.44,2.58,,3.1,90,,,percent of total billed charges,90% of total billed charges,3.2,93,,,percent of total billed charges,93% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.8,81.4,,,percent of total billed charges,81.4% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.58,75,,,percent of total billed charges,75% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,3.2,
"Diltiazem 120 mg/24 hours oral capsule, extended release",CAR613,CDM,637,RC,A9270,HCPCS,outpatient,,,3.44,2.58,,3.1,90,,,percent of total billed charges,90% of total billed charges,3.2,93,,,percent of total billed charges,93% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.8,81.4,,,percent of total billed charges,81.4% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.58,75,,,percent of total billed charges,75% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,3.2,
Alteplase (Cathflo) 2 mg injection,CAT1003206,CDM,636,RC,J2997,HCPCS,outpatient,,,202.73,152.05,,182.46,90,,,percent of total billed charges,90% of total billed charges,188.54,93,,,percent of total billed charges,93% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,172.32,85,,,percent of total billed charges,85% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,165.02,81.4,,,percent of total billed charges,81.4% of total billed charges,182.46,90,,,percent of total billed charges,90% of total billed charges,182.46,90,,,percent of total billed charges,90% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,152.05,75,,,percent of total billed charges,75% of total billed charges,172.32,85,,,percent of total billed charges,85% of total billed charges,77.04,188.54,
Alteplase (Cathflo) 2 mg injection,CAT1003206,CDM,250,RC,J2997,HCPCS,outpatient,,,202.73,152.05,,182.46,90,,,percent of total billed charges,90% of total billed charges,188.54,93,,,percent of total billed charges,93% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,172.32,85,,,percent of total billed charges,85% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,165.02,81.4,,,percent of total billed charges,81.4% of total billed charges,182.46,90,,,percent of total billed charges,90% of total billed charges,182.46,90,,,percent of total billed charges,90% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,77.04,38,,,percent of total billed charges,38% of total billed charges,152.05,75,,,percent of total billed charges,75% of total billed charges,172.32,85,,,percent of total billed charges,85% of total billed charges,77.04,188.54,
ceFAZolin 1 g injection,CEF1002993,CDM,636,RC,J0690,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
ceFAZolin 1 g injection,CEF1002993,CDM,250,RC,J0690,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
cefTRIAXone 1 g injection,CEF1003038,CDM,636,RC,J0696,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
cefTRIAXone 1 g injection,CEF1003038,CDM,250,RC,J0696,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
cefTRIAXone 250 mg injection,CEF1003039,CDM,636,RC,J0696,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
cefTRIAXone 250 mg injection,CEF1003039,CDM,250,RC,J0696,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
cefTRIAXone 500 mg injection,CEF1003040,CDM,636,RC,J0696,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
cefTRIAXone 500 mg injection,CEF1003040,CDM,250,RC,J0696,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
Cefuroxime 250 mg oral tablet,CEF1003041,CDM,637,RC,A9270,HCPCS,outpatient,,,5.8,4.35,,5.22,90,,,percent of total billed charges,90% of total billed charges,5.39,93,,,percent of total billed charges,93% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,4.93,85,,,percent of total billed charges,85% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,4.72,81.4,,,percent of total billed charges,81.4% of total billed charges,5.22,90,,,percent of total billed charges,90% of total billed charges,5.22,90,,,percent of total billed charges,90% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,2.2,38,,,percent of total billed charges,38% of total billed charges,4.35,75,,,percent of total billed charges,75% of total billed charges,4.93,85,,,percent of total billed charges,85% of total billed charges,2.2,5.39,
cefpodoxime 200 mg oral tablet,CEF1268,CDM,250,RC,,,outpatient,,,8.32,6.24,,7.49,90,,,percent of total billed charges,90% of total billed charges,7.74,93,,,percent of total billed charges,93% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,7.07,85,,,percent of total billed charges,85% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,6.77,81.4,,,percent of total billed charges,81.4% of total billed charges,7.49,90,,,percent of total billed charges,90% of total billed charges,7.49,90,,,percent of total billed charges,90% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,6.24,75,,,percent of total billed charges,75% of total billed charges,7.07,85,,,percent of total billed charges,85% of total billed charges,3.16,7.74,
cefpodoxime 200 mg oral tablet,CEF1268,CDM,637,RC,,,outpatient,,,8.32,6.24,,7.49,90,,,percent of total billed charges,90% of total billed charges,7.74,93,,,percent of total billed charges,93% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,7.07,85,,,percent of total billed charges,85% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,6.77,81.4,,,percent of total billed charges,81.4% of total billed charges,7.49,90,,,percent of total billed charges,90% of total billed charges,7.49,90,,,percent of total billed charges,90% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,3.16,38,,,percent of total billed charges,38% of total billed charges,6.24,75,,,percent of total billed charges,75% of total billed charges,7.07,85,,,percent of total billed charges,85% of total billed charges,3.16,7.74,
cefepime 1 g injection,CEF13254,CDM,636,RC,J0692,HCPCS,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
cefepime 2 g injection,CEF13255,CDM,636,RC,J0692,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
cefTAZidime 1 g injection,CEF192,CDM,636,RC,J0713,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
cefTRIAXone 2 g injection,CEF901,CDM,636,RC,J0696,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
cefTRIAXone 2 g injection,CEF901,CDM,250,RC,J0696,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
celecoxib 200 mg oral capsule,CEL15225,CDM,250,RC,,,outpatient,,,9.19,6.89,,8.27,90,,,percent of total billed charges,90% of total billed charges,8.55,93,,,percent of total billed charges,93% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,7.81,85,,,percent of total billed charges,85% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,7.48,81.4,,,percent of total billed charges,81.4% of total billed charges,8.27,90,,,percent of total billed charges,90% of total billed charges,8.27,90,,,percent of total billed charges,90% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,6.89,75,,,percent of total billed charges,75% of total billed charges,7.81,85,,,percent of total billed charges,85% of total billed charges,3.49,8.55,
celecoxib 200 mg oral capsule,CEL15225,CDM,637,RC,,,outpatient,,,9.19,6.89,,8.27,90,,,percent of total billed charges,90% of total billed charges,8.55,93,,,percent of total billed charges,93% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,7.81,85,,,percent of total billed charges,85% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,7.48,81.4,,,percent of total billed charges,81.4% of total billed charges,8.27,90,,,percent of total billed charges,90% of total billed charges,8.27,90,,,percent of total billed charges,90% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,3.49,38,,,percent of total billed charges,38% of total billed charges,6.89,75,,,percent of total billed charges,75% of total billed charges,7.81,85,,,percent of total billed charges,85% of total billed charges,3.49,8.55,
cephalexin 125 mg/5 mL oral liquid,CEP1003070,CDM,637,RC,A9270,HCPCS,outpatient,,,10.82,8.12,,9.74,90,,,percent of total billed charges,90% of total billed charges,10.06,93,,,percent of total billed charges,93% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,9.2,85,,,percent of total billed charges,85% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,8.81,81.4,,,percent of total billed charges,81.4% of total billed charges,9.74,90,,,percent of total billed charges,90% of total billed charges,9.74,90,,,percent of total billed charges,90% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,8.12,75,,,percent of total billed charges,75% of total billed charges,9.2,85,,,percent of total billed charges,85% of total billed charges,4.11,10.06,
cephalexin 250 mg/5 mL oral liquid,CEP1003071,CDM,637,RC,A9270,HCPCS,outpatient,,,10.82,8.12,,9.74,90,,,percent of total billed charges,90% of total billed charges,10.06,93,,,percent of total billed charges,93% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,9.2,85,,,percent of total billed charges,85% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,8.81,81.4,,,percent of total billed charges,81.4% of total billed charges,9.74,90,,,percent of total billed charges,90% of total billed charges,9.74,90,,,percent of total billed charges,90% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,4.11,38,,,percent of total billed charges,38% of total billed charges,8.12,75,,,percent of total billed charges,75% of total billed charges,9.2,85,,,percent of total billed charges,85% of total billed charges,4.11,10.06,
cetirizine 1 mg/mL oral syrup,CET1003351,CDM,637,RC,A9270,HCPCS,outpatient,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
z* Children's Ibuprofen Berry 100 mg/5 mL oral suspension,CHI276,CDM,250,RC,,,outpatient,,,1.81,1.36,,1.63,90,,,percent of total billed charges,90% of total billed charges,1.68,93,,,percent of total billed charges,93% of total billed charges,0.69,38,,,percent of total billed charges,38% of total billed charges,0.69,38,,,percent of total billed charges,38% of total billed charges,1.54,85,,,percent of total billed charges,85% of total billed charges,0.69,38,,,percent of total billed charges,38% of total billed charges,1.47,81.4,,,percent of total billed charges,81.4% of total billed charges,1.63,90,,,percent of total billed charges,90% of total billed charges,1.63,90,,,percent of total billed charges,90% of total billed charges,0.69,38,,,percent of total billed charges,38% of total billed charges,0.69,38,,,percent of total billed charges,38% of total billed charges,0.69,38,,,percent of total billed charges,38% of total billed charges,1.36,75,,,percent of total billed charges,75% of total billed charges,1.54,85,,,percent of total billed charges,85% of total billed charges,0.69,1.68,
Chloraseptic 6 mg-10 mg mucous membrane lozenge,CHL1003432,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
cholestyramine 4 g/9 g oral powder for reconstitution,CHO1944,CDM,250,RC,J3490,HCPCS,outpatient,,,3.95,2.96,,3.56,90,,,percent of total billed charges,90% of total billed charges,3.67,93,,,percent of total billed charges,93% of total billed charges,1.5,38,,,percent of total billed charges,38% of total billed charges,1.5,38,,,percent of total billed charges,38% of total billed charges,3.36,85,,,percent of total billed charges,85% of total billed charges,1.5,38,,,percent of total billed charges,38% of total billed charges,3.22,81.4,,,percent of total billed charges,81.4% of total billed charges,3.56,90,,,percent of total billed charges,90% of total billed charges,3.56,90,,,percent of total billed charges,90% of total billed charges,1.5,38,,,percent of total billed charges,38% of total billed charges,1.5,38,,,percent of total billed charges,38% of total billed charges,1.5,38,,,percent of total billed charges,38% of total billed charges,2.96,75,,,percent of total billed charges,75% of total billed charges,3.36,85,,,percent of total billed charges,85% of total billed charges,1.5,3.67,
Ciprofloxacin 250 mg oral tablet,CIP1002995,CDM,637,RC,A9270,HCPCS,outpatient,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
Ciprofloxacin 500 mg oral tablet,CIP1002996,CDM,637,RC,A9270,HCPCS,outpatient,,,4.64,3.48,,4.18,90,,,percent of total billed charges,90% of total billed charges,4.32,93,,,percent of total billed charges,93% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,3.94,85,,,percent of total billed charges,85% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,3.78,81.4,,,percent of total billed charges,81.4% of total billed charges,4.18,90,,,percent of total billed charges,90% of total billed charges,4.18,90,,,percent of total billed charges,90% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,3.48,75,,,percent of total billed charges,75% of total billed charges,3.94,85,,,percent of total billed charges,85% of total billed charges,1.76,4.32,
Ciprofloxacin I.V. 400 mg,CIP1002997,CDM,636,RC,J0744,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Ciprofloxacin I.V. 400 mg,CIP1002997,CDM,250,RC,J0744,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
ciprofloxacin 0.3% ophthalmic solution,CIP1003311,CDM,250,RC,,,outpatient,,,19.48,14.61,,17.53,90,,,percent of total billed charges,90% of total billed charges,18.12,93,,,percent of total billed charges,93% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,16.56,85,,,percent of total billed charges,85% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,15.86,81.4,,,percent of total billed charges,81.4% of total billed charges,17.53,90,,,percent of total billed charges,90% of total billed charges,17.53,90,,,percent of total billed charges,90% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,14.61,75,,,percent of total billed charges,75% of total billed charges,16.56,85,,,percent of total billed charges,85% of total billed charges,7.4,18.12,
ciprofloxacin 200 mg/100 mL-D5% intravenous solution,CIP210,CDM,636,RC,J0744,HCPCS,outpatient,,,4.3,3.23,,3.87,90,,,percent of total billed charges,90% of total billed charges,4,93,,,percent of total billed charges,93% of total billed charges,1.63,38,,,percent of total billed charges,38% of total billed charges,1.63,38,,,percent of total billed charges,38% of total billed charges,3.66,85,,,percent of total billed charges,85% of total billed charges,1.63,38,,,percent of total billed charges,38% of total billed charges,3.5,81.4,,,percent of total billed charges,81.4% of total billed charges,3.87,90,,,percent of total billed charges,90% of total billed charges,3.87,90,,,percent of total billed charges,90% of total billed charges,1.63,38,,,percent of total billed charges,38% of total billed charges,1.63,38,,,percent of total billed charges,38% of total billed charges,1.63,38,,,percent of total billed charges,38% of total billed charges,3.23,75,,,percent of total billed charges,75% of total billed charges,3.66,85,,,percent of total billed charges,85% of total billed charges,1.63,4,
citalopram 20 mg oral tablet,CIT15105,CDM,637,RC,,,outpatient,,,2.24,1.68,,2.02,90,,,percent of total billed charges,90% of total billed charges,2.08,93,,,percent of total billed charges,93% of total billed charges,0.85,38,,,percent of total billed charges,38% of total billed charges,0.85,38,,,percent of total billed charges,38% of total billed charges,1.9,85,,,percent of total billed charges,85% of total billed charges,0.85,38,,,percent of total billed charges,38% of total billed charges,1.82,81.4,,,percent of total billed charges,81.4% of total billed charges,2.02,90,,,percent of total billed charges,90% of total billed charges,2.02,90,,,percent of total billed charges,90% of total billed charges,0.85,38,,,percent of total billed charges,38% of total billed charges,0.85,38,,,percent of total billed charges,38% of total billed charges,0.85,38,,,percent of total billed charges,38% of total billed charges,1.68,75,,,percent of total billed charges,75% of total billed charges,1.9,85,,,percent of total billed charges,85% of total billed charges,0.85,2.08,
clindamycin 150 mg oral capsule,CLI1003019,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
clindamycin 600 mg/ 4mL injectable solution,CLI1003020,CDM,636,RC,J0665,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
clindamycin 600 mg/ 4mL injectable solution,CLI1003020,CDM,250,RC,J0665,HCPCS,outpatient,,,37.5,28.13,,33.75,90,,,percent of total billed charges,90% of total billed charges,34.88,93,,,percent of total billed charges,93% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,30.53,81.4,,,percent of total billed charges,81.4% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,14.25,38,,,percent of total billed charges,38% of total billed charges,28.13,75,,,percent of total billed charges,75% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,14.25,34.88,
clindamycin 300 mg/50 mL-D5% intravenous solution,CLI572,CDM,250,RC,A9270,HCPCS,outpatient,,,11.77,8.83,,10.59,90,,,percent of total billed charges,90% of total billed charges,10.95,93,,,percent of total billed charges,93% of total billed charges,4.47,38,,,percent of total billed charges,38% of total billed charges,4.47,38,,,percent of total billed charges,38% of total billed charges,10,85,,,percent of total billed charges,85% of total billed charges,4.47,38,,,percent of total billed charges,38% of total billed charges,9.58,81.4,,,percent of total billed charges,81.4% of total billed charges,10.59,90,,,percent of total billed charges,90% of total billed charges,10.59,90,,,percent of total billed charges,90% of total billed charges,4.47,38,,,percent of total billed charges,38% of total billed charges,4.47,38,,,percent of total billed charges,38% of total billed charges,4.47,38,,,percent of total billed charges,38% of total billed charges,8.83,75,,,percent of total billed charges,75% of total billed charges,10,85,,,percent of total billed charges,85% of total billed charges,4.47,10.95,
clindamycin 600 mg/50 mL-D5% intravenous solution,CLI573,CDM,250,RC,A9270,HCPCS,outpatient,,,15.33,11.5,,13.8,90,,,percent of total billed charges,90% of total billed charges,14.26,93,,,percent of total billed charges,93% of total billed charges,5.83,38,,,percent of total billed charges,38% of total billed charges,5.83,38,,,percent of total billed charges,38% of total billed charges,13.03,85,,,percent of total billed charges,85% of total billed charges,5.83,38,,,percent of total billed charges,38% of total billed charges,12.48,81.4,,,percent of total billed charges,81.4% of total billed charges,13.8,90,,,percent of total billed charges,90% of total billed charges,13.8,90,,,percent of total billed charges,90% of total billed charges,5.83,38,,,percent of total billed charges,38% of total billed charges,5.83,38,,,percent of total billed charges,38% of total billed charges,5.83,38,,,percent of total billed charges,38% of total billed charges,11.5,75,,,percent of total billed charges,75% of total billed charges,13.03,85,,,percent of total billed charges,85% of total billed charges,5.83,14.26,
Clindamycin 300mg/2mL IV,clinda300,CDM,636,RC,J0665,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
cloNIDine 0.1 mg oral tablet,CLO1003021,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
clotrimazole 1% topical cream,CLO15256,CDM,637,RC,,,outpatient,,,11.26,8.45,,10.13,90,,,percent of total billed charges,90% of total billed charges,10.47,93,,,percent of total billed charges,93% of total billed charges,4.28,38,,,percent of total billed charges,38% of total billed charges,4.28,38,,,percent of total billed charges,38% of total billed charges,9.57,85,,,percent of total billed charges,85% of total billed charges,4.28,38,,,percent of total billed charges,38% of total billed charges,9.17,81.4,,,percent of total billed charges,81.4% of total billed charges,10.13,90,,,percent of total billed charges,90% of total billed charges,10.13,90,,,percent of total billed charges,90% of total billed charges,4.28,38,,,percent of total billed charges,38% of total billed charges,4.28,38,,,percent of total billed charges,38% of total billed charges,4.28,38,,,percent of total billed charges,38% of total billed charges,8.45,75,,,percent of total billed charges,75% of total billed charges,9.57,85,,,percent of total billed charges,85% of total billed charges,4.28,10.47,
clobetasol 0.05% topical cream,CLO6844,CDM,637,RC,250,HCPCS,outpatient,,,300.83,225.62,,270.75,90,,,percent of total billed charges,90% of total billed charges,279.77,93,,,percent of total billed charges,93% of total billed charges,114.32,38,,,percent of total billed charges,38% of total billed charges,114.32,38,,,percent of total billed charges,38% of total billed charges,255.71,85,,,percent of total billed charges,85% of total billed charges,114.32,38,,,percent of total billed charges,38% of total billed charges,244.88,81.4,,,percent of total billed charges,81.4% of total billed charges,270.75,90,,,percent of total billed charges,90% of total billed charges,270.75,90,,,percent of total billed charges,90% of total billed charges,114.32,38,,,percent of total billed charges,38% of total billed charges,114.32,38,,,percent of total billed charges,38% of total billed charges,114.32,38,,,percent of total billed charges,38% of total billed charges,225.62,75,,,percent of total billed charges,75% of total billed charges,255.71,85,,,percent of total billed charges,85% of total billed charges,114.32,279.77,
codeine-guaiFENesin 10 mg-100 mg/5 mL oral syrup,COD10606,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Docusate Sodium 100 mg oral capsule,COL1003258,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
colchicine 0.6 mg oral,COL1670,CDM,637,RC,A9270,HCPCS,outpatient,,,11.6,8.7,,10.44,90,,,percent of total billed charges,90% of total billed charges,10.79,93,,,percent of total billed charges,93% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,9.86,85,,,percent of total billed charges,85% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,9.44,81.4,,,percent of total billed charges,81.4% of total billed charges,10.44,90,,,percent of total billed charges,90% of total billed charges,10.44,90,,,percent of total billed charges,90% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,8.7,75,,,percent of total billed charges,75% of total billed charges,9.86,85,,,percent of total billed charges,85% of total billed charges,4.41,10.79,
Carvedilol 12.5 mg oral tablet,COR1003353,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Carvedilol 3.125 mg oral tablet,COR1003354,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
cosyntropin 0.25 mg injection,COS4361,CDM,636,RC,J0833,HCPCS,outpatient,,,126.35,94.76,,113.72,90,,,percent of total billed charges,90% of total billed charges,117.51,93,,,percent of total billed charges,93% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,107.4,85,,,percent of total billed charges,85% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,102.85,81.4,,,percent of total billed charges,81.4% of total billed charges,113.72,90,,,percent of total billed charges,90% of total billed charges,113.72,90,,,percent of total billed charges,90% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,48.01,38,,,percent of total billed charges,38% of total billed charges,94.76,75,,,percent of total billed charges,75% of total billed charges,107.4,85,,,percent of total billed charges,85% of total billed charges,48.01,117.51,
Warfarin 2 mg oral tablet,COU1003010,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Warfarin 5 mg oral tablet,COU1003011,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
CroFab intravenous injection,CRO23264,CDM,636,RC,J0840,HCPCS,outpatient,,,4970.02,3727.52,,4473.02,90,,,percent of total billed charges,90% of total billed charges,4622.12,93,,,percent of total billed charges,93% of total billed charges,1888.61,38,,,percent of total billed charges,38% of total billed charges,1888.61,38,,,percent of total billed charges,38% of total billed charges,4224.52,85,,,percent of total billed charges,85% of total billed charges,1888.61,38,,,percent of total billed charges,38% of total billed charges,4045.6,81.4,,,percent of total billed charges,81.4% of total billed charges,4473.02,90,,,percent of total billed charges,90% of total billed charges,4473.02,90,,,percent of total billed charges,90% of total billed charges,1888.61,38,,,percent of total billed charges,38% of total billed charges,1888.61,38,,,percent of total billed charges,38% of total billed charges,1888.61,38,,,percent of total billed charges,38% of total billed charges,3727.52,75,,,percent of total billed charges,75% of total billed charges,4224.52,85,,,percent of total billed charges,85% of total billed charges,1888.61,4622.12,
DAPTOmycin 500 mg IV,CUB16623,CDM,636,RC,J0878,HCPCS,outpatient,,,25.5,19.13,,22.95,90,,,percent of total billed charges,90% of total billed charges,23.72,93,,,percent of total billed charges,93% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,20.76,81.4,,,percent of total billed charges,81.4% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,9.69,38,,,percent of total billed charges,38% of total billed charges,19.13,75,,,percent of total billed charges,75% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.69,23.72,
Cyanokit 5 g intravenous injection,CYA20101,CDM,250,RC,,,outpatient,,,1225.31,918.98,,1102.78,90,,,percent of total billed charges,90% of total billed charges,1139.54,93,,,percent of total billed charges,93% of total billed charges,465.62,38,,,percent of total billed charges,38% of total billed charges,465.62,38,,,percent of total billed charges,38% of total billed charges,1041.51,85,,,percent of total billed charges,85% of total billed charges,465.62,38,,,percent of total billed charges,38% of total billed charges,997.4,81.4,,,percent of total billed charges,81.4% of total billed charges,1102.78,90,,,percent of total billed charges,90% of total billed charges,1102.78,90,,,percent of total billed charges,90% of total billed charges,465.62,38,,,percent of total billed charges,38% of total billed charges,465.62,38,,,percent of total billed charges,38% of total billed charges,465.62,38,,,percent of total billed charges,38% of total billed charges,918.98,75,,,percent of total billed charges,75% of total billed charges,1041.51,85,,,percent of total billed charges,85% of total billed charges,465.62,1139.54,
Cyclopentolate 1% ophthalmic solution,CYC1003269,CDM,250,RC,,,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
Cyclopentolate 2% ophthalmic solution,CYC1003270,CDM,250,RC,,,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
cyclobenzaprine 5 mg oral tablet,CYC5562,CDM,250,RC,,,outpatient,,,3.24,2.43,,2.92,90,,,percent of total billed charges,90% of total billed charges,3.01,93,,,percent of total billed charges,93% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.64,81.4,,,percent of total billed charges,81.4% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.43,75,,,percent of total billed charges,75% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,3.01,
cyclobenzaprine 5 mg oral tablet,CYC5562,CDM,637,RC,,,outpatient,,,3.24,2.43,,2.92,90,,,percent of total billed charges,90% of total billed charges,3.01,93,,,percent of total billed charges,93% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.64,81.4,,,percent of total billed charges,81.4% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.43,75,,,percent of total billed charges,75% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,3.01,
DULoxetine 30 mg oral delayed release capsule,CYM17007,CDM,637,RC,A9270,HCPCS,outpatient,,,15.24,11.43,,13.72,90,,,percent of total billed charges,90% of total billed charges,14.17,93,,,percent of total billed charges,93% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,12.95,85,,,percent of total billed charges,85% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,12.41,81.4,,,percent of total billed charges,81.4% of total billed charges,13.72,90,,,percent of total billed charges,90% of total billed charges,13.72,90,,,percent of total billed charges,90% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,11.43,75,,,percent of total billed charges,75% of total billed charges,12.95,85,,,percent of total billed charges,85% of total billed charges,5.79,14.17,
Dalvance 500 mg intravenous injection,DAL21572,CDM,636,RC,J0875,HCPCS,outpatient,,,2435.47,1826.6,,2191.92,90,,,percent of total billed charges,90% of total billed charges,2264.99,93,,,percent of total billed charges,93% of total billed charges,925.48,38,,,percent of total billed charges,38% of total billed charges,925.48,38,,,percent of total billed charges,38% of total billed charges,2070.15,85,,,percent of total billed charges,85% of total billed charges,925.48,38,,,percent of total billed charges,38% of total billed charges,1982.47,81.4,,,percent of total billed charges,81.4% of total billed charges,2191.92,90,,,percent of total billed charges,90% of total billed charges,2191.92,90,,,percent of total billed charges,90% of total billed charges,925.48,38,,,percent of total billed charges,38% of total billed charges,925.48,38,,,percent of total billed charges,38% of total billed charges,925.48,38,,,percent of total billed charges,38% of total billed charges,1826.6,75,,,percent of total billed charges,75% of total billed charges,2070.15,85,,,percent of total billed charges,85% of total billed charges,925.48,2264.99,
Divalproex Sodium 250 mg oral delayed release tablet,DEP13091,CDM,250,RC,,,outpatient,,,10.54,7.91,,9.49,90,,,percent of total billed charges,90% of total billed charges,9.8,93,,,percent of total billed charges,93% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.58,81.4,,,percent of total billed charges,81.4% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,7.91,75,,,percent of total billed charges,75% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,9.8,
desmopressin 4 mcg/mL injectable solution,DES4222,CDM,636,RC,J2597,HCPCS,outpatient,,,56.28,42.21,,50.65,90,,,percent of total billed charges,90% of total billed charges,52.34,93,,,percent of total billed charges,93% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,47.84,85,,,percent of total billed charges,85% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,45.81,81.4,,,percent of total billed charges,81.4% of total billed charges,50.65,90,,,percent of total billed charges,90% of total billed charges,50.65,90,,,percent of total billed charges,90% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,21.39,38,,,percent of total billed charges,38% of total billed charges,42.21,75,,,percent of total billed charges,75% of total billed charges,47.84,85,,,percent of total billed charges,85% of total billed charges,21.39,52.34,
Desitin Maximum Strength Original 40% topical ointment,DES9021,CDM,637,RC,,,outpatient,,,21.04,15.78,,18.94,90,,,percent of total billed charges,90% of total billed charges,19.57,93,,,percent of total billed charges,93% of total billed charges,8,38,,,percent of total billed charges,38% of total billed charges,8,38,,,percent of total billed charges,38% of total billed charges,17.88,85,,,percent of total billed charges,85% of total billed charges,8,38,,,percent of total billed charges,38% of total billed charges,17.13,81.4,,,percent of total billed charges,81.4% of total billed charges,18.94,90,,,percent of total billed charges,90% of total billed charges,18.94,90,,,percent of total billed charges,90% of total billed charges,8,38,,,percent of total billed charges,38% of total billed charges,8,38,,,percent of total billed charges,38% of total billed charges,8,38,,,percent of total billed charges,38% of total billed charges,15.78,75,,,percent of total billed charges,75% of total billed charges,17.88,85,,,percent of total billed charges,85% of total billed charges,8,19.57,
dexamethasone 4 mg oral tablet,DEX1003112,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
dexamethasone 4 mg/mL injectable solution,DEX1003114,CDM,636,RC,J1100,HCPCS,outpatient,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
dexamethasone 4 mg/mL injectable solution,DEX1003114,CDM,250,RC,J1100,HCPCS,outpatient,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Dextrose 50% 25g/50mL intravenous solution syr.,DEX1003211,CDM,250,RC,,,outpatient,,,30.46,22.85,,27.41,90,,,percent of total billed charges,90% of total billed charges,28.33,93,,,percent of total billed charges,93% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,24.79,81.4,,,percent of total billed charges,81.4% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,22.85,75,,,percent of total billed charges,75% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,28.33,
Dextrose 25% intravenous solution,DEX1003212,CDM,250,RC,,,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
Dextrose 10% in Water intravenous solution,DEX1003379,CDM,258,RC,,,outpatient,,,44.53,33.4,,40.08,90,,,percent of total billed charges,90% of total billed charges,41.41,93,,,percent of total billed charges,93% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,36.25,81.4,,,percent of total billed charges,81.4% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,40.08,90,,,percent of total billed charges,90% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,16.92,38,,,percent of total billed charges,38% of total billed charges,33.4,75,,,percent of total billed charges,75% of total billed charges,37.85,85,,,percent of total billed charges,85% of total billed charges,16.92,41.41,
dextromethorphan-guaiFENesin 10mg-100 mg/5 mL oral liquid,DEX10722,CDM,250,RC,,,outpatient,,,4.59,3.44,,4.13,90,,,percent of total billed charges,90% of total billed charges,4.27,93,,,percent of total billed charges,93% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,3.9,85,,,percent of total billed charges,85% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,3.74,81.4,,,percent of total billed charges,81.4% of total billed charges,4.13,90,,,percent of total billed charges,90% of total billed charges,4.13,90,,,percent of total billed charges,90% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,3.44,75,,,percent of total billed charges,75% of total billed charges,3.9,85,,,percent of total billed charges,85% of total billed charges,1.74,4.27,
Dextrose 50% in Water intravenous solution 50mL SDV,DEX14287,CDM,250,RC,,,outpatient,,,5.66,4.25,,5.09,90,,,percent of total billed charges,90% of total billed charges,5.26,93,,,percent of total billed charges,93% of total billed charges,2.15,38,,,percent of total billed charges,38% of total billed charges,2.15,38,,,percent of total billed charges,38% of total billed charges,4.81,85,,,percent of total billed charges,85% of total billed charges,2.15,38,,,percent of total billed charges,38% of total billed charges,4.61,81.4,,,percent of total billed charges,81.4% of total billed charges,5.09,90,,,percent of total billed charges,90% of total billed charges,5.09,90,,,percent of total billed charges,90% of total billed charges,2.15,38,,,percent of total billed charges,38% of total billed charges,2.15,38,,,percent of total billed charges,38% of total billed charges,2.15,38,,,percent of total billed charges,38% of total billed charges,4.25,75,,,percent of total billed charges,75% of total billed charges,4.81,85,,,percent of total billed charges,85% of total billed charges,2.15,5.26,
dexamethasone 10 mg/mL injectable solution,DEX2029,CDM,636,RC,J1100,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
dexamethasone 10 mg/mL preservative-free injectable solution,DEX2039,CDM,636,RC,J1100,HCPCS,outpatient,,,7.23,5.42,,6.51,90,,,percent of total billed charges,90% of total billed charges,6.72,93,,,percent of total billed charges,93% of total billed charges,2.75,38,,,percent of total billed charges,38% of total billed charges,2.75,38,,,percent of total billed charges,38% of total billed charges,6.15,85,,,percent of total billed charges,85% of total billed charges,2.75,38,,,percent of total billed charges,38% of total billed charges,5.89,81.4,,,percent of total billed charges,81.4% of total billed charges,6.51,90,,,percent of total billed charges,90% of total billed charges,6.51,90,,,percent of total billed charges,90% of total billed charges,2.75,38,,,percent of total billed charges,38% of total billed charges,2.75,38,,,percent of total billed charges,38% of total billed charges,2.75,38,,,percent of total billed charges,38% of total billed charges,5.42,75,,,percent of total billed charges,75% of total billed charges,6.15,85,,,percent of total billed charges,85% of total billed charges,2.75,6.72,
diazePAM 5 mg oral tablet,DIA1003090,CDM,637,RC,A9270,HCPCS,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
Diazepam 5 mg/mL IV,DIA1003091,CDM,636,RC,J3360,HCPCS,outpatient,,,34.65,25.99,,31.19,90,,,percent of total billed charges,90% of total billed charges,32.22,93,,,percent of total billed charges,93% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,29.45,85,,,percent of total billed charges,85% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,28.21,81.4,,,percent of total billed charges,81.4% of total billed charges,31.19,90,,,percent of total billed charges,90% of total billed charges,31.19,90,,,percent of total billed charges,90% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,25.99,75,,,percent of total billed charges,75% of total billed charges,29.45,85,,,percent of total billed charges,85% of total billed charges,13.17,32.22,
Diazepam 5 mg/mL IV,DIA1003091,CDM,250,RC,J3360,HCPCS,outpatient,,,34.65,25.99,,31.19,90,,,percent of total billed charges,90% of total billed charges,32.22,93,,,percent of total billed charges,93% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,29.45,85,,,percent of total billed charges,85% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,28.21,81.4,,,percent of total billed charges,81.4% of total billed charges,31.19,90,,,percent of total billed charges,90% of total billed charges,31.19,90,,,percent of total billed charges,90% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,13.17,38,,,percent of total billed charges,38% of total billed charges,25.99,75,,,percent of total billed charges,75% of total billed charges,29.45,85,,,percent of total billed charges,85% of total billed charges,13.17,32.22,
Fluconazole 100 mg oral tablet,DIF1003052,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
digoxin 125 mcg (0.125 mg) oral tablet,DIG1003116,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
digoxin 250 mcg/mL (0.25 mg/mL) injectable solution,DIG1003117,CDM,636,RC,J1160,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
digoxin 250 mcg/mL (0.25 mg/mL) injectable solution,DIG1003117,CDM,250,RC,J1160,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
diltiaZEM 125mg/25mL intravenous solution,DIL1003025,CDM,636,RC,J3490,HCPCS,outpatient,,,27.06,20.3,,24.35,90,,,percent of total billed charges,90% of total billed charges,25.17,93,,,percent of total billed charges,93% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,22.03,81.4,,,percent of total billed charges,81.4% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,20.3,75,,,percent of total billed charges,75% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,25.17,
diltiaZEM 125mg/25mL intravenous solution,DIL1003025,CDM,250,RC,J3490,HCPCS,outpatient,,,27.06,20.3,,24.35,90,,,percent of total billed charges,90% of total billed charges,25.17,93,,,percent of total billed charges,93% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,22.03,81.4,,,percent of total billed charges,81.4% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,20.3,75,,,percent of total billed charges,75% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,25.17,
HYDROmorphone 1 mg/mL IV solution,DIL1003136,CDM,636,RC,J1170,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
HYDROmorphone 1 mg/mL IV solution,DIL1003136,CDM,250,RC,J1170,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
HYDROmorphone 2 mg oral tablet,DIL2457,CDM,637,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
Hydromorphone 2mg/mL IV solution,dil2mgiv,CDM,636,RC,J1170,HCPCS,outpatient,,,27.03,20.27,,24.33,90,,,percent of total billed charges,90% of total billed charges,25.14,93,,,percent of total billed charges,93% of total billed charges,10.27,38,,,percent of total billed charges,38% of total billed charges,10.27,38,,,percent of total billed charges,38% of total billed charges,22.98,85,,,percent of total billed charges,85% of total billed charges,10.27,38,,,percent of total billed charges,38% of total billed charges,22,81.4,,,percent of total billed charges,81.4% of total billed charges,24.33,90,,,percent of total billed charges,90% of total billed charges,24.33,90,,,percent of total billed charges,90% of total billed charges,10.27,38,,,percent of total billed charges,38% of total billed charges,10.27,38,,,percent of total billed charges,38% of total billed charges,10.27,38,,,percent of total billed charges,38% of total billed charges,20.27,75,,,percent of total billed charges,75% of total billed charges,22.98,85,,,percent of total billed charges,85% of total billed charges,10.27,25.14,
"diltiaZEM 240 mg/24 hours oral capsule, extended release",DIL608,CDM,637,RC,A9270,HCPCS,outpatient,,,3.44,2.58,,3.1,90,,,percent of total billed charges,90% of total billed charges,3.2,93,,,percent of total billed charges,93% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.8,81.4,,,percent of total billed charges,81.4% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.58,75,,,percent of total billed charges,75% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,3.2,
"Diltiazem 180 mg/24 hours oral capsule, extended release",DIL654,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
diphenhydrAMINE 25 mg oral capsule,DIP1003118,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
diphenhydrAMINE 12.5 mg/5 mL oral liquid,DIP1003119,CDM,637,RC,A9270,HCPCS,outpatient,,,0.13,0.1,,0.12,90,,,percent of total billed charges,90% of total billed charges,0.12,93,,,percent of total billed charges,93% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.11,85,,,percent of total billed charges,85% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.11,81.4,,,percent of total billed charges,81.4% of total billed charges,0.12,90,,,percent of total billed charges,90% of total billed charges,0.12,90,,,percent of total billed charges,90% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.05,38,,,percent of total billed charges,38% of total billed charges,0.1,75,,,percent of total billed charges,75% of total billed charges,0.11,85,,,percent of total billed charges,85% of total billed charges,0.05,0.12,
diphenhydrAMINE 50 mg/mL injectable solution,DIP1003120,CDM,636,RC,J1200,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
diphenhydrAMINE 50 mg/mL injectable solution,DIP1003120,CDM,250,RC,J1200,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
Oxybutynin 5 mg oral tablet,DIT1003166,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
DOBUTamine 1 mg/mL-D5% intravenous solution,DOB2203,CDM,636,RC,J1250,HCPCS,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
Donnatal oral elixir,DON1003324,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
donepezil 10 mg oral tablet,DON14044,CDM,250,RC,,,outpatient,,,9.37,7.03,,8.43,90,,,percent of total billed charges,90% of total billed charges,8.71,93,,,percent of total billed charges,93% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,7.96,85,,,percent of total billed charges,85% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,7.63,81.4,,,percent of total billed charges,81.4% of total billed charges,8.43,90,,,percent of total billed charges,90% of total billed charges,8.43,90,,,percent of total billed charges,90% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,7.03,75,,,percent of total billed charges,75% of total billed charges,7.96,85,,,percent of total billed charges,85% of total billed charges,3.56,8.71,
donepezil 10 mg oral tablet,DON14044,CDM,637,RC,,,outpatient,,,9.37,7.03,,8.43,90,,,percent of total billed charges,90% of total billed charges,8.71,93,,,percent of total billed charges,93% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,7.96,85,,,percent of total billed charges,85% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,7.63,81.4,,,percent of total billed charges,81.4% of total billed charges,8.43,90,,,percent of total billed charges,90% of total billed charges,8.43,90,,,percent of total billed charges,90% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,3.56,38,,,percent of total billed charges,38% of total billed charges,7.03,75,,,percent of total billed charges,75% of total billed charges,7.96,85,,,percent of total billed charges,85% of total billed charges,3.56,8.71,
DOPamine 3.2 mg/mL-D5% intravenous solution,DOP2210,CDM,636,RC,J1265,HCPCS,outpatient,,,27.86,20.9,,25.07,90,,,percent of total billed charges,90% of total billed charges,25.91,93,,,percent of total billed charges,93% of total billed charges,10.59,38,,,percent of total billed charges,38% of total billed charges,10.59,38,,,percent of total billed charges,38% of total billed charges,23.68,85,,,percent of total billed charges,85% of total billed charges,10.59,38,,,percent of total billed charges,38% of total billed charges,22.68,81.4,,,percent of total billed charges,81.4% of total billed charges,25.07,90,,,percent of total billed charges,90% of total billed charges,25.07,90,,,percent of total billed charges,90% of total billed charges,10.59,38,,,percent of total billed charges,38% of total billed charges,10.59,38,,,percent of total billed charges,38% of total billed charges,10.59,38,,,percent of total billed charges,38% of total billed charges,20.9,75,,,percent of total billed charges,75% of total billed charges,23.68,85,,,percent of total billed charges,85% of total billed charges,10.59,25.91,
doxepin 25 mg oral capsule,DOX1003123,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
doxycycline hyclate 100 mg oral tablet,DOX496,CDM,250,RC,A9270,HCPCS,outpatient,,,3.13,2.35,,2.82,90,,,percent of total billed charges,90% of total billed charges,2.91,93,,,percent of total billed charges,93% of total billed charges,1.19,38,,,percent of total billed charges,38% of total billed charges,1.19,38,,,percent of total billed charges,38% of total billed charges,2.66,85,,,percent of total billed charges,85% of total billed charges,1.19,38,,,percent of total billed charges,38% of total billed charges,2.55,81.4,,,percent of total billed charges,81.4% of total billed charges,2.82,90,,,percent of total billed charges,90% of total billed charges,2.82,90,,,percent of total billed charges,90% of total billed charges,1.19,38,,,percent of total billed charges,38% of total billed charges,1.19,38,,,percent of total billed charges,38% of total billed charges,1.19,38,,,percent of total billed charges,38% of total billed charges,2.35,75,,,percent of total billed charges,75% of total billed charges,2.66,85,,,percent of total billed charges,85% of total billed charges,1.19,2.91,
doxycycline 100 mg injection,DOX502,CDM,250,RC,,,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
droperidol 2.5 mg/mL injectable solution,DRO2231,CDM,636,RC,J1790,HCPCS,outpatient,,,12.85,9.64,,11.57,90,,,percent of total billed charges,90% of total billed charges,11.95,93,,,percent of total billed charges,93% of total billed charges,4.88,38,,,percent of total billed charges,38% of total billed charges,4.88,38,,,percent of total billed charges,38% of total billed charges,10.92,85,,,percent of total billed charges,85% of total billed charges,4.88,38,,,percent of total billed charges,38% of total billed charges,10.46,81.4,,,percent of total billed charges,81.4% of total billed charges,11.57,90,,,percent of total billed charges,90% of total billed charges,11.57,90,,,percent of total billed charges,90% of total billed charges,4.88,38,,,percent of total billed charges,38% of total billed charges,4.88,38,,,percent of total billed charges,38% of total billed charges,4.88,38,,,percent of total billed charges,38% of total billed charges,9.64,75,,,percent of total billed charges,75% of total billed charges,10.92,85,,,percent of total billed charges,85% of total billed charges,4.88,11.95,
Bisacodyl 10 mg rectal suppository,DUL1003255,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Bisacodyl 5 mg oral delayed release tablet,DUL1003256,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Ipratropium/albuterol 0.5 mg-2.5 mg/3 mL inhalation solution,DUO1003368,CDM,250,RC,,,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
FentaNYL 50 mcg/hr Patch,DUR2293,CDM,250,RC,,,outpatient,,,79.68,59.76,,71.71,90,,,percent of total billed charges,90% of total billed charges,74.1,93,,,percent of total billed charges,93% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,67.73,85,,,percent of total billed charges,85% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,64.86,81.4,,,percent of total billed charges,81.4% of total billed charges,71.71,90,,,percent of total billed charges,90% of total billed charges,71.71,90,,,percent of total billed charges,90% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,59.76,75,,,percent of total billed charges,75% of total billed charges,67.73,85,,,percent of total billed charges,85% of total billed charges,30.28,74.1,
FentaNYL 25 mcg/hr Patch,DUR2297,CDM,252,RC,,,outpatient,,,79.68,59.76,,71.71,90,,,percent of total billed charges,90% of total billed charges,74.1,93,,,percent of total billed charges,93% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,67.73,85,,,percent of total billed charges,85% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,64.86,81.4,,,percent of total billed charges,81.4% of total billed charges,71.71,90,,,percent of total billed charges,90% of total billed charges,71.71,90,,,percent of total billed charges,90% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,30.28,38,,,percent of total billed charges,38% of total billed charges,59.76,75,,,percent of total billed charges,75% of total billed charges,67.73,85,,,percent of total billed charges,85% of total billed charges,30.28,74.1,
Duramorph PF (morphine) 1 mg/mL preservative-free injectable solution,DUR2878,CDM,636,RC,J2274,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
Durolane 60mg/3mL,duro,CDM,636,RC,J7318,HCPCS,outpatient,,,1432.63,1074.47,,1289.37,90,,,percent of total billed charges,90% of total billed charges,1332.35,93,,,percent of total billed charges,93% of total billed charges,544.4,38,,,percent of total billed charges,38% of total billed charges,544.4,38,,,percent of total billed charges,38% of total billed charges,1217.74,85,,,percent of total billed charges,85% of total billed charges,544.4,38,,,percent of total billed charges,38% of total billed charges,1166.16,81.4,,,percent of total billed charges,81.4% of total billed charges,1289.37,90,,,percent of total billed charges,90% of total billed charges,1289.37,90,,,percent of total billed charges,90% of total billed charges,544.4,38,,,percent of total billed charges,38% of total billed charges,544.4,38,,,percent of total billed charges,38% of total billed charges,544.4,38,,,percent of total billed charges,38% of total billed charges,1074.47,75,,,percent of total billed charges,75% of total billed charges,1217.74,85,,,percent of total billed charges,85% of total billed charges,544.4,1332.35,
Venlafaxine 75 mg oral tablet,EFF1003304,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Apixaban (Eliquis) 5 mg oral tablet,ELI20660,CDM,250,RC,J3490,HCPCS,outpatient,,,13.16,9.87,,11.84,90,,,percent of total billed charges,90% of total billed charges,12.24,93,,,percent of total billed charges,93% of total billed charges,5,38,,,percent of total billed charges,38% of total billed charges,5,38,,,percent of total billed charges,38% of total billed charges,11.19,85,,,percent of total billed charges,85% of total billed charges,5,38,,,percent of total billed charges,38% of total billed charges,10.71,81.4,,,percent of total billed charges,81.4% of total billed charges,11.84,90,,,percent of total billed charges,90% of total billed charges,11.84,90,,,percent of total billed charges,90% of total billed charges,5,38,,,percent of total billed charges,38% of total billed charges,5,38,,,percent of total billed charges,38% of total billed charges,5,38,,,percent of total billed charges,38% of total billed charges,9.87,75,,,percent of total billed charges,75% of total billed charges,11.19,85,,,percent of total billed charges,85% of total billed charges,5,12.24,
Lidocaine-prilocaine 2.5%-2.5% topical cream,EML1003335,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
enalaprilat 1.25 mg/mL intravenous solution,ENA1013551,CDM,258,RC,,,outpatient,,,12.52,9.39,,11.27,90,,,percent of total billed charges,90% of total billed charges,11.64,93,,,percent of total billed charges,93% of total billed charges,4.76,38,,,percent of total billed charges,38% of total billed charges,4.76,38,,,percent of total billed charges,38% of total billed charges,10.64,85,,,percent of total billed charges,85% of total billed charges,4.76,38,,,percent of total billed charges,38% of total billed charges,10.19,81.4,,,percent of total billed charges,81.4% of total billed charges,11.27,90,,,percent of total billed charges,90% of total billed charges,11.27,90,,,percent of total billed charges,90% of total billed charges,4.76,38,,,percent of total billed charges,38% of total billed charges,4.76,38,,,percent of total billed charges,38% of total billed charges,4.76,38,,,percent of total billed charges,38% of total billed charges,9.39,75,,,percent of total billed charges,75% of total billed charges,10.64,85,,,percent of total billed charges,85% of total billed charges,4.76,11.64,
Entresto 24 mg-26 mg oral tablet,ENT22856,CDM,637,RC,,,outpatient,,,15.61,11.71,,14.05,90,,,percent of total billed charges,90% of total billed charges,14.52,93,,,percent of total billed charges,93% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,13.27,85,,,percent of total billed charges,85% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,12.71,81.4,,,percent of total billed charges,81.4% of total billed charges,14.05,90,,,percent of total billed charges,90% of total billed charges,14.05,90,,,percent of total billed charges,90% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,11.71,75,,,percent of total billed charges,75% of total billed charges,13.27,85,,,percent of total billed charges,85% of total billed charges,5.93,14.52,
Entresto 49 mg-51 mg oral tablet,ENT22858,CDM,637,RC,,,outpatient,,,15.61,11.71,,14.05,90,,,percent of total billed charges,90% of total billed charges,14.52,93,,,percent of total billed charges,93% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,13.27,85,,,percent of total billed charges,85% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,12.71,81.4,,,percent of total billed charges,81.4% of total billed charges,14.05,90,,,percent of total billed charges,90% of total billed charges,14.05,90,,,percent of total billed charges,90% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,11.71,75,,,percent of total billed charges,75% of total billed charges,13.27,85,,,percent of total billed charges,85% of total billed charges,5.93,14.52,
Entresto 97 mg-103 mg oral tablet,ENT22860,CDM,637,RC,,,outpatient,,,15.61,11.71,,14.05,90,,,percent of total billed charges,90% of total billed charges,14.52,93,,,percent of total billed charges,93% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,13.27,85,,,percent of total billed charges,85% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,12.71,81.4,,,percent of total billed charges,81.4% of total billed charges,14.05,90,,,percent of total billed charges,90% of total billed charges,14.05,90,,,percent of total billed charges,90% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,5.93,38,,,percent of total billed charges,38% of total billed charges,11.71,75,,,percent of total billed charges,75% of total billed charges,13.27,85,,,percent of total billed charges,85% of total billed charges,5.93,14.52,
ePHEDrine 50 mg/mL injectable solution,EPH1003220,CDM,636,RC,J3490,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
ePHEDrine 50 mg/mL injectable solution,EPH1003220,CDM,250,RC,J3490,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
EPINEPHrine 1 mg/mL injectable solution,EPI1003218,CDM,636,RC,J0171,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
EPINEPHrine 1 mg/mL injectable solution,EPI1003218,CDM,250,RC,J0171,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
EPINEPHrine 0.1 mg/mL injectable solution,EPI1003219,CDM,636,RC,J0171,HCPCS,outpatient,,,83.21,62.41,,74.89,90,,,percent of total billed charges,90% of total billed charges,77.39,93,,,percent of total billed charges,93% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,70.73,85,,,percent of total billed charges,85% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,67.73,81.4,,,percent of total billed charges,81.4% of total billed charges,74.89,90,,,percent of total billed charges,90% of total billed charges,74.89,90,,,percent of total billed charges,90% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,62.41,75,,,percent of total billed charges,75% of total billed charges,70.73,85,,,percent of total billed charges,85% of total billed charges,31.62,77.39,
EPINEPHrine 0.1 mg/mL injectable solution,EPI1003219,CDM,250,RC,J0171,HCPCS,outpatient,,,83.21,62.41,,74.89,90,,,percent of total billed charges,90% of total billed charges,77.39,93,,,percent of total billed charges,93% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,70.73,85,,,percent of total billed charges,85% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,67.73,81.4,,,percent of total billed charges,81.4% of total billed charges,74.89,90,,,percent of total billed charges,90% of total billed charges,74.89,90,,,percent of total billed charges,90% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,31.62,38,,,percent of total billed charges,38% of total billed charges,62.41,75,,,percent of total billed charges,75% of total billed charges,70.73,85,,,percent of total billed charges,85% of total billed charges,31.62,77.39,
"epoetin alfa 40,000 units/mL preservative-free injectable solution",EPO22987,CDM,636,RC,Q5106,HCPCS,outpatient,,,15.52,11.64,,13.97,90,,,percent of total billed charges,90% of total billed charges,14.43,93,,,percent of total billed charges,93% of total billed charges,5.9,38,,,percent of total billed charges,38% of total billed charges,5.9,38,,,percent of total billed charges,38% of total billed charges,13.19,85,,,percent of total billed charges,85% of total billed charges,5.9,38,,,percent of total billed charges,38% of total billed charges,12.63,81.4,,,percent of total billed charges,81.4% of total billed charges,13.97,90,,,percent of total billed charges,90% of total billed charges,13.97,90,,,percent of total billed charges,90% of total billed charges,5.9,38,,,percent of total billed charges,38% of total billed charges,5.9,38,,,percent of total billed charges,38% of total billed charges,5.9,38,,,percent of total billed charges,38% of total billed charges,11.64,75,,,percent of total billed charges,75% of total billed charges,13.19,85,,,percent of total billed charges,85% of total billed charges,5.9,14.43,
"ergocalciferol 50,000 intl units (1.25 mg) oral capsule",ERG7830,CDM,637,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Erythromycin 0.5% ophthalmic oint 1 gram tube,ERY051,CDM,250,RC,,,outpatient,,,13.76,10.32,,12.38,90,,,percent of total billed charges,90% of total billed charges,12.8,93,,,percent of total billed charges,93% of total billed charges,5.23,38,,,percent of total billed charges,38% of total billed charges,5.23,38,,,percent of total billed charges,38% of total billed charges,11.7,85,,,percent of total billed charges,85% of total billed charges,5.23,38,,,percent of total billed charges,38% of total billed charges,11.2,81.4,,,percent of total billed charges,81.4% of total billed charges,12.38,90,,,percent of total billed charges,90% of total billed charges,12.38,90,,,percent of total billed charges,90% of total billed charges,5.23,38,,,percent of total billed charges,38% of total billed charges,5.23,38,,,percent of total billed charges,38% of total billed charges,5.23,38,,,percent of total billed charges,38% of total billed charges,10.32,75,,,percent of total billed charges,75% of total billed charges,11.7,85,,,percent of total billed charges,85% of total billed charges,5.23,12.8,
esmolol 10 mg/mL intravenous solution,ESM1003124,CDM,636,RC,J3490,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
esmolol 10 mg/mL intravenous solution,ESM1003124,CDM,250,RC,J3490,HCPCS,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
etomidate 2 mg/mL intravenous solution,ETO1003248,CDM,250,RC,J3490,HCPCS,outpatient,,,16.24,12.18,,14.62,90,,,percent of total billed charges,90% of total billed charges,15.1,93,,,percent of total billed charges,93% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.22,81.4,,,percent of total billed charges,81.4% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,12.18,75,,,percent of total billed charges,75% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,15.1,
Euflexxa 10 mg/mL intra-articular solution,EUF15093,CDM,636,RC,,,outpatient,,,1478.49,1108.87,,1330.64,90,,,percent of total billed charges,90% of total billed charges,1375,93,,,percent of total billed charges,93% of total billed charges,561.83,38,,,percent of total billed charges,38% of total billed charges,561.83,38,,,percent of total billed charges,38% of total billed charges,1256.72,85,,,percent of total billed charges,85% of total billed charges,561.83,38,,,percent of total billed charges,38% of total billed charges,1203.49,81.4,,,percent of total billed charges,81.4% of total billed charges,1330.64,90,,,percent of total billed charges,90% of total billed charges,1330.64,90,,,percent of total billed charges,90% of total billed charges,561.83,38,,,percent of total billed charges,38% of total billed charges,561.83,38,,,percent of total billed charges,38% of total billed charges,561.83,38,,,percent of total billed charges,38% of total billed charges,1108.87,75,,,percent of total billed charges,75% of total billed charges,1256.72,85,,,percent of total billed charges,85% of total billed charges,561.83,1375,
Exparel 1.3% (13.3 mg/mL) injectable suspension,EXP19859,CDM,250,RC,,,outpatient,,,308.33,231.25,,277.5,90,,,percent of total billed charges,90% of total billed charges,286.75,93,,,percent of total billed charges,93% of total billed charges,117.17,38,,,percent of total billed charges,38% of total billed charges,117.17,38,,,percent of total billed charges,38% of total billed charges,262.08,85,,,percent of total billed charges,85% of total billed charges,117.17,38,,,percent of total billed charges,38% of total billed charges,250.98,81.4,,,percent of total billed charges,81.4% of total billed charges,277.5,90,,,percent of total billed charges,90% of total billed charges,277.5,90,,,percent of total billed charges,90% of total billed charges,117.17,38,,,percent of total billed charges,38% of total billed charges,117.17,38,,,percent of total billed charges,38% of total billed charges,117.17,38,,,percent of total billed charges,38% of total billed charges,231.25,75,,,percent of total billed charges,75% of total billed charges,262.08,85,,,percent of total billed charges,85% of total billed charges,117.17,286.75,
famotidine 20 mg oral tablet,FAM1547,CDM,637,RC,,,outpatient,,,1.08,0.81,,0.97,90,,,percent of total billed charges,90% of total billed charges,1,93,,,percent of total billed charges,93% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.92,85,,,percent of total billed charges,85% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.88,81.4,,,percent of total billed charges,81.4% of total billed charges,0.97,90,,,percent of total billed charges,90% of total billed charges,0.97,90,,,percent of total billed charges,90% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.81,75,,,percent of total billed charges,75% of total billed charges,0.92,85,,,percent of total billed charges,85% of total billed charges,0.41,1,
Farxiga 5 mg oral tablet,FAR20644,CDM,637,RC,,,outpatient,,,26.81,20.11,,24.13,90,,,percent of total billed charges,90% of total billed charges,24.93,93,,,percent of total billed charges,93% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,22.79,85,,,percent of total billed charges,85% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,21.82,81.4,,,percent of total billed charges,81.4% of total billed charges,24.13,90,,,percent of total billed charges,90% of total billed charges,24.13,90,,,percent of total billed charges,90% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,20.11,75,,,percent of total billed charges,75% of total billed charges,22.79,85,,,percent of total billed charges,85% of total billed charges,10.19,24.93,
Farxiga 5 mg oral tablet,FAR20644,CDM,250,RC,,,outpatient,,,26.81,20.11,,24.13,90,,,percent of total billed charges,90% of total billed charges,24.93,93,,,percent of total billed charges,93% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,22.79,85,,,percent of total billed charges,85% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,21.82,81.4,,,percent of total billed charges,81.4% of total billed charges,24.13,90,,,percent of total billed charges,90% of total billed charges,24.13,90,,,percent of total billed charges,90% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,20.11,75,,,percent of total billed charges,75% of total billed charges,22.79,85,,,percent of total billed charges,85% of total billed charges,10.19,24.93,
Farxiga 10 mg oral tablet,FAR20646,CDM,250,RC,,,outpatient,,,26.81,20.11,,24.13,90,,,percent of total billed charges,90% of total billed charges,24.93,93,,,percent of total billed charges,93% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,22.79,85,,,percent of total billed charges,85% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,21.82,81.4,,,percent of total billed charges,81.4% of total billed charges,24.13,90,,,percent of total billed charges,90% of total billed charges,24.13,90,,,percent of total billed charges,90% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,20.11,75,,,percent of total billed charges,75% of total billed charges,22.79,85,,,percent of total billed charges,85% of total billed charges,10.19,24.93,
Farxiga 10 mg oral tablet,FAR20646,CDM,637,RC,,,outpatient,,,26.81,20.11,,24.13,90,,,percent of total billed charges,90% of total billed charges,24.93,93,,,percent of total billed charges,93% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,22.79,85,,,percent of total billed charges,85% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,21.82,81.4,,,percent of total billed charges,81.4% of total billed charges,24.13,90,,,percent of total billed charges,90% of total billed charges,24.13,90,,,percent of total billed charges,90% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,10.19,38,,,percent of total billed charges,38% of total billed charges,20.11,75,,,percent of total billed charges,75% of total billed charges,22.79,85,,,percent of total billed charges,85% of total billed charges,10.19,24.93,
"Lipid emulsion, intravenous 20% intravenous emulsion",FAT12136,CDM,250,RC,,,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
fentaNYL 50 mcg/mL injectable solution,FEN1003125,CDM,636,RC,J3010,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
fentaNYL 50 mcg/mL injectable solution,FEN1003125,CDM,250,RC,J3010,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
fentaNYL 12 mcg/hr Patch,FEN2292,CDM,250,RC,,,outpatient,,,27.08,20.31,,24.37,90,,,percent of total billed charges,90% of total billed charges,25.18,93,,,percent of total billed charges,93% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,23.02,85,,,percent of total billed charges,85% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,22.04,81.4,,,percent of total billed charges,81.4% of total billed charges,24.37,90,,,percent of total billed charges,90% of total billed charges,24.37,90,,,percent of total billed charges,90% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,20.31,75,,,percent of total billed charges,75% of total billed charges,23.02,85,,,percent of total billed charges,85% of total billed charges,10.29,25.18,
fentaNYL 12 mcg/hr Patch,FEN2292,CDM,637,RC,,,outpatient,,,27.08,20.31,,24.37,90,,,percent of total billed charges,90% of total billed charges,25.18,93,,,percent of total billed charges,93% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,23.02,85,,,percent of total billed charges,85% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,22.04,81.4,,,percent of total billed charges,81.4% of total billed charges,24.37,90,,,percent of total billed charges,90% of total billed charges,24.37,90,,,percent of total billed charges,90% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,10.29,38,,,percent of total billed charges,38% of total billed charges,20.31,75,,,percent of total billed charges,75% of total billed charges,23.02,85,,,percent of total billed charges,85% of total billed charges,10.29,25.18,
ferrous sulfate 325 mg (65 mg elemental iron) oral tablet,FER12991,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Sodium ferric gluconate 62.5mg/5ml IV solution,FER15239,CDM,636,RC,j2916,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
Feraheme 30 mg/mL intravenous solution,FER18350,CDM,636,RC,Q0138,HCPCS,outpatient,,,455.83,341.87,,410.25,90,,,percent of total billed charges,90% of total billed charges,423.92,93,,,percent of total billed charges,93% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,387.46,85,,,percent of total billed charges,85% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,371.05,81.4,,,percent of total billed charges,81.4% of total billed charges,410.25,90,,,percent of total billed charges,90% of total billed charges,410.25,90,,,percent of total billed charges,90% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,341.87,75,,,percent of total billed charges,75% of total billed charges,387.46,85,,,percent of total billed charges,85% of total billed charges,173.22,423.92,
Feraheme 30 mg/mL intravenous solution,FER18350,CDM,250,RC,Q0138,HCPCS,outpatient,,,455.83,341.87,,410.25,90,,,percent of total billed charges,90% of total billed charges,423.92,93,,,percent of total billed charges,93% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,387.46,85,,,percent of total billed charges,85% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,371.05,81.4,,,percent of total billed charges,81.4% of total billed charges,410.25,90,,,percent of total billed charges,90% of total billed charges,410.25,90,,,percent of total billed charges,90% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,173.22,38,,,percent of total billed charges,38% of total billed charges,341.87,75,,,percent of total billed charges,75% of total billed charges,387.46,85,,,percent of total billed charges,85% of total billed charges,173.22,423.92,
Psyllium 3.4 g/5.8 g oral powder for reconstitution,FIB1003257,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Fish Oil oral capsule,FIS3829,CDM,637,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
flecainide 50 mg oral tablet,FLE2324,CDM,250,RC,A9270,HCPCS,outpatient,,,2.37,1.78,,2.13,90,,,percent of total billed charges,90% of total billed charges,2.2,93,,,percent of total billed charges,93% of total billed charges,0.9,38,,,percent of total billed charges,38% of total billed charges,0.9,38,,,percent of total billed charges,38% of total billed charges,2.01,85,,,percent of total billed charges,85% of total billed charges,0.9,38,,,percent of total billed charges,38% of total billed charges,1.93,81.4,,,percent of total billed charges,81.4% of total billed charges,2.13,90,,,percent of total billed charges,90% of total billed charges,2.13,90,,,percent of total billed charges,90% of total billed charges,0.9,38,,,percent of total billed charges,38% of total billed charges,0.9,38,,,percent of total billed charges,38% of total billed charges,0.9,38,,,percent of total billed charges,38% of total billed charges,1.78,75,,,percent of total billed charges,75% of total billed charges,2.01,85,,,percent of total billed charges,85% of total billed charges,0.9,2.2,
Mineral Oil rectal enema,FLE5902,CDM,250,RC,,,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Fluticasone inhalation 110 mcg/inh,FLO1003278,CDM,250,RC,,,outpatient,,,363.81,272.86,,327.43,90,,,percent of total billed charges,90% of total billed charges,338.34,93,,,percent of total billed charges,93% of total billed charges,138.25,38,,,percent of total billed charges,38% of total billed charges,138.25,38,,,percent of total billed charges,38% of total billed charges,309.24,85,,,percent of total billed charges,85% of total billed charges,138.25,38,,,percent of total billed charges,38% of total billed charges,296.14,81.4,,,percent of total billed charges,81.4% of total billed charges,327.43,90,,,percent of total billed charges,90% of total billed charges,327.43,90,,,percent of total billed charges,90% of total billed charges,138.25,38,,,percent of total billed charges,38% of total billed charges,138.25,38,,,percent of total billed charges,38% of total billed charges,138.25,38,,,percent of total billed charges,38% of total billed charges,272.86,75,,,percent of total billed charges,75% of total billed charges,309.24,85,,,percent of total billed charges,85% of total billed charges,138.25,338.34,
Tamsulosin 0.4 mg oral capsule,FLO1003377,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Fluticasone nasal 50 mcg/inh spray,FLO1003390,CDM,250,RC,,,outpatient,,,19.48,14.61,,17.53,90,,,percent of total billed charges,90% of total billed charges,18.12,93,,,percent of total billed charges,93% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,16.56,85,,,percent of total billed charges,85% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,15.86,81.4,,,percent of total billed charges,81.4% of total billed charges,17.53,90,,,percent of total billed charges,90% of total billed charges,17.53,90,,,percent of total billed charges,90% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,14.61,75,,,percent of total billed charges,75% of total billed charges,16.56,85,,,percent of total billed charges,85% of total billed charges,7.4,18.12,
fluPHENAZine decanoate 25 mg/mL injectable solution,FLU1003128,CDM,636,RC,J2680,HCPCS,outpatient,,,135.3,101.48,,121.77,90,,,percent of total billed charges,90% of total billed charges,125.83,93,,,percent of total billed charges,93% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,115.01,85,,,percent of total billed charges,85% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,110.13,81.4,,,percent of total billed charges,81.4% of total billed charges,121.77,90,,,percent of total billed charges,90% of total billed charges,121.77,90,,,percent of total billed charges,90% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,101.48,75,,,percent of total billed charges,75% of total billed charges,115.01,85,,,percent of total billed charges,85% of total billed charges,51.41,125.83,
fluPHENAZine decanoate 25 mg/mL injectable solution,FLU1003128,CDM,250,RC,J2680,HCPCS,outpatient,,,135.3,101.48,,121.77,90,,,percent of total billed charges,90% of total billed charges,125.83,93,,,percent of total billed charges,93% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,115.01,85,,,percent of total billed charges,85% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,110.13,81.4,,,percent of total billed charges,81.4% of total billed charges,121.77,90,,,percent of total billed charges,90% of total billed charges,121.77,90,,,percent of total billed charges,90% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,51.41,38,,,percent of total billed charges,38% of total billed charges,101.48,75,,,percent of total billed charges,75% of total billed charges,115.01,85,,,percent of total billed charges,85% of total billed charges,51.41,125.83,
fluorescein 1 mg ophthalmic test,FLU1003273,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
FLUoxetine 10 mg oral capsule,FLU2330,CDM,250,RC,,,outpatient,,,2.78,2.09,,2.5,90,,,percent of total billed charges,90% of total billed charges,2.59,93,,,percent of total billed charges,93% of total billed charges,1.06,38,,,percent of total billed charges,38% of total billed charges,1.06,38,,,percent of total billed charges,38% of total billed charges,2.36,85,,,percent of total billed charges,85% of total billed charges,1.06,38,,,percent of total billed charges,38% of total billed charges,2.26,81.4,,,percent of total billed charges,81.4% of total billed charges,2.5,90,,,percent of total billed charges,90% of total billed charges,2.5,90,,,percent of total billed charges,90% of total billed charges,1.06,38,,,percent of total billed charges,38% of total billed charges,1.06,38,,,percent of total billed charges,38% of total billed charges,1.06,38,,,percent of total billed charges,38% of total billed charges,2.09,75,,,percent of total billed charges,75% of total billed charges,2.36,85,,,percent of total billed charges,85% of total billed charges,1.06,2.59,
fludrocortisone 0.1 mg oral tablet,FLU4362,CDM,250,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
fludrocortisone 0.1 mg oral tablet,FLU4362,CDM,637,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
folic acid 1 mg oral tablet,FOL1003129,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
folic acid 5 mg/mL injectable solution,FOL2368,CDM,636,RC,j3490,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
z* fomepizole 1 g/mL intravenous solution,FOM14866,CDM,636,RC,J1451,HCPCS,outpatient,,,14.17,10.63,,12.75,90,,,percent of total billed charges,90% of total billed charges,13.18,93,,,percent of total billed charges,93% of total billed charges,5.38,38,,,percent of total billed charges,38% of total billed charges,5.38,38,,,percent of total billed charges,38% of total billed charges,12.04,85,,,percent of total billed charges,85% of total billed charges,5.38,38,,,percent of total billed charges,38% of total billed charges,11.53,81.4,,,percent of total billed charges,81.4% of total billed charges,12.75,90,,,percent of total billed charges,90% of total billed charges,12.75,90,,,percent of total billed charges,90% of total billed charges,5.38,38,,,percent of total billed charges,38% of total billed charges,5.38,38,,,percent of total billed charges,38% of total billed charges,5.38,38,,,percent of total billed charges,38% of total billed charges,10.63,75,,,percent of total billed charges,75% of total billed charges,12.04,85,,,percent of total billed charges,85% of total billed charges,5.38,13.18,
fosphenytoin 500 mg (as PE)/10 mL injectable solution,FOS1003364,CDM,636,RC,Q2009,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
fosphenytoin 500 mg (as PE)/10 mL injectable solution,FOS1003364,CDM,250,RC,Q2009,HCPCS,outpatient,,,94.91,71.18,,85.42,90,,,percent of total billed charges,90% of total billed charges,88.27,93,,,percent of total billed charges,93% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,77.26,81.4,,,percent of total billed charges,81.4% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,85.42,90,,,percent of total billed charges,90% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,36.07,38,,,percent of total billed charges,38% of total billed charges,71.18,75,,,percent of total billed charges,75% of total billed charges,80.67,85,,,percent of total billed charges,85% of total billed charges,36.07,88.27,
furosemide 40 mg oral tablet,FUR1003050,CDM,637,RC,1402,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
furosemide 40 mg oral tablet,FUR1003050,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
furosemide 40 mg/4mL injectable solution,FUR1003051,CDM,636,RC,J1940,HCPCS,outpatient,,,22.74,17.06,,20.47,90,,,percent of total billed charges,90% of total billed charges,21.15,93,,,percent of total billed charges,93% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,18.51,81.4,,,percent of total billed charges,81.4% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,17.06,75,,,percent of total billed charges,75% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,21.15,
furosemide 40 mg/4mL injectable solution,FUR1003051,CDM,250,RC,J1940,HCPCS,outpatient,,,22.74,17.06,,20.47,90,,,percent of total billed charges,90% of total billed charges,21.15,93,,,percent of total billed charges,93% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,18.51,81.4,,,percent of total billed charges,81.4% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,17.06,75,,,percent of total billed charges,75% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,21.15,
furosemide 20 mg oral tablet,FUR1037,CDM,250,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
furosemide 20 mg oral tablet,FUR1037,CDM,636,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
furosemide 20mg/2mL injectable solution,FUR20IV,CDM,636,RC,J1940,HCPCS,outpatient,,,16.24,12.18,,14.62,90,,,percent of total billed charges,90% of total billed charges,15.1,93,,,percent of total billed charges,93% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.22,81.4,,,percent of total billed charges,81.4% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,12.18,75,,,percent of total billed charges,75% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,15.1,
furosemide 20mg/2mL injectable solution,FUR20IV,CDM,250,RC,J1940,HCPCS,outpatient,,,16.24,12.18,,14.62,90,,,percent of total billed charges,90% of total billed charges,15.1,93,,,percent of total billed charges,93% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.22,81.4,,,percent of total billed charges,81.4% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,12.18,75,,,percent of total billed charges,75% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,15.1,
gabapentin 600 mg oral tablet,GAB8939,CDM,637,RC,,,outpatient,,,4.41,3.31,,3.97,90,,,percent of total billed charges,90% of total billed charges,4.1,93,,,percent of total billed charges,93% of total billed charges,1.68,38,,,percent of total billed charges,38% of total billed charges,1.68,38,,,percent of total billed charges,38% of total billed charges,3.75,85,,,percent of total billed charges,85% of total billed charges,1.68,38,,,percent of total billed charges,38% of total billed charges,3.59,81.4,,,percent of total billed charges,81.4% of total billed charges,3.97,90,,,percent of total billed charges,90% of total billed charges,3.97,90,,,percent of total billed charges,90% of total billed charges,1.68,38,,,percent of total billed charges,38% of total billed charges,1.68,38,,,percent of total billed charges,38% of total billed charges,1.68,38,,,percent of total billed charges,38% of total billed charges,3.31,75,,,percent of total billed charges,75% of total billed charges,3.75,85,,,percent of total billed charges,85% of total billed charges,1.68,4.1,
Gardasil quadrivalent intramuscular suspension,GAR17624,CDM,636,RC,90651,HCPCS,outpatient,,,385.7,289.28,,347.13,90,,,percent of total billed charges,90% of total billed charges,358.7,93,,,percent of total billed charges,93% of total billed charges,146.57,38,,,percent of total billed charges,38% of total billed charges,146.57,38,,,percent of total billed charges,38% of total billed charges,327.85,85,,,percent of total billed charges,85% of total billed charges,146.57,38,,,percent of total billed charges,38% of total billed charges,313.96,81.4,,,percent of total billed charges,81.4% of total billed charges,347.13,90,,,percent of total billed charges,90% of total billed charges,347.13,90,,,percent of total billed charges,90% of total billed charges,146.57,38,,,percent of total billed charges,38% of total billed charges,146.57,38,,,percent of total billed charges,38% of total billed charges,146.57,38,,,percent of total billed charges,38% of total billed charges,289.28,75,,,percent of total billed charges,75% of total billed charges,327.85,85,,,percent of total billed charges,85% of total billed charges,146.57,358.7,
gentamicin 40 mg/mL injectable solution,GEN1003000,CDM,636,RC,J1580,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
gentamicin 40 mg/mL injectable solution,GEN1003000,CDM,250,RC,J1580,HCPCS,outpatient,,,48.04,36.03,,43.24,90,,,percent of total billed charges,90% of total billed charges,44.68,93,,,percent of total billed charges,93% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,39.1,81.4,,,percent of total billed charges,81.4% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,43.24,90,,,percent of total billed charges,90% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,18.26,38,,,percent of total billed charges,38% of total billed charges,36.03,75,,,percent of total billed charges,75% of total billed charges,40.83,85,,,percent of total billed charges,85% of total billed charges,18.26,44.68,
Dantrolene 20 mg intravenous injection,GEN1003079,CDM,250,RC,,,outpatient,,,216.79,162.59,,195.11,90,,,percent of total billed charges,90% of total billed charges,201.61,93,,,percent of total billed charges,93% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,176.47,81.4,,,percent of total billed charges,81.4% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,195.11,90,,,percent of total billed charges,90% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,82.38,38,,,percent of total billed charges,38% of total billed charges,162.59,75,,,percent of total billed charges,75% of total billed charges,184.27,85,,,percent of total billed charges,85% of total billed charges,82.38,201.61,
gentamicin 0.3% ophthalmic solution,GEN1003358,CDM,637,RC,A9270,HCPCS,outpatient,,,76.17,57.13,,68.55,90,,,percent of total billed charges,90% of total billed charges,70.84,93,,,percent of total billed charges,93% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,62,81.4,,,percent of total billed charges,81.4% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,68.55,90,,,percent of total billed charges,90% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,28.94,38,,,percent of total billed charges,38% of total billed charges,57.13,75,,,percent of total billed charges,75% of total billed charges,64.74,85,,,percent of total billed charges,85% of total billed charges,28.94,70.84,
glipiZIDE 5 mg oral tablet,GLI1003130,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
GlucaGen 1 mg injection,GLU4276,CDM,636,RC,J1610,HCPCS,outpatient,,,348.01,261.01,,313.21,90,,,percent of total billed charges,90% of total billed charges,323.65,93,,,percent of total billed charges,93% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,295.81,85,,,percent of total billed charges,85% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,283.28,81.4,,,percent of total billed charges,81.4% of total billed charges,313.21,90,,,percent of total billed charges,90% of total billed charges,313.21,90,,,percent of total billed charges,90% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,132.24,38,,,percent of total billed charges,38% of total billed charges,261.01,75,,,percent of total billed charges,75% of total billed charges,295.81,85,,,percent of total billed charges,85% of total billed charges,132.24,323.65,
glucose 40% oral gel,GLU4279,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
"glucose 4 g oral tablet, chewable",GLU4286,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
glyBURIDE 5 mg oral tablet,GLY1003131,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
glycopyrrolate 0.2 mg/mL injectable solution,GLY1312012,CDM,250,RC,,,outpatient,,,23.65,17.74,,21.29,90,,,percent of total billed charges,90% of total billed charges,21.99,93,,,percent of total billed charges,93% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,19.25,81.4,,,percent of total billed charges,81.4% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,17.74,75,,,percent of total billed charges,75% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,21.99,
guaiFENesin 200 mg/10 mL oral liquid,GUA5049,CDM,637,RC,,,outpatient,,,0.58,0.44,,0.52,90,,,percent of total billed charges,90% of total billed charges,0.54,93,,,percent of total billed charges,93% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.49,85,,,percent of total billed charges,85% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.47,81.4,,,percent of total billed charges,81.4% of total billed charges,0.52,90,,,percent of total billed charges,90% of total billed charges,0.52,90,,,percent of total billed charges,90% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.44,75,,,percent of total billed charges,75% of total billed charges,0.49,85,,,percent of total billed charges,85% of total billed charges,0.22,0.54,
haloperidol 1 mg oral tablet,HAL1003013,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Haloperidol 5 mg/mL injectable solution,HAL1003015,CDM,636,RC,J1630,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Haloperidol 5 mg/mL injectable solution,HAL1003015,CDM,250,RC,J1630,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
heparin 5000 units/mL injectable solution,HEP1003132,CDM,636,RC,J1644,HCPCS,outpatient,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
heparin 5000 units/mL injectable solution,HEP1003132,CDM,250,RC,J1644,HCPCS,outpatient,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
Heparin Lock Flush 100 units/mL intravenous solution,HEP1003433,CDM,636,RC,J1642,HCPCS,outpatient,,,10.54,7.91,,9.49,90,,,percent of total billed charges,90% of total billed charges,9.8,93,,,percent of total billed charges,93% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.58,81.4,,,percent of total billed charges,81.4% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,7.91,75,,,percent of total billed charges,75% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,9.8,
Heparin Lock Flush 100 units/mL intravenous solution,HEP1003433,CDM,250,RC,J1642,HCPCS,outpatient,,,10.54,7.91,,9.49,90,,,percent of total billed charges,90% of total billed charges,9.8,93,,,percent of total billed charges,93% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.58,81.4,,,percent of total billed charges,81.4% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,7.91,75,,,percent of total billed charges,75% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,9.8,
hepatitis B pediatric vaccine 10 mcg/0.5 ml intramuscular suspension,HEP18491,CDM,250,RC,,,outpatient,,,32.47,24.35,,29.22,90,,,percent of total billed charges,90% of total billed charges,30.2,93,,,percent of total billed charges,93% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,27.6,85,,,percent of total billed charges,85% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,26.43,81.4,,,percent of total billed charges,81.4% of total billed charges,29.22,90,,,percent of total billed charges,90% of total billed charges,29.22,90,,,percent of total billed charges,90% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,24.35,75,,,percent of total billed charges,75% of total billed charges,27.6,85,,,percent of total billed charges,85% of total billed charges,12.34,30.2,
hepatitis B adult vaccine 20 mcg/mL intramuscular suspension,HEP18496,CDM,636,RC,,,outpatient,,,86.59,64.94,,77.93,90,,,percent of total billed charges,90% of total billed charges,80.53,93,,,percent of total billed charges,93% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,73.6,85,,,percent of total billed charges,85% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,70.48,81.4,,,percent of total billed charges,81.4% of total billed charges,77.93,90,,,percent of total billed charges,90% of total billed charges,77.93,90,,,percent of total billed charges,90% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,32.9,38,,,percent of total billed charges,38% of total billed charges,64.94,75,,,percent of total billed charges,75% of total billed charges,73.6,85,,,percent of total billed charges,85% of total billed charges,32.9,80.53,
Insulin Regular (HumuLIN R) 100 units/mL injectable solution,HUM1003397,CDM,636,RC,J1815,HCPCS,outpatient,,,0.9,0.68,,0.81,90,,,percent of total billed charges,90% of total billed charges,0.84,93,,,percent of total billed charges,93% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.77,85,,,percent of total billed charges,85% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.73,81.4,,,percent of total billed charges,81.4% of total billed charges,0.81,90,,,percent of total billed charges,90% of total billed charges,0.81,90,,,percent of total billed charges,90% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.68,75,,,percent of total billed charges,75% of total billed charges,0.77,85,,,percent of total billed charges,85% of total billed charges,0.34,0.84,
Insulin Regular (HumuLIN R) 100 units/mL injectable solution,HUM1003397,CDM,250,RC,J1815,HCPCS,outpatient,,,0.9,0.68,,0.81,90,,,percent of total billed charges,90% of total billed charges,0.84,93,,,percent of total billed charges,93% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.77,85,,,percent of total billed charges,85% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.73,81.4,,,percent of total billed charges,81.4% of total billed charges,0.81,90,,,percent of total billed charges,90% of total billed charges,0.81,90,,,percent of total billed charges,90% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.34,38,,,percent of total billed charges,38% of total billed charges,0.68,75,,,percent of total billed charges,75% of total billed charges,0.77,85,,,percent of total billed charges,85% of total billed charges,0.34,0.84,
Insulin NPH (HumuLIN N) 100 units/mL subcutaneous suspension,HUM1003398,CDM,636,RC,J1815,HCPCS,outpatient,,,0.69,0.52,,0.62,90,,,percent of total billed charges,90% of total billed charges,0.64,93,,,percent of total billed charges,93% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.59,85,,,percent of total billed charges,85% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.56,81.4,,,percent of total billed charges,81.4% of total billed charges,0.62,90,,,percent of total billed charges,90% of total billed charges,0.62,90,,,percent of total billed charges,90% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.52,75,,,percent of total billed charges,75% of total billed charges,0.59,85,,,percent of total billed charges,85% of total billed charges,0.26,0.64,
Insulin NPH (HumuLIN N) 100 units/mL subcutaneous suspension,HUM1003398,CDM,250,RC,J1815,HCPCS,outpatient,,,0.69,0.52,,0.62,90,,,percent of total billed charges,90% of total billed charges,0.64,93,,,percent of total billed charges,93% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.59,85,,,percent of total billed charges,85% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.56,81.4,,,percent of total billed charges,81.4% of total billed charges,0.62,90,,,percent of total billed charges,90% of total billed charges,0.62,90,,,percent of total billed charges,90% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.52,75,,,percent of total billed charges,75% of total billed charges,0.59,85,,,percent of total billed charges,85% of total billed charges,0.26,0.64,
Insulin lispro (HumaLOG) 100 units/mL subcutaneous,HUM1003399,CDM,636,RC,J1815,HCPCS,outpatient,,,0.59,0.44,,0.53,90,,,percent of total billed charges,90% of total billed charges,0.55,93,,,percent of total billed charges,93% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.5,85,,,percent of total billed charges,85% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.48,81.4,,,percent of total billed charges,81.4% of total billed charges,0.53,90,,,percent of total billed charges,90% of total billed charges,0.53,90,,,percent of total billed charges,90% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.44,75,,,percent of total billed charges,75% of total billed charges,0.5,85,,,percent of total billed charges,85% of total billed charges,0.22,0.55,
Insulin lispro (HumaLOG) 100 units/mL subcutaneous,HUM1003399,CDM,250,RC,J1815,HCPCS,outpatient,,,0.59,0.44,,0.53,90,,,percent of total billed charges,90% of total billed charges,0.55,93,,,percent of total billed charges,93% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.5,85,,,percent of total billed charges,85% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.48,81.4,,,percent of total billed charges,81.4% of total billed charges,0.53,90,,,percent of total billed charges,90% of total billed charges,0.53,90,,,percent of total billed charges,90% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.22,38,,,percent of total billed charges,38% of total billed charges,0.44,75,,,percent of total billed charges,75% of total billed charges,0.5,85,,,percent of total billed charges,85% of total billed charges,0.22,0.55,
HumuLIN 70/30 subcutaneous suspension,HUM15195,CDM,636,RC,J1815,HCPCS,outpatient,,,0.65,0.49,,0.59,90,,,percent of total billed charges,90% of total billed charges,0.6,93,,,percent of total billed charges,93% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.55,85,,,percent of total billed charges,85% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.53,81.4,,,percent of total billed charges,81.4% of total billed charges,0.59,90,,,percent of total billed charges,90% of total billed charges,0.59,90,,,percent of total billed charges,90% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.49,75,,,percent of total billed charges,75% of total billed charges,0.55,85,,,percent of total billed charges,85% of total billed charges,0.25,0.6,
HumuLIN 70/30 subcutaneous suspension,HUM15195,CDM,250,RC,J1815,HCPCS,outpatient,,,0.65,0.49,,0.59,90,,,percent of total billed charges,90% of total billed charges,0.6,93,,,percent of total billed charges,93% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.55,85,,,percent of total billed charges,85% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.53,81.4,,,percent of total billed charges,81.4% of total billed charges,0.59,90,,,percent of total billed charges,90% of total billed charges,0.59,90,,,percent of total billed charges,90% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.25,38,,,percent of total billed charges,38% of total billed charges,0.49,75,,,percent of total billed charges,75% of total billed charges,0.55,85,,,percent of total billed charges,85% of total billed charges,0.25,0.6,
Hyalgan 10 mg/mL intra-articular solution,HYA1003394,CDM,636,RC,J7321,HCPCS,outpatient,,,372.63,279.47,,335.37,90,,,percent of total billed charges,90% of total billed charges,346.55,93,,,percent of total billed charges,93% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,303.32,81.4,,,percent of total billed charges,81.4% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,279.47,75,,,percent of total billed charges,75% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,346.55,
Hyalgan 10 mg/mL intra-articular solution,HYA1003394,CDM,250,RC,J7321,HCPCS,outpatient,,,372.63,279.47,,335.37,90,,,percent of total billed charges,90% of total billed charges,346.55,93,,,percent of total billed charges,93% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,303.32,81.4,,,percent of total billed charges,81.4% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,335.37,90,,,percent of total billed charges,90% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,141.6,38,,,percent of total billed charges,38% of total billed charges,279.47,75,,,percent of total billed charges,75% of total billed charges,316.74,85,,,percent of total billed charges,85% of total billed charges,141.6,346.55,
hydrALAZINE 10 mg oral tablet,HYD1003081,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
hydrALAZINE 25 mg oral tablet,HYD1003082,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
hydrALAZINE 20 mg/mL injectable solution,HYD1003083,CDM,636,RC,J0360,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
hydrALAZINE 20 mg/mL injectable solution,HYD1003083,CDM,250,RC,J0360,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
hydroCHLOROthiazide 25 mg oral tablet,HYD1003134,CDM,637,RC,A9270,HCPCS,outpatient,,,1.15,0.86,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.07,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.98,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.86,75,,,percent of total billed charges,75% of total billed charges,0.98,85,,,percent of total billed charges,85% of total billed charges,0.44,1.07,
hydrocortisone 25 mg rectal suppository,HYD1003308,CDM,637,RC,A9270,HCPCS,outpatient,,,29.9,22.43,,26.91,90,,,percent of total billed charges,90% of total billed charges,27.81,93,,,percent of total billed charges,93% of total billed charges,11.36,38,,,percent of total billed charges,38% of total billed charges,11.36,38,,,percent of total billed charges,38% of total billed charges,25.42,85,,,percent of total billed charges,85% of total billed charges,11.36,38,,,percent of total billed charges,38% of total billed charges,24.34,81.4,,,percent of total billed charges,81.4% of total billed charges,26.91,90,,,percent of total billed charges,90% of total billed charges,26.91,90,,,percent of total billed charges,90% of total billed charges,11.36,38,,,percent of total billed charges,38% of total billed charges,11.36,38,,,percent of total billed charges,38% of total billed charges,11.36,38,,,percent of total billed charges,38% of total billed charges,22.43,75,,,percent of total billed charges,75% of total billed charges,25.42,85,,,percent of total billed charges,85% of total billed charges,11.36,27.81,
Hydrocortisone 1% ointment,HYD1003309,CDM,637,RC,A9270,HCPCS,outpatient,,,5.41,4.06,,4.87,90,,,percent of total billed charges,90% of total billed charges,5.03,93,,,percent of total billed charges,93% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,4.6,85,,,percent of total billed charges,85% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,4.4,81.4,,,percent of total billed charges,81.4% of total billed charges,4.87,90,,,percent of total billed charges,90% of total billed charges,4.87,90,,,percent of total billed charges,90% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,4.06,75,,,percent of total billed charges,75% of total billed charges,4.6,85,,,percent of total billed charges,85% of total billed charges,2.06,5.03,
hydrocortisone 100 mg injection,HYD2438,CDM,636,RC,J1720,HCPCS,outpatient,,,19.66,14.75,,17.69,90,,,percent of total billed charges,90% of total billed charges,18.28,93,,,percent of total billed charges,93% of total billed charges,7.47,38,,,percent of total billed charges,38% of total billed charges,7.47,38,,,percent of total billed charges,38% of total billed charges,16.71,85,,,percent of total billed charges,85% of total billed charges,7.47,38,,,percent of total billed charges,38% of total billed charges,16,81.4,,,percent of total billed charges,81.4% of total billed charges,17.69,90,,,percent of total billed charges,90% of total billed charges,17.69,90,,,percent of total billed charges,90% of total billed charges,7.47,38,,,percent of total billed charges,38% of total billed charges,7.47,38,,,percent of total billed charges,38% of total billed charges,7.47,38,,,percent of total billed charges,38% of total billed charges,14.75,75,,,percent of total billed charges,75% of total billed charges,16.71,85,,,percent of total billed charges,85% of total billed charges,7.47,18.28,
hydrocortisone 2.5% rectal cream with applicator,HYD9220,CDM,637,RC,,,outpatient,,,19.48,14.61,,17.53,90,,,percent of total billed charges,90% of total billed charges,18.12,93,,,percent of total billed charges,93% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,16.56,85,,,percent of total billed charges,85% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,15.86,81.4,,,percent of total billed charges,81.4% of total billed charges,17.53,90,,,percent of total billed charges,90% of total billed charges,17.53,90,,,percent of total billed charges,90% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,7.4,38,,,percent of total billed charges,38% of total billed charges,14.61,75,,,percent of total billed charges,75% of total billed charges,16.56,85,,,percent of total billed charges,85% of total billed charges,7.4,18.12,
Hymovis 24mg/3mL syringe,hymovis,CDM,636,RC,J7322,HCPCS,outpatient,,,677.59,508.19,,609.83,90,,,percent of total billed charges,90% of total billed charges,630.16,93,,,percent of total billed charges,93% of total billed charges,257.48,38,,,percent of total billed charges,38% of total billed charges,257.48,38,,,percent of total billed charges,38% of total billed charges,575.95,85,,,percent of total billed charges,85% of total billed charges,257.48,38,,,percent of total billed charges,38% of total billed charges,551.56,81.4,,,percent of total billed charges,81.4% of total billed charges,609.83,90,,,percent of total billed charges,90% of total billed charges,609.83,90,,,percent of total billed charges,90% of total billed charges,257.48,38,,,percent of total billed charges,38% of total billed charges,257.48,38,,,percent of total billed charges,38% of total billed charges,257.48,38,,,percent of total billed charges,38% of total billed charges,508.19,75,,,percent of total billed charges,75% of total billed charges,575.95,85,,,percent of total billed charges,85% of total billed charges,257.48,630.16,
ibuprofen 400 mg oral tablet,IBU1003001,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
ibuprofen 100 mg/5 mL oral suspension,IBU1003002,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
ibuprofen 600 mg oral tablet,IBU255,CDM,250,RC,,,outpatient,,,2.28,1.71,,2.05,90,,,percent of total billed charges,90% of total billed charges,2.12,93,,,percent of total billed charges,93% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.86,81.4,,,percent of total billed charges,81.4% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.71,75,,,percent of total billed charges,75% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,2.12,
ibuprofen 600 mg oral tablet,IBU255,CDM,637,RC,,,outpatient,,,2.28,1.71,,2.05,90,,,percent of total billed charges,90% of total billed charges,2.12,93,,,percent of total billed charges,93% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.86,81.4,,,percent of total billed charges,81.4% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.71,75,,,percent of total billed charges,75% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,2.12,
SUMAtriptan 6 mg/0.5 mL subcutaneous solution,IMI1003301,CDM,636,RC,J3030,HCPCS,outpatient,,,90.22,67.67,,81.2,90,,,percent of total billed charges,90% of total billed charges,83.9,93,,,percent of total billed charges,93% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,73.44,81.4,,,percent of total billed charges,81.4% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,67.67,75,,,percent of total billed charges,75% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,83.9,
SUMAtriptan 6 mg/0.5 mL subcutaneous solution,IMI1003301,CDM,250,RC,J3030,HCPCS,outpatient,,,90.22,67.67,,81.2,90,,,percent of total billed charges,90% of total billed charges,83.9,93,,,percent of total billed charges,93% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,73.44,81.4,,,percent of total billed charges,81.4% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,81.2,90,,,percent of total billed charges,90% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,34.28,38,,,percent of total billed charges,38% of total billed charges,67.67,75,,,percent of total billed charges,75% of total billed charges,76.69,85,,,percent of total billed charges,85% of total billed charges,34.28,83.9,
z* Imitrex Statdose 6 mg/0.5 mL subcutaneous kit,IMI8836,CDM,637,RC,J3030,HCPCS,outpatient,,,579.01,434.26,,521.11,90,,,percent of total billed charges,90% of total billed charges,538.48,93,,,percent of total billed charges,93% of total billed charges,220.02,38,,,percent of total billed charges,38% of total billed charges,220.02,38,,,percent of total billed charges,38% of total billed charges,492.16,85,,,percent of total billed charges,85% of total billed charges,220.02,38,,,percent of total billed charges,38% of total billed charges,471.31,81.4,,,percent of total billed charges,81.4% of total billed charges,521.11,90,,,percent of total billed charges,90% of total billed charges,521.11,90,,,percent of total billed charges,90% of total billed charges,220.02,38,,,percent of total billed charges,38% of total billed charges,220.02,38,,,percent of total billed charges,38% of total billed charges,220.02,38,,,percent of total billed charges,38% of total billed charges,434.26,75,,,percent of total billed charges,75% of total billed charges,492.16,85,,,percent of total billed charges,85% of total billed charges,220.02,538.48,
Loperamide 2 mg oral tablet,IMO1003260,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
indomethacin 25 mg oral capsule,IND1003018,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Fluzone Quadrivalent,INF21119,CDM,636,RC,90686,HCPCS,outpatient,,,32.47,24.35,,29.22,90,,,percent of total billed charges,90% of total billed charges,30.2,93,,,percent of total billed charges,93% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,27.6,85,,,percent of total billed charges,85% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,26.43,81.4,,,percent of total billed charges,81.4% of total billed charges,29.22,90,,,percent of total billed charges,90% of total billed charges,29.22,90,,,percent of total billed charges,90% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,24.35,75,,,percent of total billed charges,75% of total billed charges,27.6,85,,,percent of total billed charges,85% of total billed charges,12.34,30.2,
Fluzone Quadrivalent,INF21119,CDM,250,RC,90686,HCPCS,outpatient,,,32.47,24.35,,29.22,90,,,percent of total billed charges,90% of total billed charges,30.2,93,,,percent of total billed charges,93% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,27.6,85,,,percent of total billed charges,85% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,26.43,81.4,,,percent of total billed charges,81.4% of total billed charges,29.22,90,,,percent of total billed charges,90% of total billed charges,29.22,90,,,percent of total billed charges,90% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,12.34,38,,,percent of total billed charges,38% of total billed charges,24.35,75,,,percent of total billed charges,75% of total billed charges,27.6,85,,,percent of total billed charges,85% of total billed charges,12.34,30.2,
Fluzone High Dose,INF6252,CDM,636,RC,90662,HCPCS,outpatient,,,75.78,56.84,,68.2,90,,,percent of total billed charges,90% of total billed charges,70.48,93,,,percent of total billed charges,93% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,61.68,81.4,,,percent of total billed charges,81.4% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,56.84,75,,,percent of total billed charges,75% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,70.48,
Eptifibatide 2 mg/mL IV solution,INT1003393,CDM,636,RC,J1327,HCPCS,outpatient,,,240.3,180.23,,216.27,90,,,percent of total billed charges,90% of total billed charges,223.48,93,,,percent of total billed charges,93% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,204.26,85,,,percent of total billed charges,85% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,195.6,81.4,,,percent of total billed charges,81.4% of total billed charges,216.27,90,,,percent of total billed charges,90% of total billed charges,216.27,90,,,percent of total billed charges,90% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,180.23,75,,,percent of total billed charges,75% of total billed charges,204.26,85,,,percent of total billed charges,85% of total billed charges,91.31,223.48,
Eptifibatide 2 mg/mL IV solution,INT1003393,CDM,250,RC,J1327,HCPCS,outpatient,,,240.3,180.23,,216.27,90,,,percent of total billed charges,90% of total billed charges,223.48,93,,,percent of total billed charges,93% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,204.26,85,,,percent of total billed charges,85% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,195.6,81.4,,,percent of total billed charges,81.4% of total billed charges,216.27,90,,,percent of total billed charges,90% of total billed charges,216.27,90,,,percent of total billed charges,90% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,91.31,38,,,percent of total billed charges,38% of total billed charges,180.23,75,,,percent of total billed charges,75% of total billed charges,204.26,85,,,percent of total billed charges,85% of total billed charges,91.31,223.48,
Ertapenem 1 g injection,INV1003416,CDM,636,RC,J1335,HCPCS,outpatient,,,140.62,105.47,,126.56,90,,,percent of total billed charges,90% of total billed charges,130.78,93,,,percent of total billed charges,93% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,114.46,81.4,,,percent of total billed charges,81.4% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,105.47,75,,,percent of total billed charges,75% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,130.78,
Ertapenem 1 g injection,INV1003416,CDM,250,RC,J1335,HCPCS,outpatient,,,140.62,105.47,,126.56,90,,,percent of total billed charges,90% of total billed charges,130.78,93,,,percent of total billed charges,93% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,114.46,81.4,,,percent of total billed charges,81.4% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,126.56,90,,,percent of total billed charges,90% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,53.44,38,,,percent of total billed charges,38% of total billed charges,105.47,75,,,percent of total billed charges,75% of total billed charges,119.53,85,,,percent of total billed charges,85% of total billed charges,53.44,130.78,
ipratropium 500 mcg/2.5 mL inhalation solution,IPR1003137,CDM,250,RC,,,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
z* Raltegravir (Isentress) 400 mg oral tablet,ISE17971,CDM,250,RC,,,outpatient,,,22.97,17.23,,20.67,90,,,percent of total billed charges,90% of total billed charges,21.36,93,,,percent of total billed charges,93% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,19.52,85,,,percent of total billed charges,85% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,18.7,81.4,,,percent of total billed charges,81.4% of total billed charges,20.67,90,,,percent of total billed charges,90% of total billed charges,20.67,90,,,percent of total billed charges,90% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,17.23,75,,,percent of total billed charges,75% of total billed charges,19.52,85,,,percent of total billed charges,85% of total billed charges,8.73,21.36,
"isosorbide mononitrate 60 mg oral tablet, extended release",ISO2544,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
"Potassium Chloride 10 mEq oral tablet, extended release",K D3176,CDM,250,RC,,,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
"Potassium chloride  20 mEq oral tablet, extended release",K D3177,CDM,250,RC,,,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Kcentra 1000 units intravenous injection,KCE18870,CDM,636,RC,J7168,HCPCS,outpatient,,,4.2,3.15,,3.78,90,,,percent of total billed charges,90% of total billed charges,3.91,93,,,percent of total billed charges,93% of total billed charges,1.6,38,,,percent of total billed charges,38% of total billed charges,1.6,38,,,percent of total billed charges,38% of total billed charges,3.57,85,,,percent of total billed charges,85% of total billed charges,1.6,38,,,percent of total billed charges,38% of total billed charges,3.42,81.4,,,percent of total billed charges,81.4% of total billed charges,3.78,90,,,percent of total billed charges,90% of total billed charges,3.78,90,,,percent of total billed charges,90% of total billed charges,1.6,38,,,percent of total billed charges,38% of total billed charges,1.6,38,,,percent of total billed charges,38% of total billed charges,1.6,38,,,percent of total billed charges,38% of total billed charges,3.15,75,,,percent of total billed charges,75% of total billed charges,3.57,85,,,percent of total billed charges,85% of total billed charges,1.6,3.91,
Potassium Chloride 20 mEq/15mL,kcl20meqpo,CDM,250,RC,,,outpatient,,,17.23,12.92,,15.51,90,,,percent of total billed charges,90% of total billed charges,16.02,93,,,percent of total billed charges,93% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,14.65,85,,,percent of total billed charges,85% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,14.03,81.4,,,percent of total billed charges,81.4% of total billed charges,15.51,90,,,percent of total billed charges,90% of total billed charges,15.51,90,,,percent of total billed charges,90% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,12.92,75,,,percent of total billed charges,75% of total billed charges,14.65,85,,,percent of total billed charges,85% of total billed charges,6.55,16.02,
Potassium Chloride 20 mEq/15mL,kcl20meqpo,CDM,637,RC,,,outpatient,,,17.23,12.92,,15.51,90,,,percent of total billed charges,90% of total billed charges,16.02,93,,,percent of total billed charges,93% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,14.65,85,,,percent of total billed charges,85% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,14.03,81.4,,,percent of total billed charges,81.4% of total billed charges,15.51,90,,,percent of total billed charges,90% of total billed charges,15.51,90,,,percent of total billed charges,90% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,6.55,38,,,percent of total billed charges,38% of total billed charges,12.92,75,,,percent of total billed charges,75% of total billed charges,14.65,85,,,percent of total billed charges,85% of total billed charges,6.55,16.02,
Cephalexin 500 mg oral capsule,KEF1003069,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Triamcinolone acetonide 40mg/mL  injectable suspension,KEN1003213,CDM,636,RC,J3301,HCPCS,outpatient,,,21.65,16.24,,19.49,90,,,percent of total billed charges,90% of total billed charges,20.13,93,,,percent of total billed charges,93% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,18.4,85,,,percent of total billed charges,85% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,17.62,81.4,,,percent of total billed charges,81.4% of total billed charges,19.49,90,,,percent of total billed charges,90% of total billed charges,19.49,90,,,percent of total billed charges,90% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,16.24,75,,,percent of total billed charges,75% of total billed charges,18.4,85,,,percent of total billed charges,85% of total billed charges,8.23,20.13,
Triamcinolone acetonide 40mg/mL  injectable suspension,KEN1003213,CDM,250,RC,J3301,HCPCS,outpatient,,,21.65,16.24,,19.49,90,,,percent of total billed charges,90% of total billed charges,20.13,93,,,percent of total billed charges,93% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,18.4,85,,,percent of total billed charges,85% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,17.62,81.4,,,percent of total billed charges,81.4% of total billed charges,19.49,90,,,percent of total billed charges,90% of total billed charges,19.49,90,,,percent of total billed charges,90% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,8.23,38,,,percent of total billed charges,38% of total billed charges,16.24,75,,,percent of total billed charges,75% of total billed charges,18.4,85,,,percent of total billed charges,85% of total billed charges,8.23,20.13,
LevETIRAcetam (Keppra) 100 mg/mL oral solution,KEP15598,CDM,250,RC,,,outpatient,,,2.28,1.71,,2.05,90,,,percent of total billed charges,90% of total billed charges,2.12,93,,,percent of total billed charges,93% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.86,81.4,,,percent of total billed charges,81.4% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.71,75,,,percent of total billed charges,75% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,2.12,
levETIRAcetam (Keppra) 100 mg/mL intravenous solution,KEP15603,CDM,636,RC,J1953,HCPCS,outpatient,,,0.11,0.08,,0.1,90,,,percent of total billed charges,90% of total billed charges,0.1,93,,,percent of total billed charges,93% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.09,85,,,percent of total billed charges,85% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.09,81.4,,,percent of total billed charges,81.4% of total billed charges,0.1,90,,,percent of total billed charges,90% of total billed charges,0.1,90,,,percent of total billed charges,90% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.04,38,,,percent of total billed charges,38% of total billed charges,0.08,75,,,percent of total billed charges,75% of total billed charges,0.09,85,,,percent of total billed charges,85% of total billed charges,0.04,0.1,
ketamine 100 mg/mL injectable solution,KET1003139,CDM,636,RC,J3490,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
ketamine 100 mg/mL injectable solution,KET1003139,CDM,250,RC,J3490,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
ketorolac (toradol) 30 mg  injectable solution,KET1003140,CDM,636,RC,J1885,HCPCS,outpatient,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
ketorolac (toradol) 30 mg  injectable solution,KET1003140,CDM,250,RC,J1885,HCPCS,outpatient,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
ketorolac (toradol) 60 mg  injectable solution,KET1003141,CDM,636,RC,J1885,HCPCS,outpatient,,,29.28,21.96,,26.35,90,,,percent of total billed charges,90% of total billed charges,27.23,93,,,percent of total billed charges,93% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,23.83,81.4,,,percent of total billed charges,81.4% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,21.96,75,,,percent of total billed charges,75% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,27.23,
ketorolac (toradol) 60 mg  injectable solution,KET1003141,CDM,250,RC,J1885,HCPCS,outpatient,,,29.28,21.96,,26.35,90,,,percent of total billed charges,90% of total billed charges,27.23,93,,,percent of total billed charges,93% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,23.83,81.4,,,percent of total billed charges,81.4% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,21.96,75,,,percent of total billed charges,75% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,27.23,
ketamine 50 mg/mL injectable solution,KET2558,CDM,636,RC,J3490,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
labetalol 100 mg oral tablet,LAB1003003,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
labetalol 5 mg/mL intravenous solution,LAB1003004,CDM,636,RC,J3490,HCPCS,outpatient,,,13.5,10.13,,12.15,90,,,percent of total billed charges,90% of total billed charges,12.56,93,,,percent of total billed charges,93% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,11.48,85,,,percent of total billed charges,85% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,10.99,81.4,,,percent of total billed charges,81.4% of total billed charges,12.15,90,,,percent of total billed charges,90% of total billed charges,12.15,90,,,percent of total billed charges,90% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,10.13,75,,,percent of total billed charges,75% of total billed charges,11.48,85,,,percent of total billed charges,85% of total billed charges,5.13,12.56,
labetalol 5 mg/mL intravenous solution,LAB1003004,CDM,250,RC,J3490,HCPCS,outpatient,,,13.5,10.13,,12.15,90,,,percent of total billed charges,90% of total billed charges,12.56,93,,,percent of total billed charges,93% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,11.48,85,,,percent of total billed charges,85% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,10.99,81.4,,,percent of total billed charges,81.4% of total billed charges,12.15,90,,,percent of total billed charges,90% of total billed charges,12.15,90,,,percent of total billed charges,90% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,5.13,38,,,percent of total billed charges,38% of total billed charges,10.13,75,,,percent of total billed charges,75% of total billed charges,11.48,85,,,percent of total billed charges,85% of total billed charges,5.13,12.56,
lactulose 20 g/30 mL oral syrup,LAC1003259,CDM,637,RC,A9270,HCPCS,outpatient,,,15.24,11.43,,13.72,90,,,percent of total billed charges,90% of total billed charges,14.17,93,,,percent of total billed charges,93% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,12.95,85,,,percent of total billed charges,85% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,12.41,81.4,,,percent of total billed charges,81.4% of total billed charges,13.72,90,,,percent of total billed charges,90% of total billed charges,13.72,90,,,percent of total billed charges,90% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,11.43,75,,,percent of total billed charges,75% of total billed charges,12.95,85,,,percent of total billed charges,85% of total billed charges,5.79,14.17,
Insulin Glargine (Lantus) 100 units/mL subcutaneous solution,LAN1003408,CDM,636,RC,J1815,HCPCS,outpatient,,,0.69,0.52,,0.62,90,,,percent of total billed charges,90% of total billed charges,0.64,93,,,percent of total billed charges,93% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.59,85,,,percent of total billed charges,85% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.56,81.4,,,percent of total billed charges,81.4% of total billed charges,0.62,90,,,percent of total billed charges,90% of total billed charges,0.62,90,,,percent of total billed charges,90% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.52,75,,,percent of total billed charges,75% of total billed charges,0.59,85,,,percent of total billed charges,85% of total billed charges,0.26,0.64,
Insulin Glargine (Lantus) 100 units/mL subcutaneous solution,LAN1003408,CDM,250,RC,J1815,HCPCS,outpatient,,,0.69,0.52,,0.62,90,,,percent of total billed charges,90% of total billed charges,0.64,93,,,percent of total billed charges,93% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.59,85,,,percent of total billed charges,85% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.56,81.4,,,percent of total billed charges,81.4% of total billed charges,0.62,90,,,percent of total billed charges,90% of total billed charges,0.62,90,,,percent of total billed charges,90% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.26,38,,,percent of total billed charges,38% of total billed charges,0.52,75,,,percent of total billed charges,75% of total billed charges,0.59,85,,,percent of total billed charges,85% of total billed charges,0.26,0.64,
latanoprost 0.005% ophthalmic solution,LAT13634,CDM,637,RC,,,outpatient,,,111.44,83.58,,100.3,90,,,percent of total billed charges,90% of total billed charges,103.64,93,,,percent of total billed charges,93% of total billed charges,42.35,38,,,percent of total billed charges,38% of total billed charges,42.35,38,,,percent of total billed charges,38% of total billed charges,94.72,85,,,percent of total billed charges,85% of total billed charges,42.35,38,,,percent of total billed charges,38% of total billed charges,90.71,81.4,,,percent of total billed charges,81.4% of total billed charges,100.3,90,,,percent of total billed charges,90% of total billed charges,100.3,90,,,percent of total billed charges,90% of total billed charges,42.35,38,,,percent of total billed charges,38% of total billed charges,42.35,38,,,percent of total billed charges,38% of total billed charges,42.35,38,,,percent of total billed charges,38% of total billed charges,83.58,75,,,percent of total billed charges,75% of total billed charges,94.72,85,,,percent of total billed charges,85% of total billed charges,42.35,103.64,
Levofloxacin 500 mg oral tablet,LEV1003373,CDM,637,RC,A9270,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
levoFLOXacin 500 mg/100 mL intravenous solution,LEV14087,CDM,636,RC,J1956,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
levoFLOXacin 750 mg/150 mL intravenous solution,LEV14088,CDM,636,RC,J1956,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
levoFLOXacin 750 mg oral tablet,LEV14089,CDM,250,RC,,,outpatient,,,4.59,3.44,,4.13,90,,,percent of total billed charges,90% of total billed charges,4.27,93,,,percent of total billed charges,93% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,3.9,85,,,percent of total billed charges,85% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,3.74,81.4,,,percent of total billed charges,81.4% of total billed charges,4.13,90,,,percent of total billed charges,90% of total billed charges,4.13,90,,,percent of total billed charges,90% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,1.74,38,,,percent of total billed charges,38% of total billed charges,3.44,75,,,percent of total billed charges,75% of total billed charges,3.9,85,,,percent of total billed charges,85% of total billed charges,1.74,4.27,
levETIRAcetam (Keppra) 500 mg oral tablet,LEV15593,CDM,637,RC,,,outpatient,,,4.27,3.2,,3.84,90,,,percent of total billed charges,90% of total billed charges,3.97,93,,,percent of total billed charges,93% of total billed charges,1.62,38,,,percent of total billed charges,38% of total billed charges,1.62,38,,,percent of total billed charges,38% of total billed charges,3.63,85,,,percent of total billed charges,85% of total billed charges,1.62,38,,,percent of total billed charges,38% of total billed charges,3.48,81.4,,,percent of total billed charges,81.4% of total billed charges,3.84,90,,,percent of total billed charges,90% of total billed charges,3.84,90,,,percent of total billed charges,90% of total billed charges,1.62,38,,,percent of total billed charges,38% of total billed charges,1.62,38,,,percent of total billed charges,38% of total billed charges,1.62,38,,,percent of total billed charges,38% of total billed charges,3.2,75,,,percent of total billed charges,75% of total billed charges,3.63,85,,,percent of total billed charges,85% of total billed charges,1.62,3.97,
levothyroxine 100 mcg (0.1 mg) intravenous injection,LEV19830,CDM,250,RC,,,outpatient,,,151.59,113.69,,136.43,90,,,percent of total billed charges,90% of total billed charges,140.98,93,,,percent of total billed charges,93% of total billed charges,57.6,38,,,percent of total billed charges,38% of total billed charges,57.6,38,,,percent of total billed charges,38% of total billed charges,128.85,85,,,percent of total billed charges,85% of total billed charges,57.6,38,,,percent of total billed charges,38% of total billed charges,123.39,81.4,,,percent of total billed charges,81.4% of total billed charges,136.43,90,,,percent of total billed charges,90% of total billed charges,136.43,90,,,percent of total billed charges,90% of total billed charges,57.6,38,,,percent of total billed charges,38% of total billed charges,57.6,38,,,percent of total billed charges,38% of total billed charges,57.6,38,,,percent of total billed charges,38% of total billed charges,113.69,75,,,percent of total billed charges,75% of total billed charges,128.85,85,,,percent of total billed charges,85% of total billed charges,57.6,140.98,
levothyroxine 200 mcg (0.2 mg) intravenous injection,LEV19832,CDM,250,RC,A9270,HCPCS,outpatient,,,291.4,218.55,,262.26,90,,,percent of total billed charges,90% of total billed charges,271,93,,,percent of total billed charges,93% of total billed charges,110.73,38,,,percent of total billed charges,38% of total billed charges,110.73,38,,,percent of total billed charges,38% of total billed charges,247.69,85,,,percent of total billed charges,85% of total billed charges,110.73,38,,,percent of total billed charges,38% of total billed charges,237.2,81.4,,,percent of total billed charges,81.4% of total billed charges,262.26,90,,,percent of total billed charges,90% of total billed charges,262.26,90,,,percent of total billed charges,90% of total billed charges,110.73,38,,,percent of total billed charges,38% of total billed charges,110.73,38,,,percent of total billed charges,38% of total billed charges,110.73,38,,,percent of total billed charges,38% of total billed charges,218.55,75,,,percent of total billed charges,75% of total billed charges,247.69,85,,,percent of total billed charges,85% of total billed charges,110.73,271,
Escitalopram (Lexapro) 10 mg oral tablet,LEX1003419,CDM,637,RC,A9270,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
lidocaine 1% injectable solution,LID1003042,CDM,250,RC,,,outpatient,,,5.74,4.31,,5.17,90,,,percent of total billed charges,90% of total billed charges,5.34,93,,,percent of total billed charges,93% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,4.88,85,,,percent of total billed charges,85% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,4.67,81.4,,,percent of total billed charges,81.4% of total billed charges,5.17,90,,,percent of total billed charges,90% of total billed charges,5.17,90,,,percent of total billed charges,90% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,4.31,75,,,percent of total billed charges,75% of total billed charges,4.88,85,,,percent of total billed charges,85% of total billed charges,2.18,5.34,
lidocaine IV only (2%),LID1003043,CDM,250,RC,,,outpatient,,,23.65,17.74,,21.29,90,,,percent of total billed charges,90% of total billed charges,21.99,93,,,percent of total billed charges,93% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,19.25,81.4,,,percent of total billed charges,81.4% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,17.74,75,,,percent of total billed charges,75% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,21.99,
lidocaine 5%-D7.5% injectable solution,LID1003044,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
lidocaine 1% preservative-free injectable solution,LID1003045,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
lidocaine 2% preservative-free injectable solution,LID1003047,CDM,636,RC,J2001,HCPCS,outpatient,,,5.74,4.31,,5.17,90,,,percent of total billed charges,90% of total billed charges,5.34,93,,,percent of total billed charges,93% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,4.88,85,,,percent of total billed charges,85% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,4.67,81.4,,,percent of total billed charges,81.4% of total billed charges,5.17,90,,,percent of total billed charges,90% of total billed charges,5.17,90,,,percent of total billed charges,90% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,4.31,75,,,percent of total billed charges,75% of total billed charges,4.88,85,,,percent of total billed charges,85% of total billed charges,2.18,5.34,
lidocaine 2% preservative-free injectable solution,LID1003047,CDM,250,RC,J2001,HCPCS,outpatient,,,5.74,4.31,,5.17,90,,,percent of total billed charges,90% of total billed charges,5.34,93,,,percent of total billed charges,93% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,4.88,85,,,percent of total billed charges,85% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,4.67,81.4,,,percent of total billed charges,81.4% of total billed charges,5.17,90,,,percent of total billed charges,90% of total billed charges,5.17,90,,,percent of total billed charges,90% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,2.18,38,,,percent of total billed charges,38% of total billed charges,4.31,75,,,percent of total billed charges,75% of total billed charges,4.88,85,,,percent of total billed charges,85% of total billed charges,2.18,5.34,
lidocaine 1%-NaCl 0.9% injectable solution,LID1003048,CDM,636,RC,J2001,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
lidocaine 1%-NaCl 0.9% injectable solution,LID1003048,CDM,250,RC,J2001,HCPCS,outpatient,,,118.35,88.76,,106.52,90,,,percent of total billed charges,90% of total billed charges,110.07,93,,,percent of total billed charges,93% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,96.34,81.4,,,percent of total billed charges,81.4% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,106.52,90,,,percent of total billed charges,90% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,44.97,38,,,percent of total billed charges,38% of total billed charges,88.76,75,,,percent of total billed charges,75% of total billed charges,100.6,85,,,percent of total billed charges,85% of total billed charges,44.97,110.07,
Lidocaine 5% Patch,LID1003214,CDM,637,RC,A9270,HCPCS,outpatient,,,26.96,20.22,,24.26,90,,,percent of total billed charges,90% of total billed charges,25.07,93,,,percent of total billed charges,93% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,21.95,81.4,,,percent of total billed charges,81.4% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,24.26,90,,,percent of total billed charges,90% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,10.24,38,,,percent of total billed charges,38% of total billed charges,20.22,75,,,percent of total billed charges,75% of total billed charges,22.92,85,,,percent of total billed charges,85% of total billed charges,10.24,25.07,
lidocaine 2% topical gel Uro-jet,LID1003215,CDM,250,RC,,,outpatient,,,9.31,6.98,,8.38,90,,,percent of total billed charges,90% of total billed charges,8.66,93,,,percent of total billed charges,93% of total billed charges,3.54,38,,,percent of total billed charges,38% of total billed charges,3.54,38,,,percent of total billed charges,38% of total billed charges,7.91,85,,,percent of total billed charges,85% of total billed charges,3.54,38,,,percent of total billed charges,38% of total billed charges,7.58,81.4,,,percent of total billed charges,81.4% of total billed charges,8.38,90,,,percent of total billed charges,90% of total billed charges,8.38,90,,,percent of total billed charges,90% of total billed charges,3.54,38,,,percent of total billed charges,38% of total billed charges,3.54,38,,,percent of total billed charges,38% of total billed charges,3.54,38,,,percent of total billed charges,38% of total billed charges,6.98,75,,,percent of total billed charges,75% of total billed charges,7.91,85,,,percent of total billed charges,85% of total billed charges,3.54,8.66,
Lidocaine Viscous 2% mucous membrane solution 100mL,LID1003216,CDM,637,RC,A9270,HCPCS,outpatient,,,15.24,11.43,,13.72,90,,,percent of total billed charges,90% of total billed charges,14.17,93,,,percent of total billed charges,93% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,12.95,85,,,percent of total billed charges,85% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,12.41,81.4,,,percent of total billed charges,81.4% of total billed charges,13.72,90,,,percent of total billed charges,90% of total billed charges,13.72,90,,,percent of total billed charges,90% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,5.79,38,,,percent of total billed charges,38% of total billed charges,11.43,75,,,percent of total billed charges,75% of total billed charges,12.95,85,,,percent of total billed charges,85% of total billed charges,5.79,14.17,
lidocaine 1% preservative-free intravenous solution,LID22291,CDM,250,RC,J2001,HCPCS,outpatient,,,2.89,2.17,,2.6,90,,,percent of total billed charges,90% of total billed charges,2.69,93,,,percent of total billed charges,93% of total billed charges,1.1,38,,,percent of total billed charges,38% of total billed charges,1.1,38,,,percent of total billed charges,38% of total billed charges,2.46,85,,,percent of total billed charges,85% of total billed charges,1.1,38,,,percent of total billed charges,38% of total billed charges,2.35,81.4,,,percent of total billed charges,81.4% of total billed charges,2.6,90,,,percent of total billed charges,90% of total billed charges,2.6,90,,,percent of total billed charges,90% of total billed charges,1.1,38,,,percent of total billed charges,38% of total billed charges,1.1,38,,,percent of total billed charges,38% of total billed charges,1.1,38,,,percent of total billed charges,38% of total billed charges,2.17,75,,,percent of total billed charges,75% of total billed charges,2.46,85,,,percent of total billed charges,85% of total billed charges,1.1,2.69,
lidocaine 4% topical solution,LID4596,CDM,250,RC,,,outpatient,,,2.28,1.71,,2.05,90,,,percent of total billed charges,90% of total billed charges,2.12,93,,,percent of total billed charges,93% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.86,81.4,,,percent of total billed charges,81.4% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.71,75,,,percent of total billed charges,75% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,2.12,
lidocaine 2% Jelly,LID4604,CDM,250,RC,,,outpatient,,,22.46,16.85,,20.21,90,,,percent of total billed charges,90% of total billed charges,20.89,93,,,percent of total billed charges,93% of total billed charges,8.53,38,,,percent of total billed charges,38% of total billed charges,8.53,38,,,percent of total billed charges,38% of total billed charges,19.09,85,,,percent of total billed charges,85% of total billed charges,8.53,38,,,percent of total billed charges,38% of total billed charges,18.28,81.4,,,percent of total billed charges,81.4% of total billed charges,20.21,90,,,percent of total billed charges,90% of total billed charges,20.21,90,,,percent of total billed charges,90% of total billed charges,8.53,38,,,percent of total billed charges,38% of total billed charges,8.53,38,,,percent of total billed charges,38% of total billed charges,8.53,38,,,percent of total billed charges,38% of total billed charges,16.85,75,,,percent of total billed charges,75% of total billed charges,19.09,85,,,percent of total billed charges,85% of total billed charges,8.53,20.89,
lidocaine 4% preservative-free injectable solution,LIDO1312012,CDM,250,RC,,,outpatient,,,4.75,3.56,,4.28,90,,,percent of total billed charges,90% of total billed charges,4.42,93,,,percent of total billed charges,93% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,4.04,85,,,percent of total billed charges,85% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,3.87,81.4,,,percent of total billed charges,81.4% of total billed charges,4.28,90,,,percent of total billed charges,90% of total billed charges,4.28,90,,,percent of total billed charges,90% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,1.81,38,,,percent of total billed charges,38% of total billed charges,3.56,75,,,percent of total billed charges,75% of total billed charges,4.04,85,,,percent of total billed charges,85% of total billed charges,1.81,4.42,
linezolid 600mg IV,LIN22973,CDM,636,RC,J2020,HCPCS,outpatient,,,134.24,100.68,,120.82,90,,,percent of total billed charges,90% of total billed charges,124.84,93,,,percent of total billed charges,93% of total billed charges,51.01,38,,,percent of total billed charges,38% of total billed charges,51.01,38,,,percent of total billed charges,38% of total billed charges,114.1,85,,,percent of total billed charges,85% of total billed charges,51.01,38,,,percent of total billed charges,38% of total billed charges,109.27,81.4,,,percent of total billed charges,81.4% of total billed charges,120.82,90,,,percent of total billed charges,90% of total billed charges,120.82,90,,,percent of total billed charges,90% of total billed charges,51.01,38,,,percent of total billed charges,38% of total billed charges,51.01,38,,,percent of total billed charges,38% of total billed charges,51.01,38,,,percent of total billed charges,38% of total billed charges,100.68,75,,,percent of total billed charges,75% of total billed charges,114.1,85,,,percent of total billed charges,85% of total billed charges,51.01,124.84,
Atorvastatin 20 mg oral tablet,LIP1003371,CDM,637,RC,A9270,HCPCS,outpatient,,,3.44,2.58,,3.1,90,,,percent of total billed charges,90% of total billed charges,3.2,93,,,percent of total billed charges,93% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.8,81.4,,,percent of total billed charges,81.4% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.58,75,,,percent of total billed charges,75% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,3.2,
lisinopril 10 mg oral tablet,LIS1003225,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
lisinopril 5 mg oral tablet,LIS4766,CDM,250,RC,A9270,HCPCS,outpatient,,,0.09,0.07,,0.08,90,,,percent of total billed charges,90% of total billed charges,0.08,93,,,percent of total billed charges,93% of total billed charges,0.03,38,,,percent of total billed charges,38% of total billed charges,0.03,38,,,percent of total billed charges,38% of total billed charges,0.08,85,,,percent of total billed charges,85% of total billed charges,0.03,38,,,percent of total billed charges,38% of total billed charges,0.07,81.4,,,percent of total billed charges,81.4% of total billed charges,0.08,90,,,percent of total billed charges,90% of total billed charges,0.08,90,,,percent of total billed charges,90% of total billed charges,0.03,38,,,percent of total billed charges,38% of total billed charges,0.03,38,,,percent of total billed charges,38% of total billed charges,0.03,38,,,percent of total billed charges,38% of total billed charges,0.07,75,,,percent of total billed charges,75% of total billed charges,0.08,85,,,percent of total billed charges,85% of total billed charges,0.03,0.08,
lisinopril 20 mg oral tablet,LIS4767,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Diphenoxylate-atropine 2.5 mg-0.025 mg oral tablet,LOM1003325,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
losartan 25 mg oral tablet,LOS1003348,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
losartan 50 mg oral tablet,LOS12964,CDM,637,RC,A9270,HCPCS,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
Enoxaparin (Lovenox) 100 mg/mL injectable solution,LOV1003285,CDM,636,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 100 mg/mL injectable solution,LOV1003285,CDM,250,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 40 mg/0.4 mL injectable solution,LOV1003286,CDM,636,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 40 mg/0.4 mL injectable solution,LOV1003286,CDM,250,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 40 mg/0.4 mL injectable solution,LOV1003286,CDM,636,RC,G0480,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 40 mg/0.4 mL injectable solution,LOV1003286,CDM,250,RC,G0480,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 60 mg/0.6 mL injectable solution,LOV1003287,CDM,636,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 60 mg/0.6 mL injectable solution,LOV1003287,CDM,250,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 120 mg/0.8 mL injectable solution,LOV1003288,CDM,250,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 120 mg/0.8 mL injectable solution,LOV1003288,CDM,636,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 30 mg/0.3 mL injectable solution,LOV1003289,CDM,636,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 30 mg/0.3 mL injectable solution,LOV1003289,CDM,250,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 80 mg/0.8 mL injectable solution,LOV7747,CDM,636,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Enoxaparin (Lovenox) 80 mg/0.8 mL injectable solution,LOV7747,CDM,250,RC,J1650,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
Pregabalin 50 mg oral capsule,LYR17234,CDM,250,RC,,,outpatient,,,19.92,14.94,,17.93,90,,,percent of total billed charges,90% of total billed charges,18.53,93,,,percent of total billed charges,93% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.21,81.4,,,percent of total billed charges,81.4% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,14.94,75,,,percent of total billed charges,75% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,18.53,
Pregabalin 50 mg oral capsule,LYR17234,CDM,637,RC,,,outpatient,,,19.92,14.94,,17.93,90,,,percent of total billed charges,90% of total billed charges,18.53,93,,,percent of total billed charges,93% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.21,81.4,,,percent of total billed charges,81.4% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,14.94,75,,,percent of total billed charges,75% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,18.53,
Nitrofurantoin macrocrystals (Macrobid) 100 mg oral capsule,MAC1003074,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
magnesium sulfate 1 gram IV,MAG1003203,CDM,636,RC,J3475,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
magnesium sulfate 1 gram IV,MAG1003203,CDM,250,RC,J3475,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
magnesium citrate 1.745 g/30 mL oral liquid,MAG1003252,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
magnesium oxide 400 mg (241.3 mg elemental magnesium) oral tablet,MAG1003343,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
magnesium sulfate 2 g IV,MAG20184,CDM,636,RC,J3475,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
mannitol 20% IV,MAN1003145,CDM,636,RC,J2150,HCPCS,outpatient,,,50.38,37.79,,45.34,90,,,percent of total billed charges,90% of total billed charges,46.85,93,,,percent of total billed charges,93% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,41.01,81.4,,,percent of total billed charges,81.4% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,37.79,75,,,percent of total billed charges,75% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,46.85,
mannitol 20% IV,MAN1003145,CDM,250,RC,J2150,HCPCS,outpatient,,,50.38,37.79,,45.34,90,,,percent of total billed charges,90% of total billed charges,46.85,93,,,percent of total billed charges,93% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,41.01,81.4,,,percent of total billed charges,81.4% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,45.34,90,,,percent of total billed charges,90% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,19.14,38,,,percent of total billed charges,38% of total billed charges,37.79,75,,,percent of total billed charges,75% of total billed charges,42.82,85,,,percent of total billed charges,85% of total billed charges,19.14,46.85,
Bupivacaine 0.5% injectable solution,MAR1003107,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
Triamterene-HCTZ 37.5/25mg oral tablet,MAX1003290,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Dexamethasone/neomycin/polymyxin B ophthalmic suspension,MAX1003330,CDM,637,RC,A9270,HCPCS,outpatient,,,23.3,17.48,,20.97,90,,,percent of total billed charges,90% of total billed charges,21.67,93,,,percent of total billed charges,93% of total billed charges,8.85,38,,,percent of total billed charges,38% of total billed charges,8.85,38,,,percent of total billed charges,38% of total billed charges,19.81,85,,,percent of total billed charges,85% of total billed charges,8.85,38,,,percent of total billed charges,38% of total billed charges,18.97,81.4,,,percent of total billed charges,81.4% of total billed charges,20.97,90,,,percent of total billed charges,90% of total billed charges,20.97,90,,,percent of total billed charges,90% of total billed charges,8.85,38,,,percent of total billed charges,38% of total billed charges,8.85,38,,,percent of total billed charges,38% of total billed charges,8.85,38,,,percent of total billed charges,38% of total billed charges,17.48,75,,,percent of total billed charges,75% of total billed charges,19.81,85,,,percent of total billed charges,85% of total billed charges,8.85,21.67,
measles/mumps/rubella virus vaccine subcutaneous injection,MEA7737,CDM,636,RC,90707,HCPCS,outpatient,,,838.64,628.98,,754.78,90,,,percent of total billed charges,90% of total billed charges,779.94,93,,,percent of total billed charges,93% of total billed charges,318.68,38,,,percent of total billed charges,38% of total billed charges,318.68,38,,,percent of total billed charges,38% of total billed charges,712.84,85,,,percent of total billed charges,85% of total billed charges,318.68,38,,,percent of total billed charges,38% of total billed charges,682.65,81.4,,,percent of total billed charges,81.4% of total billed charges,754.78,90,,,percent of total billed charges,90% of total billed charges,754.78,90,,,percent of total billed charges,90% of total billed charges,318.68,38,,,percent of total billed charges,38% of total billed charges,318.68,38,,,percent of total billed charges,38% of total billed charges,318.68,38,,,percent of total billed charges,38% of total billed charges,628.98,75,,,percent of total billed charges,75% of total billed charges,712.84,85,,,percent of total billed charges,85% of total billed charges,318.68,779.94,
meclizine 25 mg oral tablet,MEC1003242,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Medihoney,MED1234,CDM,250,RC,,,outpatient,,,20.21,15.16,,18.19,90,,,percent of total billed charges,90% of total billed charges,18.8,93,,,percent of total billed charges,93% of total billed charges,7.68,38,,,percent of total billed charges,38% of total billed charges,7.68,38,,,percent of total billed charges,38% of total billed charges,17.18,85,,,percent of total billed charges,85% of total billed charges,7.68,38,,,percent of total billed charges,38% of total billed charges,16.45,81.4,,,percent of total billed charges,81.4% of total billed charges,18.19,90,,,percent of total billed charges,90% of total billed charges,18.19,90,,,percent of total billed charges,90% of total billed charges,7.68,38,,,percent of total billed charges,38% of total billed charges,7.68,38,,,percent of total billed charges,38% of total billed charges,7.68,38,,,percent of total billed charges,38% of total billed charges,15.16,75,,,percent of total billed charges,75% of total billed charges,17.18,85,,,percent of total billed charges,85% of total billed charges,7.68,18.8,
megestrol 40mg/mL,meg405,CDM,250,RC,,,outpatient,,,5.41,4.06,,4.87,90,,,percent of total billed charges,90% of total billed charges,5.03,93,,,percent of total billed charges,93% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,4.6,85,,,percent of total billed charges,85% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,4.4,81.4,,,percent of total billed charges,81.4% of total billed charges,4.87,90,,,percent of total billed charges,90% of total billed charges,4.87,90,,,percent of total billed charges,90% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,4.06,75,,,percent of total billed charges,75% of total billed charges,4.6,85,,,percent of total billed charges,85% of total billed charges,2.06,5.03,
megestrol 40mg/mL,meg405,CDM,637,RC,,,outpatient,,,5.41,4.06,,4.87,90,,,percent of total billed charges,90% of total billed charges,5.03,93,,,percent of total billed charges,93% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,4.6,85,,,percent of total billed charges,85% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,4.4,81.4,,,percent of total billed charges,81.4% of total billed charges,4.87,90,,,percent of total billed charges,90% of total billed charges,4.87,90,,,percent of total billed charges,90% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,2.06,38,,,percent of total billed charges,38% of total billed charges,4.06,75,,,percent of total billed charges,75% of total billed charges,4.6,85,,,percent of total billed charges,85% of total billed charges,2.06,5.03,
Melatonin 3 mg oral tablet,MEL13940,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
melatonin 5 mg oral tablet,MEL13943,CDM,250,RC,,,outpatient,,,3.24,2.43,,2.92,90,,,percent of total billed charges,90% of total billed charges,3.01,93,,,percent of total billed charges,93% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.64,81.4,,,percent of total billed charges,81.4% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.43,75,,,percent of total billed charges,75% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,3.01,
melatonin 5 mg oral tablet,MEL13943,CDM,637,RC,,,outpatient,,,3.24,2.43,,2.92,90,,,percent of total billed charges,90% of total billed charges,3.01,93,,,percent of total billed charges,93% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.64,81.4,,,percent of total billed charges,81.4% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.43,75,,,percent of total billed charges,75% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,3.01,
meloxicam 15 mg oral tablet,MEL15707,CDM,637,RC,,,outpatient,,,4.5,3.38,,4.05,90,,,percent of total billed charges,90% of total billed charges,4.19,93,,,percent of total billed charges,93% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,3.83,85,,,percent of total billed charges,85% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,3.66,81.4,,,percent of total billed charges,81.4% of total billed charges,4.05,90,,,percent of total billed charges,90% of total billed charges,4.05,90,,,percent of total billed charges,90% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,3.38,75,,,percent of total billed charges,75% of total billed charges,3.83,85,,,percent of total billed charges,85% of total billed charges,1.71,4.19,
MenQuadfi,MEN6237,CDM,636,RC,90619,HCPCS,outpatient,,,219.57,164.68,,197.61,90,,,percent of total billed charges,90% of total billed charges,204.2,93,,,percent of total billed charges,93% of total billed charges,83.44,38,,,percent of total billed charges,38% of total billed charges,83.44,38,,,percent of total billed charges,38% of total billed charges,186.63,85,,,percent of total billed charges,85% of total billed charges,83.44,38,,,percent of total billed charges,38% of total billed charges,178.73,81.4,,,percent of total billed charges,81.4% of total billed charges,197.61,90,,,percent of total billed charges,90% of total billed charges,197.61,90,,,percent of total billed charges,90% of total billed charges,83.44,38,,,percent of total billed charges,38% of total billed charges,83.44,38,,,percent of total billed charges,38% of total billed charges,83.44,38,,,percent of total billed charges,38% of total billed charges,164.68,75,,,percent of total billed charges,75% of total billed charges,186.63,85,,,percent of total billed charges,85% of total billed charges,83.44,204.2,
meropenem 1000 mg intravenous injection,MER13657,CDM,636,RC,j2185,HCPCS,outpatient,,,39.84,29.88,,35.86,90,,,percent of total billed charges,90% of total billed charges,37.05,93,,,percent of total billed charges,93% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,32.43,81.4,,,percent of total billed charges,81.4% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,35.86,90,,,percent of total billed charges,90% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,15.14,38,,,percent of total billed charges,38% of total billed charges,29.88,75,,,percent of total billed charges,75% of total billed charges,33.86,85,,,percent of total billed charges,85% of total billed charges,15.14,37.05,
metroNIDAZOLE 500 mg/100 mL intravenous solution,MET1003073,CDM,636,RC,S0030,HCPCS,outpatient,,,31.63,23.72,,28.47,90,,,percent of total billed charges,90% of total billed charges,29.42,93,,,percent of total billed charges,93% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,26.89,85,,,percent of total billed charges,85% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,25.75,81.4,,,percent of total billed charges,81.4% of total billed charges,28.47,90,,,percent of total billed charges,90% of total billed charges,28.47,90,,,percent of total billed charges,90% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,23.72,75,,,percent of total billed charges,75% of total billed charges,26.89,85,,,percent of total billed charges,85% of total billed charges,12.02,29.42,
metroNIDAZOLE 500 mg/100 mL intravenous solution,MET1003073,CDM,250,RC,S0030,HCPCS,outpatient,,,31.63,23.72,,28.47,90,,,percent of total billed charges,90% of total billed charges,29.42,93,,,percent of total billed charges,93% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,26.89,85,,,percent of total billed charges,85% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,25.75,81.4,,,percent of total billed charges,81.4% of total billed charges,28.47,90,,,percent of total billed charges,90% of total billed charges,28.47,90,,,percent of total billed charges,90% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,12.02,38,,,percent of total billed charges,38% of total billed charges,23.72,75,,,percent of total billed charges,75% of total billed charges,26.89,85,,,percent of total billed charges,85% of total billed charges,12.02,29.42,
metoprolol tartrate 50 mg oral tablet,MET1003084,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
metoprolol tartrate 1 mg/mL injectable solution,MET1003085,CDM,250,RC,,,outpatient,,,16.24,12.18,,14.62,90,,,percent of total billed charges,90% of total billed charges,15.1,93,,,percent of total billed charges,93% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,13.22,81.4,,,percent of total billed charges,81.4% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,14.62,90,,,percent of total billed charges,90% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,6.17,38,,,percent of total billed charges,38% of total billed charges,12.18,75,,,percent of total billed charges,75% of total billed charges,13.8,85,,,percent of total billed charges,85% of total billed charges,6.17,15.1,
methylPREDNISolone (Solu-Medrol) 125 mg injection,MET1003151,CDM,636,RC,J2930,HCPCS,outpatient,,,45.7,34.28,,41.13,90,,,percent of total billed charges,90% of total billed charges,42.5,93,,,percent of total billed charges,93% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,37.2,81.4,,,percent of total billed charges,81.4% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,34.28,75,,,percent of total billed charges,75% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,42.5,
methylPREDNISolone (Solu-Medrol) 125 mg injection,MET1003151,CDM,250,RC,J2930,HCPCS,outpatient,,,45.7,34.28,,41.13,90,,,percent of total billed charges,90% of total billed charges,42.5,93,,,percent of total billed charges,93% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,37.2,81.4,,,percent of total billed charges,81.4% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,34.28,75,,,percent of total billed charges,75% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,42.5,
metoclopramide 5 mg/mL injectable solution,MET1003153,CDM,636,RC,J2765,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
metoclopramide 5 mg/mL injectable solution,MET1003153,CDM,250,RC,J2765,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
metFORMIN 500 mg oral tablet,MET1003347,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
metroNIDAZOLE 500 mg oral tablet,MET1334,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Metoprolol Tartrate 25 mg oral tablet,MET1508,CDM,637,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
methylnaltrexone 12 mg/0.6 mL subcutaneous solution,MET18089,CDM,636,RC,J2212,HCPCS,outpatient,,,216.56,162.42,,194.9,90,,,percent of total billed charges,90% of total billed charges,201.4,93,,,percent of total billed charges,93% of total billed charges,82.29,38,,,percent of total billed charges,38% of total billed charges,82.29,38,,,percent of total billed charges,38% of total billed charges,184.08,85,,,percent of total billed charges,85% of total billed charges,82.29,38,,,percent of total billed charges,38% of total billed charges,176.28,81.4,,,percent of total billed charges,81.4% of total billed charges,194.9,90,,,percent of total billed charges,90% of total billed charges,194.9,90,,,percent of total billed charges,90% of total billed charges,82.29,38,,,percent of total billed charges,38% of total billed charges,82.29,38,,,percent of total billed charges,38% of total billed charges,82.29,38,,,percent of total billed charges,38% of total billed charges,162.42,75,,,percent of total billed charges,75% of total billed charges,184.08,85,,,percent of total billed charges,85% of total billed charges,82.29,201.4,
methIMAzole 5 mg oral tablet,MET2710,CDM,637,RC,A9270,HCPCS,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
metoclopramide 10 mg oral tablet,MET2777,CDM,637,RC,A9270,HCPCS,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
methylergonovine 0.2 mg/mL injectable solution,MET4266,CDM,636,RC,J2210,HCPCS,outpatient,,,19.92,14.94,,17.93,90,,,percent of total billed charges,90% of total billed charges,18.53,93,,,percent of total billed charges,93% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.21,81.4,,,percent of total billed charges,81.4% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,14.94,75,,,percent of total billed charges,75% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,18.53,
methocarbamol 500 mg oral tablet,MET5577,CDM,637,RC,,,outpatient,,,4.5,3.38,,4.05,90,,,percent of total billed charges,90% of total billed charges,4.19,93,,,percent of total billed charges,93% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,3.83,85,,,percent of total billed charges,85% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,3.66,81.4,,,percent of total billed charges,81.4% of total billed charges,4.05,90,,,percent of total billed charges,90% of total billed charges,4.05,90,,,percent of total billed charges,90% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,1.71,38,,,percent of total billed charges,38% of total billed charges,3.38,75,,,percent of total billed charges,75% of total billed charges,3.83,85,,,percent of total billed charges,85% of total billed charges,1.71,4.19,
methadone 5 mg oral tablet,MET861,CDM,250,RC,,,outpatient,,,0.53,0.4,,0.48,90,,,percent of total billed charges,90% of total billed charges,0.49,93,,,percent of total billed charges,93% of total billed charges,0.2,38,,,percent of total billed charges,38% of total billed charges,0.2,38,,,percent of total billed charges,38% of total billed charges,0.45,85,,,percent of total billed charges,85% of total billed charges,0.2,38,,,percent of total billed charges,38% of total billed charges,0.43,81.4,,,percent of total billed charges,81.4% of total billed charges,0.48,90,,,percent of total billed charges,90% of total billed charges,0.48,90,,,percent of total billed charges,90% of total billed charges,0.2,38,,,percent of total billed charges,38% of total billed charges,0.2,38,,,percent of total billed charges,38% of total billed charges,0.2,38,,,percent of total billed charges,38% of total billed charges,0.4,75,,,percent of total billed charges,75% of total billed charges,0.45,85,,,percent of total billed charges,85% of total billed charges,0.2,0.49,
methadone 10 mg/mL oral concentrate,MET868,CDM,637,RC,,,outpatient,,,4.24,3.18,,3.82,90,,,percent of total billed charges,90% of total billed charges,3.94,93,,,percent of total billed charges,93% of total billed charges,1.61,38,,,percent of total billed charges,38% of total billed charges,1.61,38,,,percent of total billed charges,38% of total billed charges,3.6,85,,,percent of total billed charges,85% of total billed charges,1.61,38,,,percent of total billed charges,38% of total billed charges,3.45,81.4,,,percent of total billed charges,81.4% of total billed charges,3.82,90,,,percent of total billed charges,90% of total billed charges,3.82,90,,,percent of total billed charges,90% of total billed charges,1.61,38,,,percent of total billed charges,38% of total billed charges,1.61,38,,,percent of total billed charges,38% of total billed charges,1.61,38,,,percent of total billed charges,38% of total billed charges,3.18,75,,,percent of total billed charges,75% of total billed charges,3.6,85,,,percent of total billed charges,85% of total billed charges,1.61,3.94,
Midazolam 10mg/10mL IV,mid10mg,CDM,636,RC,J2250,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
midodrine 5 mg oral tablet,MID13824,CDM,250,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
midodrine 5 mg oral tablet,MID13824,CDM,637,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
midazolam 50 mg/ 10 mL injectable solution,MID2794,CDM,258,RC,J2250,HCPCS,outpatient,,,27.06,20.3,,24.35,90,,,percent of total billed charges,90% of total billed charges,25.17,93,,,percent of total billed charges,93% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,22.03,81.4,,,percent of total billed charges,81.4% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,24.35,90,,,percent of total billed charges,90% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,10.28,38,,,percent of total billed charges,38% of total billed charges,20.3,75,,,percent of total billed charges,75% of total billed charges,23,85,,,percent of total billed charges,85% of total billed charges,10.28,25.17,
Midazolam 2mg/2mL IV,MID2ML,CDM,636,RC,J2250,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
Milk of Magnesia (magnesium hydroxide) 8% oral suspension,MIL1003251,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Miochol-E System Pak 1% intraocular powder for reconstitution,MIO1003265,CDM,250,RC,,,outpatient,,,121.86,91.4,,109.67,90,,,percent of total billed charges,90% of total billed charges,113.33,93,,,percent of total billed charges,93% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,99.19,81.4,,,percent of total billed charges,81.4% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,109.67,90,,,percent of total billed charges,90% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,46.31,38,,,percent of total billed charges,38% of total billed charges,91.4,75,,,percent of total billed charges,75% of total billed charges,103.58,85,,,percent of total billed charges,85% of total billed charges,46.31,113.33,
Polyethylene glycol 3350 (Miralax) oral powder for reconstitution,MIR1003426,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Monovisc 88 mg/4 mL intra-articular solution,MON21501,CDM,250,RC,J7327,HCPCS,outpatient,,,2111.4,1583.55,,1900.26,90,,,percent of total billed charges,90% of total billed charges,1963.6,93,,,percent of total billed charges,93% of total billed charges,802.33,38,,,percent of total billed charges,38% of total billed charges,802.33,38,,,percent of total billed charges,38% of total billed charges,1794.69,85,,,percent of total billed charges,85% of total billed charges,802.33,38,,,percent of total billed charges,38% of total billed charges,1718.68,81.4,,,percent of total billed charges,81.4% of total billed charges,1900.26,90,,,percent of total billed charges,90% of total billed charges,1900.26,90,,,percent of total billed charges,90% of total billed charges,802.33,38,,,percent of total billed charges,38% of total billed charges,802.33,38,,,percent of total billed charges,38% of total billed charges,802.33,38,,,percent of total billed charges,38% of total billed charges,1583.55,75,,,percent of total billed charges,75% of total billed charges,1794.69,85,,,percent of total billed charges,85% of total billed charges,802.33,1963.6,
morphine sulfate15 mg oral tablet,MOR1003155,CDM,637,RC,A9270,HCPCS,outpatient,,,10.31,7.73,,9.28,90,,,percent of total billed charges,90% of total billed charges,9.59,93,,,percent of total billed charges,93% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,8.76,85,,,percent of total billed charges,85% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,8.39,81.4,,,percent of total billed charges,81.4% of total billed charges,9.28,90,,,percent of total billed charges,90% of total billed charges,9.28,90,,,percent of total billed charges,90% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,7.73,75,,,percent of total billed charges,75% of total billed charges,8.76,85,,,percent of total billed charges,85% of total billed charges,3.92,9.59,
morphine 5 mg/mL injectable solution,MOR1003157,CDM,636,RC,J2270,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
morphine 5 mg/mL injectable solution,MOR1003157,CDM,250,RC,J2270,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
morphine 10 mg/mL injectable solution,MOR1003158,CDM,636,RC,J2270,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
morphine 10 mg/mL injectable solution,MOR1003158,CDM,250,RC,J2270,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
morphine 2 mg/mL injectable solution,MOR2835,CDM,636,RC,J2270,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
morphine 4 mg/mL injectable solution,MOR2836,CDM,636,RC,J2270,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
"Morphine Sulfate ER 15 mg/12 hr oral tablet,",MS 2851,CDM,637,RC,A9270,HCPCS,outpatient,,,10.31,7.73,,9.28,90,,,percent of total billed charges,90% of total billed charges,9.59,93,,,percent of total billed charges,93% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,8.76,85,,,percent of total billed charges,85% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,8.39,81.4,,,percent of total billed charges,81.4% of total billed charges,9.28,90,,,percent of total billed charges,90% of total billed charges,9.28,90,,,percent of total billed charges,90% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,3.92,38,,,percent of total billed charges,38% of total billed charges,7.73,75,,,percent of total billed charges,75% of total billed charges,8.76,85,,,percent of total billed charges,85% of total billed charges,3.92,9.59,
"GuaiFENesin 600 mg oral tablet, extended release",MUC5061,CDM,250,RC,,,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Multivitamin oral tablet,MUL7955,CDM,637,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
My Way 1.5 mg oral tablet,MY 20485,CDM,250,RC,,,outpatient,,,47.3,35.48,,42.57,90,,,percent of total billed charges,90% of total billed charges,43.99,93,,,percent of total billed charges,93% of total billed charges,17.97,38,,,percent of total billed charges,38% of total billed charges,17.97,38,,,percent of total billed charges,38% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,17.97,38,,,percent of total billed charges,38% of total billed charges,38.5,81.4,,,percent of total billed charges,81.4% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,17.97,38,,,percent of total billed charges,38% of total billed charges,17.97,38,,,percent of total billed charges,38% of total billed charges,17.97,38,,,percent of total billed charges,38% of total billed charges,35.48,75,,,percent of total billed charges,75% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,17.97,43.99,
Mylanta oral suspension,MYL1003323,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Alum/Mag/Simeth (Mylanta) Maximum Strength oral suspension,MYL11340,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
nafcillin 2 g injection,NAF441,CDM,250,RC,,,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
nafcillin 10 g injection,NAF442,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
naloxone 0.4 mg/mL injectable solution,NAL1003159,CDM,636,RC,J2310,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
naloxone 0.4 mg/mL injectable solution,NAL1003159,CDM,250,RC,J2310,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
nalbuphine 10 mg/mL injectable solution,NAL1003241,CDM,636,RC,J2300,HCPCS,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
Naproxen 500 mg oral tablet,NAP1003006,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
"Refresh (carboxymethylcellulose sodium) 0.5% Tears, preserved eye drops",NAT1003341,CDM,637,RC,A9270,HCPCS,outpatient,,,11.04,8.28,,9.94,90,,,percent of total billed charges,90% of total billed charges,10.27,93,,,percent of total billed charges,93% of total billed charges,4.2,38,,,percent of total billed charges,38% of total billed charges,4.2,38,,,percent of total billed charges,38% of total billed charges,9.38,85,,,percent of total billed charges,85% of total billed charges,4.2,38,,,percent of total billed charges,38% of total billed charges,8.99,81.4,,,percent of total billed charges,81.4% of total billed charges,9.94,90,,,percent of total billed charges,90% of total billed charges,9.94,90,,,percent of total billed charges,90% of total billed charges,4.2,38,,,percent of total billed charges,38% of total billed charges,4.2,38,,,percent of total billed charges,38% of total billed charges,4.2,38,,,percent of total billed charges,38% of total billed charges,8.28,75,,,percent of total billed charges,75% of total billed charges,9.38,85,,,percent of total billed charges,85% of total billed charges,4.2,10.27,
Phenylephrine Nasal 0.25% spray,NEO1003383,CDM,250,RC,,,outpatient,,,18.75,14.06,,16.88,90,,,percent of total billed charges,90% of total billed charges,17.44,93,,,percent of total billed charges,93% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,15.26,81.4,,,percent of total billed charges,81.4% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,16.88,90,,,percent of total billed charges,90% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,7.13,38,,,percent of total billed charges,38% of total billed charges,14.06,75,,,percent of total billed charges,75% of total billed charges,15.94,85,,,percent of total billed charges,85% of total billed charges,7.13,17.44,
Filgrastim 300 mcg/mL injectable solution,NEU1003204,CDM,636,RC,Q5101,HCPCS,outpatient,,,1.29,0.97,,1.16,90,,,percent of total billed charges,90% of total billed charges,1.2,93,,,percent of total billed charges,93% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,1.1,85,,,percent of total billed charges,85% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,1.05,81.4,,,percent of total billed charges,81.4% of total billed charges,1.16,90,,,percent of total billed charges,90% of total billed charges,1.16,90,,,percent of total billed charges,90% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,0.97,75,,,percent of total billed charges,75% of total billed charges,1.1,85,,,percent of total billed charges,85% of total billed charges,0.49,1.2,
Filgrastim 300 mcg/mL injectable solution,NEU1003204,CDM,250,RC,Q5101,HCPCS,outpatient,,,1.29,0.97,,1.16,90,,,percent of total billed charges,90% of total billed charges,1.2,93,,,percent of total billed charges,93% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,1.1,85,,,percent of total billed charges,85% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,1.05,81.4,,,percent of total billed charges,81.4% of total billed charges,1.16,90,,,percent of total billed charges,90% of total billed charges,1.16,90,,,percent of total billed charges,90% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,0.49,38,,,percent of total billed charges,38% of total billed charges,0.97,75,,,percent of total billed charges,75% of total billed charges,1.1,85,,,percent of total billed charges,85% of total billed charges,0.49,1.2,
Gabapentin 100 mg oral capsule,NEU1003305,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Gabapentin 300 mg oral capsule,NEU1003306,CDM,637,RC,A9270,HCPCS,outpatient,,,4.07,3.05,,3.66,90,,,percent of total billed charges,90% of total billed charges,3.79,93,,,percent of total billed charges,93% of total billed charges,1.55,38,,,percent of total billed charges,38% of total billed charges,1.55,38,,,percent of total billed charges,38% of total billed charges,3.46,85,,,percent of total billed charges,85% of total billed charges,1.55,38,,,percent of total billed charges,38% of total billed charges,3.31,81.4,,,percent of total billed charges,81.4% of total billed charges,3.66,90,,,percent of total billed charges,90% of total billed charges,3.66,90,,,percent of total billed charges,90% of total billed charges,1.55,38,,,percent of total billed charges,38% of total billed charges,1.55,38,,,percent of total billed charges,38% of total billed charges,1.55,38,,,percent of total billed charges,38% of total billed charges,3.05,75,,,percent of total billed charges,75% of total billed charges,3.46,85,,,percent of total billed charges,85% of total billed charges,1.55,3.79,
Filgrastim 480 mcg/1.6 mL injectable solution,NEU3854,CDM,636,RC,J1442,HCPCS,outpatient,,,896.41,672.31,,806.77,90,,,percent of total billed charges,90% of total billed charges,833.66,93,,,percent of total billed charges,93% of total billed charges,340.64,38,,,percent of total billed charges,38% of total billed charges,340.64,38,,,percent of total billed charges,38% of total billed charges,761.95,85,,,percent of total billed charges,85% of total billed charges,340.64,38,,,percent of total billed charges,38% of total billed charges,729.68,81.4,,,percent of total billed charges,81.4% of total billed charges,806.77,90,,,percent of total billed charges,90% of total billed charges,806.77,90,,,percent of total billed charges,90% of total billed charges,340.64,38,,,percent of total billed charges,38% of total billed charges,340.64,38,,,percent of total billed charges,38% of total billed charges,340.64,38,,,percent of total billed charges,38% of total billed charges,672.31,75,,,percent of total billed charges,75% of total billed charges,761.95,85,,,percent of total billed charges,85% of total billed charges,340.64,833.66,
niCARdipine 2.5 mg/mL intravenous solution,NIC1003161,CDM,636,RC,J3490,HCPCS,outpatient,,,54.12,40.59,,48.71,90,,,percent of total billed charges,90% of total billed charges,50.33,93,,,percent of total billed charges,93% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,44.05,81.4,,,percent of total billed charges,81.4% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,40.59,75,,,percent of total billed charges,75% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,50.33,
niCARdipine 2.5 mg/mL intravenous solution,NIC1003161,CDM,250,RC,J3490,HCPCS,outpatient,,,54.12,40.59,,48.71,90,,,percent of total billed charges,90% of total billed charges,50.33,93,,,percent of total billed charges,93% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,44.05,81.4,,,percent of total billed charges,81.4% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,48.71,90,,,percent of total billed charges,90% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,20.57,38,,,percent of total billed charges,38% of total billed charges,40.59,75,,,percent of total billed charges,75% of total billed charges,46,85,,,percent of total billed charges,85% of total billed charges,20.57,50.33,
Nicotine 14 mg/24 hr Patch,NIC2987,CDM,637,RC,,,outpatient,,,7.58,5.69,,6.82,90,,,percent of total billed charges,90% of total billed charges,7.05,93,,,percent of total billed charges,93% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,6.44,85,,,percent of total billed charges,85% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,6.17,81.4,,,percent of total billed charges,81.4% of total billed charges,6.82,90,,,percent of total billed charges,90% of total billed charges,6.82,90,,,percent of total billed charges,90% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,5.69,75,,,percent of total billed charges,75% of total billed charges,6.44,85,,,percent of total billed charges,85% of total billed charges,2.88,7.05,
Nicotine 21 mg/24 hr Patch,NIC2988,CDM,637,RC,,,outpatient,,,7.58,5.69,,6.82,90,,,percent of total billed charges,90% of total billed charges,7.05,93,,,percent of total billed charges,93% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,6.44,85,,,percent of total billed charges,85% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,6.17,81.4,,,percent of total billed charges,81.4% of total billed charges,6.82,90,,,percent of total billed charges,90% of total billed charges,6.82,90,,,percent of total billed charges,90% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,5.69,75,,,percent of total billed charges,75% of total billed charges,6.44,85,,,percent of total billed charges,85% of total billed charges,2.88,7.05,
NIFEdipine ER 30 mg oral tablet,NIF887,CDM,637,RC,,,outpatient,,,4.32,3.24,,3.89,90,,,percent of total billed charges,90% of total billed charges,4.02,93,,,percent of total billed charges,93% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.67,85,,,percent of total billed charges,85% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.52,81.4,,,percent of total billed charges,81.4% of total billed charges,3.89,90,,,percent of total billed charges,90% of total billed charges,3.89,90,,,percent of total billed charges,90% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.24,75,,,percent of total billed charges,75% of total billed charges,3.67,85,,,percent of total billed charges,85% of total billed charges,1.64,4.02,
nitroglycerin 2% transdermal ointment,NIT1003162,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
nitroglycerin 0.4 mg sublingual tablet,NIT1003163,CDM,637,RC,A9270,HCPCS,outpatient,,,4.32,3.24,,3.89,90,,,percent of total billed charges,90% of total billed charges,4.02,93,,,percent of total billed charges,93% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.67,85,,,percent of total billed charges,85% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.52,81.4,,,percent of total billed charges,81.4% of total billed charges,3.89,90,,,percent of total billed charges,90% of total billed charges,3.89,90,,,percent of total billed charges,90% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.24,75,,,percent of total billed charges,75% of total billed charges,3.67,85,,,percent of total billed charges,85% of total billed charges,1.64,4.02,
nitroglycerin 200 mcg/mL-D5% intravenous solution,NIT1003164,CDM,636,RC,J3490,HCPCS,outpatient,,,29.03,21.77,,26.13,90,,,percent of total billed charges,90% of total billed charges,27,93,,,percent of total billed charges,93% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,23.63,81.4,,,percent of total billed charges,81.4% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,21.77,75,,,percent of total billed charges,75% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,27,
nitroglycerin 200 mcg/mL-D5% intravenous solution,NIT1003164,CDM,250,RC,J3490,HCPCS,outpatient,,,29.03,21.77,,26.13,90,,,percent of total billed charges,90% of total billed charges,27,93,,,percent of total billed charges,93% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,23.63,81.4,,,percent of total billed charges,81.4% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,21.77,75,,,percent of total billed charges,75% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,27,
nitroglycerin 100 mcg/mL-D5% intravenous solution,NIT3019,CDM,636,RC,J3490,HCPCS,outpatient,,,28.84,21.63,,25.96,90,,,percent of total billed charges,90% of total billed charges,26.82,93,,,percent of total billed charges,93% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,24.51,85,,,percent of total billed charges,85% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,23.48,81.4,,,percent of total billed charges,81.4% of total billed charges,25.96,90,,,percent of total billed charges,90% of total billed charges,25.96,90,,,percent of total billed charges,90% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,21.63,75,,,percent of total billed charges,75% of total billed charges,24.51,85,,,percent of total billed charges,85% of total billed charges,10.96,26.82,
nitroglycerin 100 mcg/mL-D5% intravenous solution,NIT3019,CDM,250,RC,J3490,HCPCS,outpatient,,,28.84,21.63,,25.96,90,,,percent of total billed charges,90% of total billed charges,26.82,93,,,percent of total billed charges,93% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,24.51,85,,,percent of total billed charges,85% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,23.48,81.4,,,percent of total billed charges,81.4% of total billed charges,25.96,90,,,percent of total billed charges,90% of total billed charges,25.96,90,,,percent of total billed charges,90% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,10.96,38,,,percent of total billed charges,38% of total billed charges,21.63,75,,,percent of total billed charges,75% of total billed charges,24.51,85,,,percent of total billed charges,85% of total billed charges,10.96,26.82,
HYDROcodone-acetaminophen 10 mg-325 mg oral tablet,NOR11049,CDM,250,RC,,,outpatient,,,2.31,1.73,,2.08,90,,,percent of total billed charges,90% of total billed charges,2.15,93,,,percent of total billed charges,93% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,1.96,85,,,percent of total billed charges,85% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,1.88,81.4,,,percent of total billed charges,81.4% of total billed charges,2.08,90,,,percent of total billed charges,90% of total billed charges,2.08,90,,,percent of total billed charges,90% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,1.73,75,,,percent of total billed charges,75% of total billed charges,1.96,85,,,percent of total billed charges,85% of total billed charges,0.88,2.15,
HYDROcodone-acetaminophen 10 mg-325 mg oral tablet,NOR11049,CDM,637,RC,,,outpatient,,,2.31,1.73,,2.08,90,,,percent of total billed charges,90% of total billed charges,2.15,93,,,percent of total billed charges,93% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,1.96,85,,,percent of total billed charges,85% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,1.88,81.4,,,percent of total billed charges,81.4% of total billed charges,2.08,90,,,percent of total billed charges,90% of total billed charges,2.08,90,,,percent of total billed charges,90% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,0.88,38,,,percent of total billed charges,38% of total billed charges,1.73,75,,,percent of total billed charges,75% of total billed charges,1.96,85,,,percent of total billed charges,85% of total billed charges,0.88,2.15,
"Nystatin 100,000 units/g topical powder",NYS15344,CDM,250,RC,,,outpatient,,,30.46,22.85,,27.41,90,,,percent of total billed charges,90% of total billed charges,28.33,93,,,percent of total billed charges,93% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,24.79,81.4,,,percent of total billed charges,81.4% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,27.41,90,,,percent of total billed charges,90% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,11.57,38,,,percent of total billed charges,38% of total billed charges,22.85,75,,,percent of total billed charges,75% of total billed charges,25.89,85,,,percent of total billed charges,85% of total billed charges,11.57,28.33,
octreotide 100 mcg/mL injectable solution,OCT1003181,CDM,636,RC,J2354,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
octreotide 100 mcg/mL injectable solution,OCT1003181,CDM,250,RC,J2354,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
ofloxacin 0.3% ophthalmic solution,OFL1003359,CDM,637,RC,A9270,HCPCS,outpatient,,,75.78,56.84,,68.2,90,,,percent of total billed charges,90% of total billed charges,70.48,93,,,percent of total billed charges,93% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,61.68,81.4,,,percent of total billed charges,81.4% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,68.2,90,,,percent of total billed charges,90% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,56.84,75,,,percent of total billed charges,75% of total billed charges,64.41,85,,,percent of total billed charges,85% of total billed charges,28.8,70.48,
OLANZapine 5 mg oral tablet,OLA13855,CDM,637,RC,,,outpatient,,,3.3,2.48,,2.97,90,,,percent of total billed charges,90% of total billed charges,3.07,93,,,percent of total billed charges,93% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,2.81,85,,,percent of total billed charges,85% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,2.69,81.4,,,percent of total billed charges,81.4% of total billed charges,2.97,90,,,percent of total billed charges,90% of total billed charges,2.97,90,,,percent of total billed charges,90% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,2.48,75,,,percent of total billed charges,75% of total billed charges,2.81,85,,,percent of total billed charges,85% of total billed charges,1.25,3.07,
oxyCODONE 5 mg oral tablet,OXY1003167,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
oxyCODONE 10 mg oral tablet,OXY1003168,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
OxyCODONE  ER (OxyCONTIN) 10 mg oral tablet,OXY3091,CDM,250,RC,,,outpatient,,,7.58,5.69,,6.82,90,,,percent of total billed charges,90% of total billed charges,7.05,93,,,percent of total billed charges,93% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,6.44,85,,,percent of total billed charges,85% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,6.17,81.4,,,percent of total billed charges,81.4% of total billed charges,6.82,90,,,percent of total billed charges,90% of total billed charges,6.82,90,,,percent of total billed charges,90% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,5.69,75,,,percent of total billed charges,75% of total billed charges,6.44,85,,,percent of total billed charges,85% of total billed charges,2.88,7.05,
OxyCODONE  ER (OxyCONTIN) 10 mg oral tablet,OXY3091,CDM,637,RC,,,outpatient,,,7.58,5.69,,6.82,90,,,percent of total billed charges,90% of total billed charges,7.05,93,,,percent of total billed charges,93% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,6.44,85,,,percent of total billed charges,85% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,6.17,81.4,,,percent of total billed charges,81.4% of total billed charges,6.82,90,,,percent of total billed charges,90% of total billed charges,6.82,90,,,percent of total billed charges,90% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,2.88,38,,,percent of total billed charges,38% of total billed charges,5.69,75,,,percent of total billed charges,75% of total billed charges,6.44,85,,,percent of total billed charges,85% of total billed charges,2.88,7.05,
OxyCODONE  ER (OxyCONTIN) 20 mg oral tablet,OXY3092,CDM,637,RC,A9270,HCPCS,outpatient,,,8.66,6.5,,7.79,90,,,percent of total billed charges,90% of total billed charges,8.05,93,,,percent of total billed charges,93% of total billed charges,3.29,38,,,percent of total billed charges,38% of total billed charges,3.29,38,,,percent of total billed charges,38% of total billed charges,7.36,85,,,percent of total billed charges,85% of total billed charges,3.29,38,,,percent of total billed charges,38% of total billed charges,7.05,81.4,,,percent of total billed charges,81.4% of total billed charges,7.79,90,,,percent of total billed charges,90% of total billed charges,7.79,90,,,percent of total billed charges,90% of total billed charges,3.29,38,,,percent of total billed charges,38% of total billed charges,3.29,38,,,percent of total billed charges,38% of total billed charges,3.29,38,,,percent of total billed charges,38% of total billed charges,6.5,75,,,percent of total billed charges,75% of total billed charges,7.36,85,,,percent of total billed charges,85% of total billed charges,3.29,8.05,
oxymetazoline (Afrin) 0.05% nasal spray,OXY4914,CDM,637,RC,,,outpatient,,,6.62,4.97,,5.96,90,,,percent of total billed charges,90% of total billed charges,6.16,93,,,percent of total billed charges,93% of total billed charges,2.52,38,,,percent of total billed charges,38% of total billed charges,2.52,38,,,percent of total billed charges,38% of total billed charges,5.63,85,,,percent of total billed charges,85% of total billed charges,2.52,38,,,percent of total billed charges,38% of total billed charges,5.39,81.4,,,percent of total billed charges,81.4% of total billed charges,5.96,90,,,percent of total billed charges,90% of total billed charges,5.96,90,,,percent of total billed charges,90% of total billed charges,2.52,38,,,percent of total billed charges,38% of total billed charges,2.52,38,,,percent of total billed charges,38% of total billed charges,2.52,38,,,percent of total billed charges,38% of total billed charges,4.97,75,,,percent of total billed charges,75% of total billed charges,5.63,85,,,percent of total billed charges,85% of total billed charges,2.52,6.16,
Gelsyn-3 16.8mg/2mL,painclinic,CDM,636,RC,J7328,HCPCS,outpatient,,,524.05,393.04,,471.65,90,,,percent of total billed charges,90% of total billed charges,487.37,93,,,percent of total billed charges,93% of total billed charges,199.14,38,,,percent of total billed charges,38% of total billed charges,199.14,38,,,percent of total billed charges,38% of total billed charges,445.44,85,,,percent of total billed charges,85% of total billed charges,199.14,38,,,percent of total billed charges,38% of total billed charges,426.58,81.4,,,percent of total billed charges,81.4% of total billed charges,471.65,90,,,percent of total billed charges,90% of total billed charges,471.65,90,,,percent of total billed charges,90% of total billed charges,199.14,38,,,percent of total billed charges,38% of total billed charges,199.14,38,,,percent of total billed charges,38% of total billed charges,199.14,38,,,percent of total billed charges,38% of total billed charges,393.04,75,,,percent of total billed charges,75% of total billed charges,445.44,85,,,percent of total billed charges,85% of total billed charges,199.14,487.37,
PARoxetine 20 mg oral tablet,PAX1003300,CDM,637,RC,A9270,HCPCS,outpatient,,,14.05,10.54,,12.65,90,,,percent of total billed charges,90% of total billed charges,13.07,93,,,percent of total billed charges,93% of total billed charges,5.34,38,,,percent of total billed charges,38% of total billed charges,5.34,38,,,percent of total billed charges,38% of total billed charges,11.94,85,,,percent of total billed charges,85% of total billed charges,5.34,38,,,percent of total billed charges,38% of total billed charges,11.44,81.4,,,percent of total billed charges,81.4% of total billed charges,12.65,90,,,percent of total billed charges,90% of total billed charges,12.65,90,,,percent of total billed charges,90% of total billed charges,5.34,38,,,percent of total billed charges,38% of total billed charges,5.34,38,,,percent of total billed charges,38% of total billed charges,5.34,38,,,percent of total billed charges,38% of total billed charges,10.54,75,,,percent of total billed charges,75% of total billed charges,11.94,85,,,percent of total billed charges,85% of total billed charges,5.34,13.07,
Pediarix intramuscular suspension,PED16356,CDM,250,RC,,,outpatient,,,97.26,72.95,,87.53,90,,,percent of total billed charges,90% of total billed charges,90.45,93,,,percent of total billed charges,93% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,79.17,81.4,,,percent of total billed charges,81.4% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,87.53,90,,,percent of total billed charges,90% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,36.96,38,,,percent of total billed charges,38% of total billed charges,72.95,75,,,percent of total billed charges,75% of total billed charges,82.67,85,,,percent of total billed charges,85% of total billed charges,36.96,90.45,
OxyCODONE-acetaminophen 5/325 oral tablet,PER1003319,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
phenytoin 50 mg/mL injectable solution,PHE1003088,CDM,636,RC,J1165,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
phenytoin 50 mg/mL injectable solution,PHE1003088,CDM,250,RC,J1165,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
phentolamine 5 mg injection,PHE1003226,CDM,636,RC,J2760,HCPCS,outpatient,,,165.21,123.91,,148.69,90,,,percent of total billed charges,90% of total billed charges,153.65,93,,,percent of total billed charges,93% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,134.48,81.4,,,percent of total billed charges,81.4% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,123.91,75,,,percent of total billed charges,75% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,153.65,
phentolamine 5 mg injection,PHE1003226,CDM,250,RC,J2760,HCPCS,outpatient,,,165.21,123.91,,148.69,90,,,percent of total billed charges,90% of total billed charges,153.65,93,,,percent of total billed charges,93% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,134.48,81.4,,,percent of total billed charges,81.4% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,148.69,90,,,percent of total billed charges,90% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,62.78,38,,,percent of total billed charges,38% of total billed charges,123.91,75,,,percent of total billed charges,75% of total billed charges,140.43,85,,,percent of total billed charges,85% of total billed charges,62.78,153.65,
phenol topical liquid,PHE11733,CDM,250,RC,A9270,HCPCS,outpatient,,,118.13,88.6,,106.32,90,,,percent of total billed charges,90% of total billed charges,109.86,93,,,percent of total billed charges,93% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,100.41,85,,,percent of total billed charges,85% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,96.16,81.4,,,percent of total billed charges,81.4% of total billed charges,106.32,90,,,percent of total billed charges,90% of total billed charges,106.32,90,,,percent of total billed charges,90% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,44.89,38,,,percent of total billed charges,38% of total billed charges,88.6,75,,,percent of total billed charges,75% of total billed charges,100.41,85,,,percent of total billed charges,85% of total billed charges,44.89,109.86,
phentolamine compounding powder,PHE4771,CDM,250,RC,,,outpatient,,,117.18,87.89,,105.46,90,,,percent of total billed charges,90% of total billed charges,108.98,93,,,percent of total billed charges,93% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,99.6,85,,,percent of total billed charges,85% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,95.38,81.4,,,percent of total billed charges,81.4% of total billed charges,105.46,90,,,percent of total billed charges,90% of total billed charges,105.46,90,,,percent of total billed charges,90% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,44.53,38,,,percent of total billed charges,38% of total billed charges,87.89,75,,,percent of total billed charges,75% of total billed charges,99.6,85,,,percent of total billed charges,85% of total billed charges,44.53,108.98,
Phosphate 250 Neutral oral tablet,PHO1003196,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
phytonadione 10 mg/mL injectable solution,PHY7883,CDM,636,RC,J3430,HCPCS,outpatient,,,61.4,46.05,,55.26,90,,,percent of total billed charges,90% of total billed charges,57.1,93,,,percent of total billed charges,93% of total billed charges,23.33,38,,,percent of total billed charges,38% of total billed charges,23.33,38,,,percent of total billed charges,38% of total billed charges,52.19,85,,,percent of total billed charges,85% of total billed charges,23.33,38,,,percent of total billed charges,38% of total billed charges,49.98,81.4,,,percent of total billed charges,81.4% of total billed charges,55.26,90,,,percent of total billed charges,90% of total billed charges,55.26,90,,,percent of total billed charges,90% of total billed charges,23.33,38,,,percent of total billed charges,38% of total billed charges,23.33,38,,,percent of total billed charges,38% of total billed charges,23.33,38,,,percent of total billed charges,38% of total billed charges,46.05,75,,,percent of total billed charges,75% of total billed charges,52.19,85,,,percent of total billed charges,85% of total billed charges,23.33,57.1,
pilocarpine 1% ophthalmic solution,PIL1003266,CDM,250,RC,,,outpatient,,,131.24,98.43,,118.12,90,,,percent of total billed charges,90% of total billed charges,122.05,93,,,percent of total billed charges,93% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,111.55,85,,,percent of total billed charges,85% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,106.83,81.4,,,percent of total billed charges,81.4% of total billed charges,118.12,90,,,percent of total billed charges,90% of total billed charges,118.12,90,,,percent of total billed charges,90% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,49.87,38,,,percent of total billed charges,38% of total billed charges,98.43,75,,,percent of total billed charges,75% of total billed charges,111.55,85,,,percent of total billed charges,85% of total billed charges,49.87,122.05,
pilocarpine 2% ophthalmic solution,PIL1003267,CDM,250,RC,,,outpatient,,,130.98,98.24,,117.88,90,,,percent of total billed charges,90% of total billed charges,121.81,93,,,percent of total billed charges,93% of total billed charges,49.77,38,,,percent of total billed charges,38% of total billed charges,49.77,38,,,percent of total billed charges,38% of total billed charges,111.33,85,,,percent of total billed charges,85% of total billed charges,49.77,38,,,percent of total billed charges,38% of total billed charges,106.62,81.4,,,percent of total billed charges,81.4% of total billed charges,117.88,90,,,percent of total billed charges,90% of total billed charges,117.88,90,,,percent of total billed charges,90% of total billed charges,49.77,38,,,percent of total billed charges,38% of total billed charges,49.77,38,,,percent of total billed charges,38% of total billed charges,49.77,38,,,percent of total billed charges,38% of total billed charges,98.24,75,,,percent of total billed charges,75% of total billed charges,111.33,85,,,percent of total billed charges,85% of total billed charges,49.77,121.81,
Clopidogrel (Plavix) 75 mg oral tablet,PLA1003387,CDM,637,RC,A9270,HCPCS,outpatient,,,8.2,6.15,,7.38,90,,,percent of total billed charges,90% of total billed charges,7.63,93,,,percent of total billed charges,93% of total billed charges,3.12,38,,,percent of total billed charges,38% of total billed charges,3.12,38,,,percent of total billed charges,38% of total billed charges,6.97,85,,,percent of total billed charges,85% of total billed charges,3.12,38,,,percent of total billed charges,38% of total billed charges,6.67,81.4,,,percent of total billed charges,81.4% of total billed charges,7.38,90,,,percent of total billed charges,90% of total billed charges,7.38,90,,,percent of total billed charges,90% of total billed charges,3.12,38,,,percent of total billed charges,38% of total billed charges,3.12,38,,,percent of total billed charges,38% of total billed charges,3.12,38,,,percent of total billed charges,38% of total billed charges,6.15,75,,,percent of total billed charges,75% of total billed charges,6.97,85,,,percent of total billed charges,85% of total billed charges,3.12,7.63,
pneumococcal 23-polyvalent vaccine injectable solution,PNE1003425,CDM,636,RC,90732,HCPCS,outpatient,,,234.7,176.03,,211.23,90,,,percent of total billed charges,90% of total billed charges,218.27,93,,,percent of total billed charges,93% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,199.5,85,,,percent of total billed charges,85% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,191.05,81.4,,,percent of total billed charges,81.4% of total billed charges,211.23,90,,,percent of total billed charges,90% of total billed charges,211.23,90,,,percent of total billed charges,90% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,176.03,75,,,percent of total billed charges,75% of total billed charges,199.5,85,,,percent of total billed charges,85% of total billed charges,89.19,218.27,
pneumococcal 23-polyvalent vaccine injectable solution,PNE1003425,CDM,250,RC,90732,HCPCS,outpatient,,,234.7,176.03,,211.23,90,,,percent of total billed charges,90% of total billed charges,218.27,93,,,percent of total billed charges,93% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,199.5,85,,,percent of total billed charges,85% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,191.05,81.4,,,percent of total billed charges,81.4% of total billed charges,211.23,90,,,percent of total billed charges,90% of total billed charges,211.23,90,,,percent of total billed charges,90% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,89.19,38,,,percent of total billed charges,38% of total billed charges,176.03,75,,,percent of total billed charges,75% of total billed charges,199.5,85,,,percent of total billed charges,85% of total billed charges,89.19,218.27,
pneumococcal 20 vaccine injectable,pneumo20,CDM,636,RC,90677,HCPCS,outpatient,,,375.67,281.75,,338.1,90,,,percent of total billed charges,90% of total billed charges,349.37,93,,,percent of total billed charges,93% of total billed charges,142.75,38,,,percent of total billed charges,38% of total billed charges,142.75,38,,,percent of total billed charges,38% of total billed charges,319.32,85,,,percent of total billed charges,85% of total billed charges,142.75,38,,,percent of total billed charges,38% of total billed charges,305.8,81.4,,,percent of total billed charges,81.4% of total billed charges,338.1,90,,,percent of total billed charges,90% of total billed charges,338.1,90,,,percent of total billed charges,90% of total billed charges,142.75,38,,,percent of total billed charges,38% of total billed charges,142.75,38,,,percent of total billed charges,38% of total billed charges,142.75,38,,,percent of total billed charges,38% of total billed charges,281.75,75,,,percent of total billed charges,75% of total billed charges,319.32,85,,,percent of total billed charges,85% of total billed charges,142.75,349.37,
potassium chloride 40 mEq/30 mL oral liquid,POT1003172,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
potassium chloride 10 mEq/100 mL intravenous solution,POT1003173,CDM,636,RC,J3480,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
potassium chloride 10 mEq/100 mL intravenous solution,POT1003173,CDM,250,RC,J3480,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
potassium phosphate 3 mmol/mL intravenous solution,POT1003342,CDM,636,RC,J3490,HCPCS,outpatient,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
potassium phosphate 3 mmol/mL intravenous solution,POT1003342,CDM,250,RC,J3490,HCPCS,outpatient,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
potassium chloride 10 mEq/50 mL intravenous solution,POT3208,CDM,636,RC,J3480,HCPCS,outpatient,,,5.45,4.09,,4.91,90,,,percent of total billed charges,90% of total billed charges,5.07,93,,,percent of total billed charges,93% of total billed charges,2.07,38,,,percent of total billed charges,38% of total billed charges,2.07,38,,,percent of total billed charges,38% of total billed charges,4.63,85,,,percent of total billed charges,85% of total billed charges,2.07,38,,,percent of total billed charges,38% of total billed charges,4.44,81.4,,,percent of total billed charges,81.4% of total billed charges,4.91,90,,,percent of total billed charges,90% of total billed charges,4.91,90,,,percent of total billed charges,90% of total billed charges,2.07,38,,,percent of total billed charges,38% of total billed charges,2.07,38,,,percent of total billed charges,38% of total billed charges,2.07,38,,,percent of total billed charges,38% of total billed charges,4.09,75,,,percent of total billed charges,75% of total billed charges,4.63,85,,,percent of total billed charges,85% of total billed charges,2.07,5.07,
Dabigatran (Pradaxa) 75 mg oral capsule,PRA18893,CDM,250,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
Dabigatran (Pradaxa) 75 mg oral capsule,PRA18893,CDM,637,RC,,,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
prednisoLONE (as sodium phosphate) 15 mg/5 mL oral syrup,PRE1003055,CDM,637,RC,A9270,HCPCS,outpatient,,,6.35,4.76,,5.72,90,,,percent of total billed charges,90% of total billed charges,5.91,93,,,percent of total billed charges,93% of total billed charges,2.41,38,,,percent of total billed charges,38% of total billed charges,2.41,38,,,percent of total billed charges,38% of total billed charges,5.4,85,,,percent of total billed charges,85% of total billed charges,2.41,38,,,percent of total billed charges,38% of total billed charges,5.17,81.4,,,percent of total billed charges,81.4% of total billed charges,5.72,90,,,percent of total billed charges,90% of total billed charges,5.72,90,,,percent of total billed charges,90% of total billed charges,2.41,38,,,percent of total billed charges,38% of total billed charges,2.41,38,,,percent of total billed charges,38% of total billed charges,2.41,38,,,percent of total billed charges,38% of total billed charges,4.76,75,,,percent of total billed charges,75% of total billed charges,5.4,85,,,percent of total billed charges,85% of total billed charges,2.41,5.91,
predniSONE 5 mg oral tablet,PRE1003174,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
predniSONE 10 mg oral tablet,PRE1003175,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
predniSONE 20 mg oral tablet,PRE1003176,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
z* prednisoLONE sodium phosphate 15 mg/5 mL oral liquid,PRE1160,CDM,250,RC,J7510,HCPCS,outpatient,,,17.02,12.77,,15.32,90,,,percent of total billed charges,90% of total billed charges,15.83,93,,,percent of total billed charges,93% of total billed charges,6.47,38,,,percent of total billed charges,38% of total billed charges,6.47,38,,,percent of total billed charges,38% of total billed charges,14.47,85,,,percent of total billed charges,85% of total billed charges,6.47,38,,,percent of total billed charges,38% of total billed charges,13.85,81.4,,,percent of total billed charges,81.4% of total billed charges,15.32,90,,,percent of total billed charges,90% of total billed charges,15.32,90,,,percent of total billed charges,90% of total billed charges,6.47,38,,,percent of total billed charges,38% of total billed charges,6.47,38,,,percent of total billed charges,38% of total billed charges,6.47,38,,,percent of total billed charges,38% of total billed charges,12.77,75,,,percent of total billed charges,75% of total billed charges,14.47,85,,,percent of total billed charges,85% of total billed charges,6.47,15.83,
pregabalin 100 mg oral capsule,PRE17222,CDM,250,RC,,,outpatient,,,5.3,3.98,,4.77,90,,,percent of total billed charges,90% of total billed charges,4.93,93,,,percent of total billed charges,93% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,4.51,85,,,percent of total billed charges,85% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,4.31,81.4,,,percent of total billed charges,81.4% of total billed charges,4.77,90,,,percent of total billed charges,90% of total billed charges,4.77,90,,,percent of total billed charges,90% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,3.98,75,,,percent of total billed charges,75% of total billed charges,4.51,85,,,percent of total billed charges,85% of total billed charges,2.01,4.93,
pregabalin 100 mg oral capsule,PRE17222,CDM,637,RC,,,outpatient,,,5.3,3.98,,4.77,90,,,percent of total billed charges,90% of total billed charges,4.93,93,,,percent of total billed charges,93% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,4.51,85,,,percent of total billed charges,85% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,4.31,81.4,,,percent of total billed charges,81.4% of total billed charges,4.77,90,,,percent of total billed charges,90% of total billed charges,4.77,90,,,percent of total billed charges,90% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,2.01,38,,,percent of total billed charges,38% of total billed charges,3.98,75,,,percent of total billed charges,75% of total billed charges,4.51,85,,,percent of total billed charges,85% of total billed charges,2.01,4.93,
Pneumococcal 13 intramuscular suspension,PRE18460,CDM,636,RC,90670,HCPCS,outpatient,,,261.05,195.79,,234.95,90,,,percent of total billed charges,90% of total billed charges,242.78,93,,,percent of total billed charges,93% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,221.89,85,,,percent of total billed charges,85% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,212.49,81.4,,,percent of total billed charges,81.4% of total billed charges,234.95,90,,,percent of total billed charges,90% of total billed charges,234.95,90,,,percent of total billed charges,90% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,195.79,75,,,percent of total billed charges,75% of total billed charges,221.89,85,,,percent of total billed charges,85% of total billed charges,99.2,242.78,
Pneumococcal 13 intramuscular suspension,PRE18460,CDM,250,RC,90670,HCPCS,outpatient,,,261.05,195.79,,234.95,90,,,percent of total billed charges,90% of total billed charges,242.78,93,,,percent of total billed charges,93% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,221.89,85,,,percent of total billed charges,85% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,212.49,81.4,,,percent of total billed charges,81.4% of total billed charges,234.95,90,,,percent of total billed charges,90% of total billed charges,234.95,90,,,percent of total billed charges,90% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,99.2,38,,,percent of total billed charges,38% of total billed charges,195.79,75,,,percent of total billed charges,75% of total billed charges,221.89,85,,,percent of total billed charges,85% of total billed charges,99.2,242.78,
prednisoLONE acetate 1% ophthalmic suspension,PRE9336,CDM,250,RC,A9270,HCPCS,outpatient,,,66.19,49.64,,59.57,90,,,percent of total billed charges,90% of total billed charges,61.56,93,,,percent of total billed charges,93% of total billed charges,25.15,38,,,percent of total billed charges,38% of total billed charges,25.15,38,,,percent of total billed charges,38% of total billed charges,56.26,85,,,percent of total billed charges,85% of total billed charges,25.15,38,,,percent of total billed charges,38% of total billed charges,53.88,81.4,,,percent of total billed charges,81.4% of total billed charges,59.57,90,,,percent of total billed charges,90% of total billed charges,59.57,90,,,percent of total billed charges,90% of total billed charges,25.15,38,,,percent of total billed charges,38% of total billed charges,25.15,38,,,percent of total billed charges,38% of total billed charges,25.15,38,,,percent of total billed charges,38% of total billed charges,49.64,75,,,percent of total billed charges,75% of total billed charges,56.26,85,,,percent of total billed charges,85% of total billed charges,25.15,61.56,
Prevnar 20 injection,prev20,CDM,636,RC,90677,HCPCS,outpatient,,,360.81,270.61,,324.73,90,,,percent of total billed charges,90% of total billed charges,335.55,93,,,percent of total billed charges,93% of total billed charges,137.11,38,,,percent of total billed charges,38% of total billed charges,137.11,38,,,percent of total billed charges,38% of total billed charges,306.69,85,,,percent of total billed charges,85% of total billed charges,137.11,38,,,percent of total billed charges,38% of total billed charges,293.7,81.4,,,percent of total billed charges,81.4% of total billed charges,324.73,90,,,percent of total billed charges,90% of total billed charges,324.73,90,,,percent of total billed charges,90% of total billed charges,137.11,38,,,percent of total billed charges,38% of total billed charges,137.11,38,,,percent of total billed charges,38% of total billed charges,137.11,38,,,percent of total billed charges,38% of total billed charges,270.61,75,,,percent of total billed charges,75% of total billed charges,306.69,85,,,percent of total billed charges,85% of total billed charges,137.11,335.55,
propranolol 40 mg oral tablet,PRO1003016,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
NIFEdipine 10 mg oral capsule,PRO1003037,CDM,637,RC,A9270,HCPCS,outpatient,,,4.32,3.24,,3.89,90,,,percent of total billed charges,90% of total billed charges,4.02,93,,,percent of total billed charges,93% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.67,85,,,percent of total billed charges,85% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.52,81.4,,,percent of total billed charges,81.4% of total billed charges,3.89,90,,,percent of total billed charges,90% of total billed charges,3.89,90,,,percent of total billed charges,90% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.24,75,,,percent of total billed charges,75% of total billed charges,3.67,85,,,percent of total billed charges,85% of total billed charges,1.64,4.02,
FLUoxetine 20 mg oral capsule,PRO1003127,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
prochlorperazine 10 mg oral tablet,PRO1003177,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
prochlorperazine 5 mg/mL injectable solution,PRO1003179,CDM,636,RC,J0780,HCPCS,outpatient,,,23.65,17.74,,21.29,90,,,percent of total billed charges,90% of total billed charges,21.99,93,,,percent of total billed charges,93% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,19.25,81.4,,,percent of total billed charges,81.4% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,17.74,75,,,percent of total billed charges,75% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,21.99,
prochlorperazine 5 mg/mL injectable solution,PRO1003179,CDM,250,RC,J0780,HCPCS,outpatient,,,23.65,17.74,,21.29,90,,,percent of total billed charges,90% of total billed charges,21.99,93,,,percent of total billed charges,93% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,19.25,81.4,,,percent of total billed charges,81.4% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,17.74,75,,,percent of total billed charges,75% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,21.99,
protamine 10 mg/mL injectable solution,PRO1003180,CDM,636,RC,J2720,HCPCS,outpatient,,,58.59,43.94,,52.73,90,,,percent of total billed charges,90% of total billed charges,54.49,93,,,percent of total billed charges,93% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,47.69,81.4,,,percent of total billed charges,81.4% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,43.94,75,,,percent of total billed charges,75% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,54.49,
protamine 10 mg/mL injectable solution,PRO1003180,CDM,250,RC,J2720,HCPCS,outpatient,,,58.59,43.94,,52.73,90,,,percent of total billed charges,90% of total billed charges,54.49,93,,,percent of total billed charges,93% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,47.69,81.4,,,percent of total billed charges,81.4% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,43.94,75,,,percent of total billed charges,75% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,54.49,
promethazine 25 mg oral tablet,PRO1003235,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
promethazine 25 mg rectal suppository,PRO1003236,CDM,637,RC,A9270,HCPCS,outpatient,,,23.38,17.54,,21.04,90,,,percent of total billed charges,90% of total billed charges,21.74,93,,,percent of total billed charges,93% of total billed charges,8.88,38,,,percent of total billed charges,38% of total billed charges,8.88,38,,,percent of total billed charges,38% of total billed charges,19.87,85,,,percent of total billed charges,85% of total billed charges,8.88,38,,,percent of total billed charges,38% of total billed charges,19.03,81.4,,,percent of total billed charges,81.4% of total billed charges,21.04,90,,,percent of total billed charges,90% of total billed charges,21.04,90,,,percent of total billed charges,90% of total billed charges,8.88,38,,,percent of total billed charges,38% of total billed charges,8.88,38,,,percent of total billed charges,38% of total billed charges,8.88,38,,,percent of total billed charges,38% of total billed charges,17.54,75,,,percent of total billed charges,75% of total billed charges,19.87,85,,,percent of total billed charges,85% of total billed charges,8.88,21.74,
promethazine 25 mg/mL injectable solution,PRO1003238,CDM,636,RC,J2550,HCPCS,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
promethazine 25 mg/mL injectable solution,PRO1003238,CDM,250,RC,J2550,HCPCS,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
propofol 10 mg/mL intravenous emulsion,PRO1003249,CDM,636,RC,J3490,HCPCS,outpatient,,,22.74,17.06,,20.47,90,,,percent of total billed charges,90% of total billed charges,21.15,93,,,percent of total billed charges,93% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,18.51,81.4,,,percent of total billed charges,81.4% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,17.06,75,,,percent of total billed charges,75% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,21.15,
propofol 10 mg/mL intravenous emulsion,PRO1003249,CDM,250,RC,J3490,HCPCS,outpatient,,,22.74,17.06,,20.47,90,,,percent of total billed charges,90% of total billed charges,21.15,93,,,percent of total billed charges,93% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,18.51,81.4,,,percent of total billed charges,81.4% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,20.47,90,,,percent of total billed charges,90% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,8.64,38,,,percent of total billed charges,38% of total billed charges,17.06,75,,,percent of total billed charges,75% of total billed charges,19.33,85,,,percent of total billed charges,85% of total billed charges,8.64,21.15,
Pantoprazole (Protonix) 40 mg oral delayed release tablet,PRO1003406,CDM,637,RC,A9270,HCPCS,outpatient,,,1.15,0.86,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.07,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.98,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.86,75,,,percent of total billed charges,75% of total billed charges,0.98,85,,,percent of total billed charges,85% of total billed charges,0.44,1.07,
Pantoprazole (Protonix) IV 40 mg intravenous injection,PRO1003407,CDM,636,RC,S0164,HCPCS,outpatient,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
Pantoprazole (Protonix) IV 40 mg intravenous injection,PRO1003407,CDM,250,RC,S0164,HCPCS,outpatient,,,32.8,24.6,,29.52,90,,,percent of total billed charges,90% of total billed charges,30.5,93,,,percent of total billed charges,93% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,26.7,81.4,,,percent of total billed charges,81.4% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,12.46,38,,,percent of total billed charges,38% of total billed charges,24.6,75,,,percent of total billed charges,75% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,12.46,30.5,
Prolia 60 mg/mL subcutaneous solution,PRO18486,CDM,636,RC,j0897,HCPCS,outpatient,,,2120.34,1590.26,,1908.31,90,,,percent of total billed charges,90% of total billed charges,1971.92,93,,,percent of total billed charges,93% of total billed charges,805.73,38,,,percent of total billed charges,38% of total billed charges,805.73,38,,,percent of total billed charges,38% of total billed charges,1802.29,85,,,percent of total billed charges,85% of total billed charges,805.73,38,,,percent of total billed charges,38% of total billed charges,1725.96,81.4,,,percent of total billed charges,81.4% of total billed charges,1908.31,90,,,percent of total billed charges,90% of total billed charges,1908.31,90,,,percent of total billed charges,90% of total billed charges,805.73,38,,,percent of total billed charges,38% of total billed charges,805.73,38,,,percent of total billed charges,38% of total billed charges,805.73,38,,,percent of total billed charges,38% of total billed charges,1590.26,75,,,percent of total billed charges,75% of total billed charges,1802.29,85,,,percent of total billed charges,85% of total billed charges,805.73,1971.92,
proparacaine 0.5% ophthalmic solution,PRO6360,CDM,259,RC,,,outpatient,,,58.59,43.94,,52.73,90,,,percent of total billed charges,90% of total billed charges,54.49,93,,,percent of total billed charges,93% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,47.69,81.4,,,percent of total billed charges,81.4% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,43.94,75,,,percent of total billed charges,75% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,54.49,
propofol 1000mg/100mL drip,prop100,CDM,636,RC,J2704,HCPCS,outpatient,,,33.78,25.34,,30.4,90,,,percent of total billed charges,90% of total billed charges,31.42,93,,,percent of total billed charges,93% of total billed charges,12.84,38,,,percent of total billed charges,38% of total billed charges,12.84,38,,,percent of total billed charges,38% of total billed charges,28.71,85,,,percent of total billed charges,85% of total billed charges,12.84,38,,,percent of total billed charges,38% of total billed charges,27.5,81.4,,,percent of total billed charges,81.4% of total billed charges,30.4,90,,,percent of total billed charges,90% of total billed charges,30.4,90,,,percent of total billed charges,90% of total billed charges,12.84,38,,,percent of total billed charges,38% of total billed charges,12.84,38,,,percent of total billed charges,38% of total billed charges,12.84,38,,,percent of total billed charges,38% of total billed charges,25.34,75,,,percent of total billed charges,75% of total billed charges,28.71,85,,,percent of total billed charges,85% of total billed charges,12.84,31.42,
Budesonide 0.5 mg/2 mL inhalation suspension,PUL1003389,CDM,250,RC,,,outpatient,,,24.6,18.45,,22.14,90,,,percent of total billed charges,90% of total billed charges,22.88,93,,,percent of total billed charges,93% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,20.02,81.4,,,percent of total billed charges,81.4% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,9.35,38,,,percent of total billed charges,38% of total billed charges,18.45,75,,,percent of total billed charges,75% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,9.35,22.88,
QUEtiapine (SEROquel) 100 mg oral tablet,QUE14661,CDM,637,RC,,,outpatient,,,3.3,2.48,,2.97,90,,,percent of total billed charges,90% of total billed charges,3.07,93,,,percent of total billed charges,93% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,2.81,85,,,percent of total billed charges,85% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,2.69,81.4,,,percent of total billed charges,81.4% of total billed charges,2.97,90,,,percent of total billed charges,90% of total billed charges,2.97,90,,,percent of total billed charges,90% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,1.25,38,,,percent of total billed charges,38% of total billed charges,2.48,75,,,percent of total billed charges,75% of total billed charges,2.81,85,,,percent of total billed charges,85% of total billed charges,1.25,3.07,
zoledronic acid (Reclast) 5 mg/100 mL intravenous solution,REC15835,CDM,636,RC,j3489,HCPCS,outpatient,,,351.04,263.28,,315.94,90,,,percent of total billed charges,90% of total billed charges,326.47,93,,,percent of total billed charges,93% of total billed charges,133.4,38,,,percent of total billed charges,38% of total billed charges,133.4,38,,,percent of total billed charges,38% of total billed charges,298.38,85,,,percent of total billed charges,85% of total billed charges,133.4,38,,,percent of total billed charges,38% of total billed charges,285.75,81.4,,,percent of total billed charges,81.4% of total billed charges,315.94,90,,,percent of total billed charges,90% of total billed charges,315.94,90,,,percent of total billed charges,90% of total billed charges,133.4,38,,,percent of total billed charges,38% of total billed charges,133.4,38,,,percent of total billed charges,38% of total billed charges,133.4,38,,,percent of total billed charges,38% of total billed charges,263.28,75,,,percent of total billed charges,75% of total billed charges,298.38,85,,,percent of total billed charges,85% of total billed charges,133.4,326.47,
Remdesivir 100mg IV,rem100,CDM,636,RC,J0248,HCPCS,outpatient,,,692.76,519.57,,623.48,90,,,percent of total billed charges,90% of total billed charges,644.27,93,,,percent of total billed charges,93% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,588.85,85,,,percent of total billed charges,85% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,563.91,81.4,,,percent of total billed charges,81.4% of total billed charges,623.48,90,,,percent of total billed charges,90% of total billed charges,623.48,90,,,percent of total billed charges,90% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,519.57,75,,,percent of total billed charges,75% of total billed charges,588.85,85,,,percent of total billed charges,85% of total billed charges,263.25,644.27,
Remdesivir 100mg IV,rem100,CDM,250,RC,J0248,HCPCS,outpatient,,,692.76,519.57,,623.48,90,,,percent of total billed charges,90% of total billed charges,644.27,93,,,percent of total billed charges,93% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,588.85,85,,,percent of total billed charges,85% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,563.91,81.4,,,percent of total billed charges,81.4% of total billed charges,623.48,90,,,percent of total billed charges,90% of total billed charges,623.48,90,,,percent of total billed charges,90% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,263.25,38,,,percent of total billed charges,38% of total billed charges,519.57,75,,,percent of total billed charges,75% of total billed charges,588.85,85,,,percent of total billed charges,85% of total billed charges,263.25,644.27,
Mirtazapine 15 mg oral tablet,REM1003363,CDM,637,RC,A9270,HCPCS,outpatient,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
Temazepam 15 mg oral capsule,RES1003185,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
RisperiDONE (RisperDAL) 1 mg oral tablet,RIS1003303,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Rocuronium 100mg/10mL intravenous solution,roc100,CDM,636,RC,,,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
ropivacaine 0.2% injectable solution,ROP13885,CDM,636,RC,J2795,HCPCS,outpatient,,,23.65,17.74,,21.29,90,,,percent of total billed charges,90% of total billed charges,21.99,93,,,percent of total billed charges,93% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,19.25,81.4,,,percent of total billed charges,81.4% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,21.29,90,,,percent of total billed charges,90% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,8.99,38,,,percent of total billed charges,38% of total billed charges,17.74,75,,,percent of total billed charges,75% of total billed charges,20.1,85,,,percent of total billed charges,85% of total billed charges,8.99,21.99,
ropivacaine 0.5% injectable solution,ROP13886,CDM,636,RC,,,outpatient,,,24.12,18.09,,21.71,90,,,percent of total billed charges,90% of total billed charges,22.43,93,,,percent of total billed charges,93% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,19.63,81.4,,,percent of total billed charges,81.4% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,21.71,90,,,percent of total billed charges,90% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,9.17,38,,,percent of total billed charges,38% of total billed charges,18.09,75,,,percent of total billed charges,75% of total billed charges,20.5,85,,,percent of total billed charges,85% of total billed charges,9.17,22.43,
Morphine 10 mg/0.5 mL oral concentrate,ROX1003156,CDM,637,RC,A9270,HCPCS,outpatient,,,2.28,1.71,,2.05,90,,,percent of total billed charges,90% of total billed charges,2.12,93,,,percent of total billed charges,93% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.86,81.4,,,percent of total billed charges,81.4% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,2.05,90,,,percent of total billed charges,90% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,0.87,38,,,percent of total billed charges,38% of total billed charges,1.71,75,,,percent of total billed charges,75% of total billed charges,1.94,85,,,percent of total billed charges,85% of total billed charges,0.87,2.12,
saliva substitutes oral lozenge,SAL9357,CDM,250,RC,,,outpatient,,,0.26,0.2,,0.23,90,,,percent of total billed charges,90% of total billed charges,0.24,93,,,percent of total billed charges,93% of total billed charges,0.1,38,,,percent of total billed charges,38% of total billed charges,0.1,38,,,percent of total billed charges,38% of total billed charges,0.22,85,,,percent of total billed charges,85% of total billed charges,0.1,38,,,percent of total billed charges,38% of total billed charges,0.21,81.4,,,percent of total billed charges,81.4% of total billed charges,0.23,90,,,percent of total billed charges,90% of total billed charges,0.23,90,,,percent of total billed charges,90% of total billed charges,0.1,38,,,percent of total billed charges,38% of total billed charges,0.1,38,,,percent of total billed charges,38% of total billed charges,0.1,38,,,percent of total billed charges,38% of total billed charges,0.2,75,,,percent of total billed charges,75% of total billed charges,0.22,85,,,percent of total billed charges,85% of total billed charges,0.1,0.24,
senna 8.6 mg oral tablet,SEN1003253,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Senna-Docusate 8.6 mg-50 mg oral tablet,SEN11386,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
QUEtiapine (SEROquel) 25 mg oral tablet,SER1003385,CDM,637,RC,A9270,HCPCS,outpatient,,,7.03,5.27,,6.33,90,,,percent of total billed charges,90% of total billed charges,6.54,93,,,percent of total billed charges,93% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.72,81.4,,,percent of total billed charges,81.4% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,6.33,90,,,percent of total billed charges,90% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,2.67,38,,,percent of total billed charges,38% of total billed charges,5.27,75,,,percent of total billed charges,75% of total billed charges,5.98,85,,,percent of total billed charges,85% of total billed charges,2.67,6.54,
sertraline 100 mg oral tablet,SER5403,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
silver nitrate topical stick,SIL1003384,CDM,250,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Silver Sulfadiazine 1% cream 25 gram tube,SIL25G,CDM,637,RC,A9270,HCPCS,outpatient,,,11.72,8.79,,10.55,90,,,percent of total billed charges,90% of total billed charges,10.9,93,,,percent of total billed charges,93% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,9.54,81.4,,,percent of total billed charges,81.4% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,10.55,90,,,percent of total billed charges,90% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,4.45,38,,,percent of total billed charges,38% of total billed charges,8.79,75,,,percent of total billed charges,75% of total billed charges,9.96,85,,,percent of total billed charges,85% of total billed charges,4.45,10.9,
simethicone 40 mg/0.6 mL oral liquid,SIM1003261,CDM,637,RC,A9270,HCPCS,outpatient,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
"simethicone 125 mg oral tablet, chewable",SIM6031,CDM,250,RC,,,outpatient,,,0.06,0.05,,0.05,90,,,percent of total billed charges,90% of total billed charges,0.06,93,,,percent of total billed charges,93% of total billed charges,0.02,38,,,percent of total billed charges,38% of total billed charges,0.02,38,,,percent of total billed charges,38% of total billed charges,0.05,85,,,percent of total billed charges,85% of total billed charges,0.02,38,,,percent of total billed charges,38% of total billed charges,0.05,81.4,,,percent of total billed charges,81.4% of total billed charges,0.05,90,,,percent of total billed charges,90% of total billed charges,0.05,90,,,percent of total billed charges,90% of total billed charges,0.02,38,,,percent of total billed charges,38% of total billed charges,0.02,38,,,percent of total billed charges,38% of total billed charges,0.02,38,,,percent of total billed charges,38% of total billed charges,0.05,75,,,percent of total billed charges,75% of total billed charges,0.05,85,,,percent of total billed charges,85% of total billed charges,0.02,0.06,
Carbidopa-Levodopa 25 mg-100 mg oral tablet,SIN1003321,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Carbidopa-levodopa 25 mg-250 mg oral tablet,SIN1003322,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Montelukast 10 mg oral tablet,SIN1003391,CDM,637,RC,A9270,HCPCS,outpatient,,,7.47,5.6,,6.72,90,,,percent of total billed charges,90% of total billed charges,6.95,93,,,percent of total billed charges,93% of total billed charges,2.84,38,,,percent of total billed charges,38% of total billed charges,2.84,38,,,percent of total billed charges,38% of total billed charges,6.35,85,,,percent of total billed charges,85% of total billed charges,2.84,38,,,percent of total billed charges,38% of total billed charges,6.08,81.4,,,percent of total billed charges,81.4% of total billed charges,6.72,90,,,percent of total billed charges,90% of total billed charges,6.72,90,,,percent of total billed charges,90% of total billed charges,2.84,38,,,percent of total billed charges,38% of total billed charges,2.84,38,,,percent of total billed charges,38% of total billed charges,2.84,38,,,percent of total billed charges,38% of total billed charges,5.6,75,,,percent of total billed charges,75% of total billed charges,6.35,85,,,percent of total billed charges,85% of total billed charges,2.84,6.95,
sodium chloride 0.9% inhalation solution,SOD1003197,CDM,250,RC,,,outpatient,,,10.54,7.91,,9.49,90,,,percent of total billed charges,90% of total billed charges,9.8,93,,,percent of total billed charges,93% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.58,81.4,,,percent of total billed charges,81.4% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,7.91,75,,,percent of total billed charges,75% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,9.8,
sodium chloride 0.9% (5mL flush),SOD1003198,CDM,250,RC,,,outpatient,,,10.54,7.91,,9.49,90,,,percent of total billed charges,90% of total billed charges,9.8,93,,,percent of total billed charges,93% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.58,81.4,,,percent of total billed charges,81.4% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,7.91,75,,,percent of total billed charges,75% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,9.8,
sodium chloride bacteriostatic 0.9% injectable solution,SOD1003199,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
sodium bicarbonate 8.4% intravenous solution,SOD1003202,CDM,636,RC,J3490,HCPCS,outpatient,,,45.7,34.28,,41.13,90,,,percent of total billed charges,90% of total billed charges,42.5,93,,,percent of total billed charges,93% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,37.2,81.4,,,percent of total billed charges,81.4% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,34.28,75,,,percent of total billed charges,75% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,42.5,
sodium bicarbonate 8.4% intravenous solution,SOD1003202,CDM,250,RC,J3490,HCPCS,outpatient,,,45.7,34.28,,41.13,90,,,percent of total billed charges,90% of total billed charges,42.5,93,,,percent of total billed charges,93% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,37.2,81.4,,,percent of total billed charges,81.4% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,41.13,90,,,percent of total billed charges,90% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,17.37,38,,,percent of total billed charges,38% of total billed charges,34.28,75,,,percent of total billed charges,75% of total billed charges,38.85,85,,,percent of total billed charges,85% of total billed charges,17.37,42.5,
sodium chloride 0.65% nasal spray,SOD1003386,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Sodium Bicarbonate 1mEq/mL (50mL vial),SOD1234,CDM,260,RC,,,outpatient,,,12.88,9.66,,11.59,90,,,percent of total billed charges,90% of total billed charges,11.98,93,,,percent of total billed charges,93% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,10.95,85,,,percent of total billed charges,85% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,10.48,81.4,,,percent of total billed charges,81.4% of total billed charges,11.59,90,,,percent of total billed charges,90% of total billed charges,11.59,90,,,percent of total billed charges,90% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,9.66,75,,,percent of total billed charges,75% of total billed charges,10.95,85,,,percent of total billed charges,85% of total billed charges,4.89,11.98,
"Sodium Chloride, Injectable 0.9% 10 mL flush",SOD3737,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
sodium bicarbonate 650 mg oral tablet,SOD3748,CDM,637,RC,,,outpatient,,,1.08,0.81,,0.97,90,,,percent of total billed charges,90% of total billed charges,1,93,,,percent of total billed charges,93% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.92,85,,,percent of total billed charges,85% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.88,81.4,,,percent of total billed charges,81.4% of total billed charges,0.97,90,,,percent of total billed charges,90% of total billed charges,0.97,90,,,percent of total billed charges,90% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.41,38,,,percent of total billed charges,38% of total billed charges,0.81,75,,,percent of total billed charges,75% of total billed charges,0.92,85,,,percent of total billed charges,85% of total billed charges,0.41,1,
sodium polystyrene sulfonate 15 g/60 mL oral suspension,SOD4783,CDM,250,RC,,,outpatient,,,14.94,11.21,,13.45,90,,,percent of total billed charges,90% of total billed charges,13.89,93,,,percent of total billed charges,93% of total billed charges,5.68,38,,,percent of total billed charges,38% of total billed charges,5.68,38,,,percent of total billed charges,38% of total billed charges,12.7,85,,,percent of total billed charges,85% of total billed charges,5.68,38,,,percent of total billed charges,38% of total billed charges,12.16,81.4,,,percent of total billed charges,81.4% of total billed charges,13.45,90,,,percent of total billed charges,90% of total billed charges,13.45,90,,,percent of total billed charges,90% of total billed charges,5.68,38,,,percent of total billed charges,38% of total billed charges,5.68,38,,,percent of total billed charges,38% of total billed charges,5.68,38,,,percent of total billed charges,38% of total billed charges,11.21,75,,,percent of total billed charges,75% of total billed charges,12.7,85,,,percent of total billed charges,85% of total billed charges,5.68,13.89,
Sodium Phosphate (Fleet) Enema 7 g-19 g rectal enema,SodiumFLE1003382,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Solu-CORTEF 100 mg injection,SOL1003135,CDM,636,RC,J1720,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Solu-CORTEF 100 mg injection,SOL1003135,CDM,250,RC,J1720,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
MethylPREDNISolone (Solu-MEDROL) 1 g injection,SOL1003149,CDM,636,RC,J2930,HCPCS,outpatient,,,46.4,34.8,,41.76,90,,,percent of total billed charges,90% of total billed charges,43.15,93,,,percent of total billed charges,93% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,39.44,85,,,percent of total billed charges,85% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,37.77,81.4,,,percent of total billed charges,81.4% of total billed charges,41.76,90,,,percent of total billed charges,90% of total billed charges,41.76,90,,,percent of total billed charges,90% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,34.8,75,,,percent of total billed charges,75% of total billed charges,39.44,85,,,percent of total billed charges,85% of total billed charges,17.63,43.15,
MethylPREDNISolone (Solu-MEDROL) 1 g injection,SOL1003149,CDM,250,RC,J2930,HCPCS,outpatient,,,46.4,34.8,,41.76,90,,,percent of total billed charges,90% of total billed charges,43.15,93,,,percent of total billed charges,93% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,39.44,85,,,percent of total billed charges,85% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,37.77,81.4,,,percent of total billed charges,81.4% of total billed charges,41.76,90,,,percent of total billed charges,90% of total billed charges,41.76,90,,,percent of total billed charges,90% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,17.63,38,,,percent of total billed charges,38% of total billed charges,34.8,75,,,percent of total billed charges,75% of total billed charges,39.44,85,,,percent of total billed charges,85% of total billed charges,17.63,43.15,
SOLU-Medrol 125 mg injection,SOL1003150,CDM,636,RC,J2930,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
SOLU-Medrol 125 mg injection,SOL1003150,CDM,250,RC,J2930,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
MethylPREDNISolone(Solu-MEDROL) 40 mg preservative-free injection,SOL2760,CDM,636,RC,J2920,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
Spiriva (tiotropium) 18 mcg inhalation capsule,SPI16352,CDM,250,RC,A9270,HCPCS,outpatient,,,351.54,263.66,,316.39,90,,,percent of total billed charges,90% of total billed charges,326.93,93,,,percent of total billed charges,93% of total billed charges,133.59,38,,,percent of total billed charges,38% of total billed charges,133.59,38,,,percent of total billed charges,38% of total billed charges,298.81,85,,,percent of total billed charges,85% of total billed charges,133.59,38,,,percent of total billed charges,38% of total billed charges,286.15,81.4,,,percent of total billed charges,81.4% of total billed charges,316.39,90,,,percent of total billed charges,90% of total billed charges,316.39,90,,,percent of total billed charges,90% of total billed charges,133.59,38,,,percent of total billed charges,38% of total billed charges,133.59,38,,,percent of total billed charges,38% of total billed charges,133.59,38,,,percent of total billed charges,38% of total billed charges,263.66,75,,,percent of total billed charges,75% of total billed charges,298.81,85,,,percent of total billed charges,85% of total billed charges,133.59,326.93,
Butorphanol (Stadol) 2 mg/mL injectable solution,STA1003240,CDM,636,RC,J0595,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
Butorphanol (Stadol) 2 mg/mL injectable solution,STA1003240,CDM,250,RC,J0595,HCPCS,outpatient,,,78.51,58.88,,70.66,90,,,percent of total billed charges,90% of total billed charges,73.01,93,,,percent of total billed charges,93% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,63.91,81.4,,,percent of total billed charges,81.4% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,70.66,90,,,percent of total billed charges,90% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,29.83,38,,,percent of total billed charges,38% of total billed charges,58.88,75,,,percent of total billed charges,75% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,29.83,73.01,
sterile water injectable solution,STE1003361,CDM,250,RC,,,outpatient,,,10.54,7.91,,9.49,90,,,percent of total billed charges,90% of total billed charges,9.8,93,,,percent of total billed charges,93% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,8.58,81.4,,,percent of total billed charges,81.4% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,9.49,90,,,percent of total billed charges,90% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,4.01,38,,,percent of total billed charges,38% of total billed charges,7.91,75,,,percent of total billed charges,75% of total billed charges,8.96,85,,,percent of total billed charges,85% of total billed charges,4.01,9.8,
Succinylcholine Chloride 20 mg/mL injectable solution,SUC1003183,CDM,636,RC,J0330,HCPCS,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
Succinylcholine Chloride 20 mg/mL injectable solution,SUC1003183,CDM,250,RC,J0330,HCPCS,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
sulfamethoxazole-trimethoprim 400 mg-80 mg/10 mL oral suspension,SUL1003077,CDM,637,RC,A9270,HCPCS,outpatient,,,6.09,4.57,,5.48,90,,,percent of total billed charges,90% of total billed charges,5.66,93,,,percent of total billed charges,93% of total billed charges,2.31,38,,,percent of total billed charges,38% of total billed charges,2.31,38,,,percent of total billed charges,38% of total billed charges,5.18,85,,,percent of total billed charges,85% of total billed charges,2.31,38,,,percent of total billed charges,38% of total billed charges,4.96,81.4,,,percent of total billed charges,81.4% of total billed charges,5.48,90,,,percent of total billed charges,90% of total billed charges,5.48,90,,,percent of total billed charges,90% of total billed charges,2.31,38,,,percent of total billed charges,38% of total billed charges,2.31,38,,,percent of total billed charges,38% of total billed charges,2.31,38,,,percent of total billed charges,38% of total billed charges,4.57,75,,,percent of total billed charges,75% of total billed charges,5.18,85,,,percent of total billed charges,85% of total billed charges,2.31,5.66,
sulfacetamide sodium 10% ophthalmic solution,SUL6344,CDM,250,RC,,,outpatient,,,81.2,60.9,,73.08,90,,,percent of total billed charges,90% of total billed charges,75.52,93,,,percent of total billed charges,93% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,66.1,81.4,,,percent of total billed charges,81.4% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,30.86,38,,,percent of total billed charges,38% of total billed charges,60.9,75,,,percent of total billed charges,75% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,30.86,75.52,
Supartz FX 10 mg/mL intra-articular solution,SUP22026,CDM,636,RC,J7321,HCPCS,outpatient,,,313.91,235.43,,282.52,90,,,percent of total billed charges,90% of total billed charges,291.94,93,,,percent of total billed charges,93% of total billed charges,119.29,38,,,percent of total billed charges,38% of total billed charges,119.29,38,,,percent of total billed charges,38% of total billed charges,266.82,85,,,percent of total billed charges,85% of total billed charges,119.29,38,,,percent of total billed charges,38% of total billed charges,255.52,81.4,,,percent of total billed charges,81.4% of total billed charges,282.52,90,,,percent of total billed charges,90% of total billed charges,282.52,90,,,percent of total billed charges,90% of total billed charges,119.29,38,,,percent of total billed charges,38% of total billed charges,119.29,38,,,percent of total billed charges,38% of total billed charges,119.29,38,,,percent of total billed charges,38% of total billed charges,235.43,75,,,percent of total billed charges,75% of total billed charges,266.82,85,,,percent of total billed charges,85% of total billed charges,119.29,291.94,
Levothyroxine 100 mcg (0.1 mg) oral tablet,SYN1003142,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Levothyroxine 50 mcg (0.05 mg) oral tablet,SYN1003143,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Levothyroxine 75 mcg (0.075 mg) oral tablet,SYN1003144,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Levothyroxine 112 mcg (0.112 mg) oral tablet,SYN3142013,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Levothyroxine 88 mcg (0.088 mg) oral tablet,SYN31420131,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Oseltamivir (Tamiflu) 6 mg/mL oral suspension,TAM1003404,CDM,637,RC,A9270,HCPCS,outpatient,,,24.41,18.31,,21.97,90,,,percent of total billed charges,90% of total billed charges,22.7,93,,,percent of total billed charges,93% of total billed charges,9.28,38,,,percent of total billed charges,38% of total billed charges,9.28,38,,,percent of total billed charges,38% of total billed charges,20.75,85,,,percent of total billed charges,85% of total billed charges,9.28,38,,,percent of total billed charges,38% of total billed charges,19.87,81.4,,,percent of total billed charges,81.4% of total billed charges,21.97,90,,,percent of total billed charges,90% of total billed charges,21.97,90,,,percent of total billed charges,90% of total billed charges,9.28,38,,,percent of total billed charges,38% of total billed charges,9.28,38,,,percent of total billed charges,38% of total billed charges,9.28,38,,,percent of total billed charges,38% of total billed charges,18.31,75,,,percent of total billed charges,75% of total billed charges,20.75,85,,,percent of total billed charges,85% of total billed charges,9.28,22.7,
Oseltamivir (Tamiflu) 30 mg oral capsule,TAM1003405,CDM,637,RC,A9270,HCPCS,outpatient,,,12.88,9.66,,11.59,90,,,percent of total billed charges,90% of total billed charges,11.98,93,,,percent of total billed charges,93% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,10.95,85,,,percent of total billed charges,85% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,10.48,81.4,,,percent of total billed charges,81.4% of total billed charges,11.59,90,,,percent of total billed charges,90% of total billed charges,11.59,90,,,percent of total billed charges,90% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,4.89,38,,,percent of total billed charges,38% of total billed charges,9.66,75,,,percent of total billed charges,75% of total billed charges,10.95,85,,,percent of total billed charges,85% of total billed charges,4.89,11.98,
Oseltamivir (Tamiflu) 75 mg oral capsule,TAM15563,CDM,637,RC,,,outpatient,,,17.57,13.18,,15.81,90,,,percent of total billed charges,90% of total billed charges,16.34,93,,,percent of total billed charges,93% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,14.3,81.4,,,percent of total billed charges,81.4% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,15.81,90,,,percent of total billed charges,90% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,6.68,38,,,percent of total billed charges,38% of total billed charges,13.18,75,,,percent of total billed charges,75% of total billed charges,14.93,85,,,percent of total billed charges,85% of total billed charges,6.68,16.34,
carBAMazepine 100 mg chewable oral tablet,TEG938,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
tetracaine 0.5% ophthalmic solution,TET1003360,CDM,250,RC,,,outpatient,,,25.8,19.35,,23.22,90,,,percent of total billed charges,90% of total billed charges,23.99,93,,,percent of total billed charges,93% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,21,81.4,,,percent of total billed charges,81.4% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,23.22,90,,,percent of total billed charges,90% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,9.8,38,,,percent of total billed charges,38% of total billed charges,19.35,75,,,percent of total billed charges,75% of total billed charges,21.93,85,,,percent of total billed charges,85% of total billed charges,9.8,23.99,
tetanus-diphtheria toxoids (Td) adult/adolescent 5 units-2units/0.5 mL intramuscular suspension,TET1003423,CDM,636,RC,90714,HCPCS,outpatient,,,66.79,50.09,,60.11,90,,,percent of total billed charges,90% of total billed charges,62.11,93,,,percent of total billed charges,93% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,54.37,81.4,,,percent of total billed charges,81.4% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,60.11,90,,,percent of total billed charges,90% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,25.38,38,,,percent of total billed charges,38% of total billed charges,50.09,75,,,percent of total billed charges,75% of total billed charges,56.77,85,,,percent of total billed charges,85% of total billed charges,25.38,62.11,
thiamine 100 mg/mL injectable solution,THI1003291,CDM,636,RC,J3411,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
thiamine 100 mg/mL injectable solution,THI1003291,CDM,250,RC,J3411,HCPCS,outpatient,,,24.36,18.27,,21.92,90,,,percent of total billed charges,90% of total billed charges,22.65,93,,,percent of total billed charges,93% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,19.83,81.4,,,percent of total billed charges,81.4% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,21.92,90,,,percent of total billed charges,90% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,9.26,38,,,percent of total billed charges,38% of total billed charges,18.27,75,,,percent of total billed charges,75% of total billed charges,20.71,85,,,percent of total billed charges,85% of total billed charges,9.26,22.65,
thiamine 100 mg oral tablet,THI7869,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
tiZANidine 4 mg oral tablet,TIZ14059,CDM,250,RC,,,outpatient,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
tobramycin 40 mg/mL injectable solution,TOB1003049,CDM,636,RC,J3260,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
tobramycin 40 mg/mL injectable solution,TOB1003049,CDM,250,RC,J3260,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
"Metoprolol succinate (Toprol-XL) 50 mg oral tablet, extended release",TOP1493,CDM,637,RC,,,outpatient,,,15.76,11.82,,14.18,90,,,percent of total billed charges,90% of total billed charges,14.66,93,,,percent of total billed charges,93% of total billed charges,5.99,38,,,percent of total billed charges,38% of total billed charges,5.99,38,,,percent of total billed charges,38% of total billed charges,13.4,85,,,percent of total billed charges,85% of total billed charges,5.99,38,,,percent of total billed charges,38% of total billed charges,12.83,81.4,,,percent of total billed charges,81.4% of total billed charges,14.18,90,,,percent of total billed charges,90% of total billed charges,14.18,90,,,percent of total billed charges,90% of total billed charges,5.99,38,,,percent of total billed charges,38% of total billed charges,5.99,38,,,percent of total billed charges,38% of total billed charges,5.99,38,,,percent of total billed charges,38% of total billed charges,11.82,75,,,percent of total billed charges,75% of total billed charges,13.4,85,,,percent of total billed charges,85% of total billed charges,5.99,14.66,
"Metoprolol succinate (Toprol-XL) 25 mg oral tablet, extended release",TOP1500,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Ketorolac (toradol) 15mg injectable solution,tor15,CDM,636,RC,J1885,HCPCS,outpatient,,,22.29,16.72,,20.06,90,,,percent of total billed charges,90% of total billed charges,20.73,93,,,percent of total billed charges,93% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,18.14,81.4,,,percent of total billed charges,81.4% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,20.06,90,,,percent of total billed charges,90% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,8.47,38,,,percent of total billed charges,38% of total billed charges,16.72,75,,,percent of total billed charges,75% of total billed charges,18.95,85,,,percent of total billed charges,85% of total billed charges,8.47,20.73,
traZODone 50 mg oral tablet,TRA1003187,CDM,637,RC,A9270,HCPCS,outpatient,,,5.85,4.39,,5.27,90,,,percent of total billed charges,90% of total billed charges,5.44,93,,,percent of total billed charges,93% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.76,81.4,,,percent of total billed charges,81.4% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,5.27,90,,,percent of total billed charges,90% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,2.22,38,,,percent of total billed charges,38% of total billed charges,4.39,75,,,percent of total billed charges,75% of total billed charges,4.97,85,,,percent of total billed charges,85% of total billed charges,2.22,5.44,
tranexamic acid 100 mg/mL intravenous solution,TRA3885,CDM,636,RC,,,outpatient,,,75.8,56.85,,68.22,90,,,percent of total billed charges,90% of total billed charges,70.49,93,,,percent of total billed charges,93% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,64.43,85,,,percent of total billed charges,85% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,61.7,81.4,,,percent of total billed charges,81.4% of total billed charges,68.22,90,,,percent of total billed charges,90% of total billed charges,68.22,90,,,percent of total billed charges,90% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,28.8,38,,,percent of total billed charges,38% of total billed charges,56.85,75,,,percent of total billed charges,75% of total billed charges,64.43,85,,,percent of total billed charges,85% of total billed charges,28.8,70.49,
tranexamic acid 650 mg oral tablet,TRA3887,CDM,637,RC,,,outpatient,,,6.89,5.17,,6.2,90,,,percent of total billed charges,90% of total billed charges,6.41,93,,,percent of total billed charges,93% of total billed charges,2.62,38,,,percent of total billed charges,38% of total billed charges,2.62,38,,,percent of total billed charges,38% of total billed charges,5.86,85,,,percent of total billed charges,85% of total billed charges,2.62,38,,,percent of total billed charges,38% of total billed charges,5.61,81.4,,,percent of total billed charges,81.4% of total billed charges,6.2,90,,,percent of total billed charges,90% of total billed charges,6.2,90,,,percent of total billed charges,90% of total billed charges,2.62,38,,,percent of total billed charges,38% of total billed charges,2.62,38,,,percent of total billed charges,38% of total billed charges,2.62,38,,,percent of total billed charges,38% of total billed charges,5.17,75,,,percent of total billed charges,75% of total billed charges,5.86,85,,,percent of total billed charges,85% of total billed charges,2.62,6.41,
Tranexamic acid 1000mg/100mL,TRA3888,CDM,250,RC,,,outpatient,,,29.56,22.17,,26.6,90,,,percent of total billed charges,90% of total billed charges,27.49,93,,,percent of total billed charges,93% of total billed charges,11.23,38,,,percent of total billed charges,38% of total billed charges,11.23,38,,,percent of total billed charges,38% of total billed charges,25.13,85,,,percent of total billed charges,85% of total billed charges,11.23,38,,,percent of total billed charges,38% of total billed charges,24.06,81.4,,,percent of total billed charges,81.4% of total billed charges,26.6,90,,,percent of total billed charges,90% of total billed charges,26.6,90,,,percent of total billed charges,90% of total billed charges,11.23,38,,,percent of total billed charges,38% of total billed charges,11.23,38,,,percent of total billed charges,38% of total billed charges,11.23,38,,,percent of total billed charges,38% of total billed charges,22.17,75,,,percent of total billed charges,75% of total billed charges,25.13,85,,,percent of total billed charges,85% of total billed charges,11.23,27.49,
"Scopolamine 1.5 mg transdermal film, extended release",TRA5674,CDM,250,RC,,,outpatient,,,34.46,25.85,,31.01,90,,,percent of total billed charges,90% of total billed charges,32.05,93,,,percent of total billed charges,93% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,29.29,85,,,percent of total billed charges,85% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,28.05,81.4,,,percent of total billed charges,81.4% of total billed charges,31.01,90,,,percent of total billed charges,90% of total billed charges,31.01,90,,,percent of total billed charges,90% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,25.85,75,,,percent of total billed charges,75% of total billed charges,29.29,85,,,percent of total billed charges,85% of total billed charges,13.09,32.05,
"Scopolamine 1.5 mg transdermal film, extended release",TRA5674,CDM,637,RC,,,outpatient,,,34.46,25.85,,31.01,90,,,percent of total billed charges,90% of total billed charges,32.05,93,,,percent of total billed charges,93% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,29.29,85,,,percent of total billed charges,85% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,28.05,81.4,,,percent of total billed charges,81.4% of total billed charges,31.01,90,,,percent of total billed charges,90% of total billed charges,31.01,90,,,percent of total billed charges,90% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,13.09,38,,,percent of total billed charges,38% of total billed charges,25.85,75,,,percent of total billed charges,75% of total billed charges,29.29,85,,,percent of total billed charges,85% of total billed charges,13.09,32.05,
triamcinolone 0.1% topical cream,TRI1003310,CDM,637,RC,A9270,HCPCS,outpatient,,,11.6,8.7,,10.44,90,,,percent of total billed charges,90% of total billed charges,10.79,93,,,percent of total billed charges,93% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,9.86,85,,,percent of total billed charges,85% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,9.44,81.4,,,percent of total billed charges,81.4% of total billed charges,10.44,90,,,percent of total billed charges,90% of total billed charges,10.44,90,,,percent of total billed charges,90% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,4.41,38,,,percent of total billed charges,38% of total billed charges,8.7,75,,,percent of total billed charges,75% of total billed charges,9.86,85,,,percent of total billed charges,85% of total billed charges,4.41,10.79,
Triple Antibiotic topical ointment,TRI1003326,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
tropicamide 1% ophthalmic solution,TRO6330,CDM,250,RC,,,outpatient,,,49.81,37.36,,44.83,90,,,percent of total billed charges,90% of total billed charges,46.32,93,,,percent of total billed charges,93% of total billed charges,18.93,38,,,percent of total billed charges,38% of total billed charges,18.93,38,,,percent of total billed charges,38% of total billed charges,42.34,85,,,percent of total billed charges,85% of total billed charges,18.93,38,,,percent of total billed charges,38% of total billed charges,40.55,81.4,,,percent of total billed charges,81.4% of total billed charges,44.83,90,,,percent of total billed charges,90% of total billed charges,44.83,90,,,percent of total billed charges,90% of total billed charges,18.93,38,,,percent of total billed charges,38% of total billed charges,18.93,38,,,percent of total billed charges,38% of total billed charges,18.93,38,,,percent of total billed charges,38% of total billed charges,37.36,75,,,percent of total billed charges,75% of total billed charges,42.34,85,,,percent of total billed charges,85% of total billed charges,18.93,46.32,
z* Emtricitabine-tenofovir disoproxil (Truvada) 200 mg-300 mg oral tablet,TRU16996,CDM,250,RC,,,outpatient,,,22.97,17.23,,20.67,90,,,percent of total billed charges,90% of total billed charges,21.36,93,,,percent of total billed charges,93% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,19.52,85,,,percent of total billed charges,85% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,18.7,81.4,,,percent of total billed charges,81.4% of total billed charges,20.67,90,,,percent of total billed charges,90% of total billed charges,20.67,90,,,percent of total billed charges,90% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,8.73,38,,,percent of total billed charges,38% of total billed charges,17.23,75,,,percent of total billed charges,75% of total billed charges,19.52,85,,,percent of total billed charges,85% of total billed charges,8.73,21.36,
trypan blue 0.06% intraocular solution,TRY1003428,CDM,250,RC,,,outpatient,,,186.31,139.73,,167.68,90,,,percent of total billed charges,90% of total billed charges,173.27,93,,,percent of total billed charges,93% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,151.66,81.4,,,percent of total billed charges,81.4% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,167.68,90,,,percent of total billed charges,90% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,70.8,38,,,percent of total billed charges,38% of total billed charges,139.73,75,,,percent of total billed charges,75% of total billed charges,158.36,85,,,percent of total billed charges,85% of total billed charges,70.8,173.27,
"Tums 500 mg oral tablet, chewable",TUM3554,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Acetaminophen-Codeine #3 oral tablet,TYL1003316,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
traMADol 50 mg oral tablet,ULT1003349,CDM,637,RC,A9270,HCPCS,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Ultane P.E.N. inhalation liquid,ULT1003352,CDM,250,RC,,,outpatient,,,246.08,184.56,,221.47,90,,,percent of total billed charges,90% of total billed charges,228.85,93,,,percent of total billed charges,93% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,209.17,85,,,percent of total billed charges,85% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,200.31,81.4,,,percent of total billed charges,81.4% of total billed charges,221.47,90,,,percent of total billed charges,90% of total billed charges,221.47,90,,,percent of total billed charges,90% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,93.51,38,,,percent of total billed charges,38% of total billed charges,184.56,75,,,percent of total billed charges,75% of total billed charges,209.17,85,,,percent of total billed charges,85% of total billed charges,93.51,228.85,
Ampicillin-sulbactam 3g injection,UNA1003063,CDM,636,RC,J0295,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Ampicillin-sulbactam 3g injection,UNA1003063,CDM,250,RC,J0295,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Ampicillin-sulbactam 1.5 g injection,UNA1003064,CDM,636,RC,J0295,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
Ampicillin-sulbactam 1.5 g injection,UNA1003064,CDM,250,RC,J0295,HCPCS,outpatient,,,23.19,17.39,,20.87,90,,,percent of total billed charges,90% of total billed charges,21.57,93,,,percent of total billed charges,93% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,18.88,81.4,,,percent of total billed charges,81.4% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,20.87,90,,,percent of total billed charges,90% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,8.81,38,,,percent of total billed charges,38% of total billed charges,17.39,75,,,percent of total billed charges,75% of total billed charges,19.71,85,,,percent of total billed charges,85% of total billed charges,8.81,21.57,
valproic acid 250 mg oral capsule,VAL1137,CDM,250,RC,,,outpatient,,,2.12,1.59,,1.91,90,,,percent of total billed charges,90% of total billed charges,1.97,93,,,percent of total billed charges,93% of total billed charges,0.81,38,,,percent of total billed charges,38% of total billed charges,0.81,38,,,percent of total billed charges,38% of total billed charges,1.8,85,,,percent of total billed charges,85% of total billed charges,0.81,38,,,percent of total billed charges,38% of total billed charges,1.73,81.4,,,percent of total billed charges,81.4% of total billed charges,1.91,90,,,percent of total billed charges,90% of total billed charges,1.91,90,,,percent of total billed charges,90% of total billed charges,0.81,38,,,percent of total billed charges,38% of total billed charges,0.81,38,,,percent of total billed charges,38% of total billed charges,0.81,38,,,percent of total billed charges,38% of total billed charges,1.59,75,,,percent of total billed charges,75% of total billed charges,1.8,85,,,percent of total billed charges,85% of total billed charges,0.81,1.97,
valACYclovir 1 g oral tablet,VAL13120,CDM,250,RC,,,outpatient,,,14.54,10.91,,13.09,90,,,percent of total billed charges,90% of total billed charges,13.52,93,,,percent of total billed charges,93% of total billed charges,5.53,38,,,percent of total billed charges,38% of total billed charges,5.53,38,,,percent of total billed charges,38% of total billed charges,12.36,85,,,percent of total billed charges,85% of total billed charges,5.53,38,,,percent of total billed charges,38% of total billed charges,11.84,81.4,,,percent of total billed charges,81.4% of total billed charges,13.09,90,,,percent of total billed charges,90% of total billed charges,13.09,90,,,percent of total billed charges,90% of total billed charges,5.53,38,,,percent of total billed charges,38% of total billed charges,5.53,38,,,percent of total billed charges,38% of total billed charges,5.53,38,,,percent of total billed charges,38% of total billed charges,10.91,75,,,percent of total billed charges,75% of total billed charges,12.36,85,,,percent of total billed charges,85% of total billed charges,5.53,13.52,
vancomycin 125 mg oral capsule,VAN1003078,CDM,637,RC,A9270,HCPCS,outpatient,,,73.83,55.37,,66.45,90,,,percent of total billed charges,90% of total billed charges,68.66,93,,,percent of total billed charges,93% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,62.76,85,,,percent of total billed charges,85% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,60.1,81.4,,,percent of total billed charges,81.4% of total billed charges,66.45,90,,,percent of total billed charges,90% of total billed charges,66.45,90,,,percent of total billed charges,90% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,28.06,38,,,percent of total billed charges,38% of total billed charges,55.37,75,,,percent of total billed charges,75% of total billed charges,62.76,85,,,percent of total billed charges,85% of total billed charges,28.06,68.66,
vancomycin 1 g intravenous injection,VAN1003079,CDM,636,RC,J3370,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
vancomycin 1 g intravenous injection,VAN1003079,CDM,250,RC,J3370,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
vancomycin 500 mg intravenous injection,VAN1003080,CDM,636,RC,J3370,HCPCS,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
vancomycin 500 mg intravenous injection,VAN1003080,CDM,250,RC,J3370,HCPCS,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
vancomycin 750 mg intravenous injection,VAN1467,CDM,258,RC,J3370,HCPCS,outpatient,,,35.74,26.81,,32.17,90,,,percent of total billed charges,90% of total billed charges,33.24,93,,,percent of total billed charges,93% of total billed charges,13.58,38,,,percent of total billed charges,38% of total billed charges,13.58,38,,,percent of total billed charges,38% of total billed charges,30.38,85,,,percent of total billed charges,85% of total billed charges,13.58,38,,,percent of total billed charges,38% of total billed charges,29.09,81.4,,,percent of total billed charges,81.4% of total billed charges,32.17,90,,,percent of total billed charges,90% of total billed charges,32.17,90,,,percent of total billed charges,90% of total billed charges,13.58,38,,,percent of total billed charges,38% of total billed charges,13.58,38,,,percent of total billed charges,38% of total billed charges,13.58,38,,,percent of total billed charges,38% of total billed charges,26.81,75,,,percent of total billed charges,75% of total billed charges,30.38,85,,,percent of total billed charges,85% of total billed charges,13.58,33.24,
vasopressin 20 units/mL injectable solution,VAS1003189,CDM,636,RC,J3490,HCPCS,outpatient,,,219.39,164.54,,197.45,90,,,percent of total billed charges,90% of total billed charges,204.03,93,,,percent of total billed charges,93% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,186.48,85,,,percent of total billed charges,85% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,178.58,81.4,,,percent of total billed charges,81.4% of total billed charges,197.45,90,,,percent of total billed charges,90% of total billed charges,197.45,90,,,percent of total billed charges,90% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,164.54,75,,,percent of total billed charges,75% of total billed charges,186.48,85,,,percent of total billed charges,85% of total billed charges,83.37,204.03,
vasopressin 20 units/mL injectable solution,VAS1003189,CDM,250,RC,J3490,HCPCS,outpatient,,,219.39,164.54,,197.45,90,,,percent of total billed charges,90% of total billed charges,204.03,93,,,percent of total billed charges,93% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,186.48,85,,,percent of total billed charges,85% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,178.58,81.4,,,percent of total billed charges,81.4% of total billed charges,197.45,90,,,percent of total billed charges,90% of total billed charges,197.45,90,,,percent of total billed charges,90% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,83.37,38,,,percent of total billed charges,38% of total billed charges,164.54,75,,,percent of total billed charges,75% of total billed charges,186.48,85,,,percent of total billed charges,85% of total billed charges,83.37,204.03,
Vecuronium Bromide 10 mg/10 mL intravenous solution,VEC1003190,CDM,636,RC,J3490,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
Vecuronium Bromide 10 mg/10 mL intravenous solution,VEC1003190,CDM,250,RC,J3490,HCPCS,outpatient,,,23.43,17.57,,21.09,90,,,percent of total billed charges,90% of total billed charges,21.79,93,,,percent of total billed charges,93% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,19.07,81.4,,,percent of total billed charges,81.4% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,21.09,90,,,percent of total billed charges,90% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,8.9,38,,,percent of total billed charges,38% of total billed charges,17.57,75,,,percent of total billed charges,75% of total billed charges,19.92,85,,,percent of total billed charges,85% of total billed charges,8.9,21.79,
"venlafaxine 75 mg oral capsule, extended release",VEN8927,CDM,637,RC,,,outpatient,,,9.01,6.76,,8.11,90,,,percent of total billed charges,90% of total billed charges,8.38,93,,,percent of total billed charges,93% of total billed charges,3.42,38,,,percent of total billed charges,38% of total billed charges,3.42,38,,,percent of total billed charges,38% of total billed charges,7.66,85,,,percent of total billed charges,85% of total billed charges,3.42,38,,,percent of total billed charges,38% of total billed charges,7.33,81.4,,,percent of total billed charges,81.4% of total billed charges,8.11,90,,,percent of total billed charges,90% of total billed charges,8.11,90,,,percent of total billed charges,90% of total billed charges,3.42,38,,,percent of total billed charges,38% of total billed charges,3.42,38,,,percent of total billed charges,38% of total billed charges,3.42,38,,,percent of total billed charges,38% of total billed charges,6.76,75,,,percent of total billed charges,75% of total billed charges,7.66,85,,,percent of total billed charges,85% of total billed charges,3.42,8.38,
verapamil 80 mg oral tablet,VER1003027,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
verapamil 120 mg oral tablet,VER1003028,CDM,637,RC,A9270,HCPCS,outpatient,,,2.33,1.75,,2.1,90,,,percent of total billed charges,90% of total billed charges,2.17,93,,,percent of total billed charges,93% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.9,81.4,,,percent of total billed charges,81.4% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,2.1,90,,,percent of total billed charges,90% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,0.89,38,,,percent of total billed charges,38% of total billed charges,1.75,75,,,percent of total billed charges,75% of total billed charges,1.98,85,,,percent of total billed charges,85% of total billed charges,0.89,2.17,
verapamil 2.5 mg/mL intravenous solution,VER1003029,CDM,636,RC,J3490,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
verapamil 2.5 mg/mL intravenous solution,VER1003029,CDM,250,RC,J3490,HCPCS,outpatient,,,36.32,27.24,,32.69,90,,,percent of total billed charges,90% of total billed charges,33.78,93,,,percent of total billed charges,93% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,29.56,81.4,,,percent of total billed charges,81.4% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,32.69,90,,,percent of total billed charges,90% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,13.8,38,,,percent of total billed charges,38% of total billed charges,27.24,75,,,percent of total billed charges,75% of total billed charges,30.87,85,,,percent of total billed charges,85% of total billed charges,13.8,33.78,
Vitamin C (ascorbic acid) 500 mg oral tablet,VIT1003195,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
Vitamin B1 (thiamine) 100 mg oral tablet,VIT1003292,CDM,637,RC,A9270,HCPCS,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
z* Vitamin K1 (neonatal phytonadione) 1 mg/0.5 mL injectable solution,VIT1003293,CDM,636,RC,J3490,HCPCS,outpatient,,,29.28,21.96,,26.35,90,,,percent of total billed charges,90% of total billed charges,27.23,93,,,percent of total billed charges,93% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,23.83,81.4,,,percent of total billed charges,81.4% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,21.96,75,,,percent of total billed charges,75% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,27.23,
z* Vitamin K1 (neonatal phytonadione) 1 mg/0.5 mL injectable solution,VIT1003293,CDM,250,RC,J3490,HCPCS,outpatient,,,29.28,21.96,,26.35,90,,,percent of total billed charges,90% of total billed charges,27.23,93,,,percent of total billed charges,93% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,23.83,81.4,,,percent of total billed charges,81.4% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,26.35,90,,,percent of total billed charges,90% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,11.13,38,,,percent of total billed charges,38% of total billed charges,21.96,75,,,percent of total billed charges,75% of total billed charges,24.89,85,,,percent of total billed charges,85% of total billed charges,11.13,27.23,
Vitamin K1 (phytonadione) 10 mg/mL injectable solution,VIT1003294,CDM,636,RC,J3430,HCPCS,outpatient,,,58.59,43.94,,52.73,90,,,percent of total billed charges,90% of total billed charges,54.49,93,,,percent of total billed charges,93% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,47.69,81.4,,,percent of total billed charges,81.4% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,43.94,75,,,percent of total billed charges,75% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,54.49,
Vitamin K1 (phytonadione) 10 mg/mL injectable solution,VIT1003294,CDM,250,RC,J3430,HCPCS,outpatient,,,58.59,43.94,,52.73,90,,,percent of total billed charges,90% of total billed charges,54.49,93,,,percent of total billed charges,93% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,47.69,81.4,,,percent of total billed charges,81.4% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,52.73,90,,,percent of total billed charges,90% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,22.26,38,,,percent of total billed charges,38% of total billed charges,43.94,75,,,percent of total billed charges,75% of total billed charges,49.8,85,,,percent of total billed charges,85% of total billed charges,22.26,54.49,
vitamin E 200 intl units oral capsule,VIT3470,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
vitamin E 200 intl units oral capsule,VIT3470,CDM,637,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Vitamin D3 (cholecalciferol) 1000 IU (25 mcg) oral tablet,VIT7847,CDM,637,RC,,,outpatient,,,2.2,1.65,,1.98,90,,,percent of total billed charges,90% of total billed charges,2.05,93,,,percent of total billed charges,93% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,1.87,85,,,percent of total billed charges,85% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,1.79,81.4,,,percent of total billed charges,81.4% of total billed charges,1.98,90,,,percent of total billed charges,90% of total billed charges,1.98,90,,,percent of total billed charges,90% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,0.84,38,,,percent of total billed charges,38% of total billed charges,1.65,75,,,percent of total billed charges,75% of total billed charges,1.87,85,,,percent of total billed charges,85% of total billed charges,0.84,2.05,
Vitamin B12 (cyanocobalamin) 1000 mcg tablet,Vitab12,CDM,250,RC,,,outpatient,,,3.51,2.63,,3.16,90,,,percent of total billed charges,90% of total billed charges,3.26,93,,,percent of total billed charges,93% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.86,81.4,,,percent of total billed charges,81.4% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,3.16,90,,,percent of total billed charges,90% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,1.33,38,,,percent of total billed charges,38% of total billed charges,2.63,75,,,percent of total billed charges,75% of total billed charges,2.98,85,,,percent of total billed charges,85% of total billed charges,1.33,3.26,
"Vivitrol 380 mg intramuscular injection, extended release",VIV7469,CDM,636,RC,J2315,HCPCS,outpatient,,,2072.64,1554.48,,1865.38,90,,,percent of total billed charges,90% of total billed charges,1927.56,93,,,percent of total billed charges,93% of total billed charges,787.6,38,,,percent of total billed charges,38% of total billed charges,787.6,38,,,percent of total billed charges,38% of total billed charges,1761.74,85,,,percent of total billed charges,85% of total billed charges,787.6,38,,,percent of total billed charges,38% of total billed charges,1687.13,81.4,,,percent of total billed charges,81.4% of total billed charges,1865.38,90,,,percent of total billed charges,90% of total billed charges,1865.38,90,,,percent of total billed charges,90% of total billed charges,787.6,38,,,percent of total billed charges,38% of total billed charges,787.6,38,,,percent of total billed charges,38% of total billed charges,787.6,38,,,percent of total billed charges,38% of total billed charges,1554.48,75,,,percent of total billed charges,75% of total billed charges,1761.74,85,,,percent of total billed charges,85% of total billed charges,787.6,1927.56,
Lidocaine 2% Viscous Cup 15mL,VLIDOUD,CDM,250,RC,,,outpatient,,,3.48,2.61,,3.13,90,,,percent of total billed charges,90% of total billed charges,3.24,93,,,percent of total billed charges,93% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.83,81.4,,,percent of total billed charges,81.4% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,3.13,90,,,percent of total billed charges,90% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,1.32,38,,,percent of total billed charges,38% of total billed charges,2.61,75,,,percent of total billed charges,75% of total billed charges,2.96,85,,,percent of total billed charges,85% of total billed charges,1.32,3.24,
Diclofenac 1% topical gel,VOL15870,CDM,250,RC,,,outpatient,,,73.35,55.01,,66.02,90,,,percent of total billed charges,90% of total billed charges,68.22,93,,,percent of total billed charges,93% of total billed charges,27.87,38,,,percent of total billed charges,38% of total billed charges,27.87,38,,,percent of total billed charges,38% of total billed charges,62.35,85,,,percent of total billed charges,85% of total billed charges,27.87,38,,,percent of total billed charges,38% of total billed charges,59.71,81.4,,,percent of total billed charges,81.4% of total billed charges,66.02,90,,,percent of total billed charges,90% of total billed charges,66.02,90,,,percent of total billed charges,90% of total billed charges,27.87,38,,,percent of total billed charges,38% of total billed charges,27.87,38,,,percent of total billed charges,38% of total billed charges,27.87,38,,,percent of total billed charges,38% of total billed charges,55.01,75,,,percent of total billed charges,75% of total billed charges,62.35,85,,,percent of total billed charges,85% of total billed charges,27.87,68.22,
BuPROPion SR 100 mg oral tablet,WEL1003111,CDM,637,RC,A9270,HCPCS,outpatient,,,19.92,14.94,,17.93,90,,,percent of total billed charges,90% of total billed charges,18.53,93,,,percent of total billed charges,93% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,16.21,81.4,,,percent of total billed charges,81.4% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,17.93,90,,,percent of total billed charges,90% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,7.57,38,,,percent of total billed charges,38% of total billed charges,14.94,75,,,percent of total billed charges,75% of total billed charges,16.93,85,,,percent of total billed charges,85% of total billed charges,7.57,18.53,
rivaroxaban (Xarelto) 10 mg oral tablet,XAR18919,CDM,250,RC,,,outpatient,,,16.96,12.72,,15.26,90,,,percent of total billed charges,90% of total billed charges,15.77,93,,,percent of total billed charges,93% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,14.42,85,,,percent of total billed charges,85% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,13.81,81.4,,,percent of total billed charges,81.4% of total billed charges,15.26,90,,,percent of total billed charges,90% of total billed charges,15.26,90,,,percent of total billed charges,90% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,12.72,75,,,percent of total billed charges,75% of total billed charges,14.42,85,,,percent of total billed charges,85% of total billed charges,6.44,15.77,
rivaroxaban (Xarelto) 15 mg oral tablet,XAR19802,CDM,250,RC,,,outpatient,,,16.96,12.72,,15.26,90,,,percent of total billed charges,90% of total billed charges,15.77,93,,,percent of total billed charges,93% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,14.42,85,,,percent of total billed charges,85% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,13.81,81.4,,,percent of total billed charges,81.4% of total billed charges,15.26,90,,,percent of total billed charges,90% of total billed charges,15.26,90,,,percent of total billed charges,90% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,6.44,38,,,percent of total billed charges,38% of total billed charges,12.72,75,,,percent of total billed charges,75% of total billed charges,14.42,85,,,percent of total billed charges,85% of total billed charges,6.44,15.77,
Xolair 300mg/2mL subcutaneous inj,XOL088002,CDM,636,RC,J2357,HCPCS,outpatient,,,3822.49,2866.87,,3440.24,90,,,percent of total billed charges,90% of total billed charges,3554.92,93,,,percent of total billed charges,93% of total billed charges,1452.55,38,,,percent of total billed charges,38% of total billed charges,1452.55,38,,,percent of total billed charges,38% of total billed charges,3249.12,85,,,percent of total billed charges,85% of total billed charges,1452.55,38,,,percent of total billed charges,38% of total billed charges,3111.51,81.4,,,percent of total billed charges,81.4% of total billed charges,3440.24,90,,,percent of total billed charges,90% of total billed charges,3440.24,90,,,percent of total billed charges,90% of total billed charges,1452.55,38,,,percent of total billed charges,38% of total billed charges,1452.55,38,,,percent of total billed charges,38% of total billed charges,1452.55,38,,,percent of total billed charges,38% of total billed charges,2866.87,75,,,percent of total billed charges,75% of total billed charges,3249.12,85,,,percent of total billed charges,85% of total billed charges,1452.55,3554.92,
Levalbuterol (Xopenex) 0.63 mg/3 mL inhalation solution,XOP15415,CDM,250,RC,,,outpatient,,,14.08,10.56,,12.67,90,,,percent of total billed charges,90% of total billed charges,13.09,93,,,percent of total billed charges,93% of total billed charges,5.35,38,,,percent of total billed charges,38% of total billed charges,5.35,38,,,percent of total billed charges,38% of total billed charges,11.97,85,,,percent of total billed charges,85% of total billed charges,5.35,38,,,percent of total billed charges,38% of total billed charges,11.46,81.4,,,percent of total billed charges,81.4% of total billed charges,12.67,90,,,percent of total billed charges,90% of total billed charges,12.67,90,,,percent of total billed charges,90% of total billed charges,5.35,38,,,percent of total billed charges,38% of total billed charges,5.35,38,,,percent of total billed charges,38% of total billed charges,5.35,38,,,percent of total billed charges,38% of total billed charges,10.56,75,,,percent of total billed charges,75% of total billed charges,11.97,85,,,percent of total billed charges,85% of total billed charges,5.35,13.09,
"Lidocaine with EPINEPHrine 1%-1:100,000 injectable solution",XYL12773,CDM,258,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
"Lidocaine with EPINEPHrine 2%-1:100,000 injectable solution",XYL12774,CDM,258,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Lidocaine-MPF 1% preservative-free injectable solution,XYL969,CDM,250,RC,,,outpatient,,,4.68,3.51,,4.21,90,,,percent of total billed charges,90% of total billed charges,4.35,93,,,percent of total billed charges,93% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.81,81.4,,,percent of total billed charges,81.4% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,4.21,90,,,percent of total billed charges,90% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,1.78,38,,,percent of total billed charges,38% of total billed charges,3.51,75,,,percent of total billed charges,75% of total billed charges,3.98,85,,,percent of total billed charges,85% of total billed charges,1.78,4.35,
Zarxio 300 mcg/0.5 mL injectable solution,ZAR22264,CDM,636,RC,Q5101,HCPCS,outpatient,,,428.51,321.38,,385.66,90,,,percent of total billed charges,90% of total billed charges,398.51,93,,,percent of total billed charges,93% of total billed charges,162.83,38,,,percent of total billed charges,38% of total billed charges,162.83,38,,,percent of total billed charges,38% of total billed charges,364.23,85,,,percent of total billed charges,85% of total billed charges,162.83,38,,,percent of total billed charges,38% of total billed charges,348.81,81.4,,,percent of total billed charges,81.4% of total billed charges,385.66,90,,,percent of total billed charges,90% of total billed charges,385.66,90,,,percent of total billed charges,90% of total billed charges,162.83,38,,,percent of total billed charges,38% of total billed charges,162.83,38,,,percent of total billed charges,38% of total billed charges,162.83,38,,,percent of total billed charges,38% of total billed charges,321.38,75,,,percent of total billed charges,75% of total billed charges,364.23,85,,,percent of total billed charges,85% of total billed charges,162.83,398.51,
Zarxio 480 mcg/0.8 mL injectable solution,ZAR22265,CDM,636,RC,Q5101,HCPCS,outpatient,,,682.25,511.69,,614.03,90,,,percent of total billed charges,90% of total billed charges,634.49,93,,,percent of total billed charges,93% of total billed charges,259.26,38,,,percent of total billed charges,38% of total billed charges,259.26,38,,,percent of total billed charges,38% of total billed charges,579.91,85,,,percent of total billed charges,85% of total billed charges,259.26,38,,,percent of total billed charges,38% of total billed charges,555.35,81.4,,,percent of total billed charges,81.4% of total billed charges,614.03,90,,,percent of total billed charges,90% of total billed charges,614.03,90,,,percent of total billed charges,90% of total billed charges,259.26,38,,,percent of total billed charges,38% of total billed charges,259.26,38,,,percent of total billed charges,38% of total billed charges,259.26,38,,,percent of total billed charges,38% of total billed charges,511.69,75,,,percent of total billed charges,75% of total billed charges,579.91,85,,,percent of total billed charges,85% of total billed charges,259.26,634.49,
Metolazone (Zaroxolyn) 5 mg oral tablet,ZAR2784,CDM,250,RC,,,outpatient,,,4.64,3.48,,4.18,90,,,percent of total billed charges,90% of total billed charges,4.32,93,,,percent of total billed charges,93% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,3.94,85,,,percent of total billed charges,85% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,3.78,81.4,,,percent of total billed charges,81.4% of total billed charges,4.18,90,,,percent of total billed charges,90% of total billed charges,4.18,90,,,percent of total billed charges,90% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,1.76,38,,,percent of total billed charges,38% of total billed charges,3.48,75,,,percent of total billed charges,75% of total billed charges,3.94,85,,,percent of total billed charges,85% of total billed charges,1.76,4.32,
Zilretta 32mg Injection,ZIL,CDM,636,RC,J3304,HCPCS,outpatient,,,23.75,17.81,,21.38,90,,,percent of total billed charges,90% of total billed charges,22.09,93,,,percent of total billed charges,93% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,20.19,85,,,percent of total billed charges,85% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,19.33,81.4,,,percent of total billed charges,81.4% of total billed charges,21.38,90,,,percent of total billed charges,90% of total billed charges,21.38,90,,,percent of total billed charges,90% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,9.03,38,,,percent of total billed charges,38% of total billed charges,17.81,75,,,percent of total billed charges,75% of total billed charges,20.19,85,,,percent of total billed charges,85% of total billed charges,9.03,22.09,
zinc sulfate 220 mg oral capsule,ZIN13924,CDM,250,RC,,,outpatient,,,3.44,2.58,,3.1,90,,,percent of total billed charges,90% of total billed charges,3.2,93,,,percent of total billed charges,93% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.8,81.4,,,percent of total billed charges,81.4% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,3.1,90,,,percent of total billed charges,90% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,1.31,38,,,percent of total billed charges,38% of total billed charges,2.58,75,,,percent of total billed charges,75% of total billed charges,2.92,85,,,percent of total billed charges,85% of total billed charges,1.31,3.2,
zinc oxide 20% topical ointment,ZIN8982,CDM,637,RC,A9270,HCPCS,outpatient,,,10.64,7.98,,9.58,90,,,percent of total billed charges,90% of total billed charges,9.9,93,,,percent of total billed charges,93% of total billed charges,4.04,38,,,percent of total billed charges,38% of total billed charges,4.04,38,,,percent of total billed charges,38% of total billed charges,9.04,85,,,percent of total billed charges,85% of total billed charges,4.04,38,,,percent of total billed charges,38% of total billed charges,8.66,81.4,,,percent of total billed charges,81.4% of total billed charges,9.58,90,,,percent of total billed charges,90% of total billed charges,9.58,90,,,percent of total billed charges,90% of total billed charges,4.04,38,,,percent of total billed charges,38% of total billed charges,4.04,38,,,percent of total billed charges,38% of total billed charges,4.04,38,,,percent of total billed charges,38% of total billed charges,7.98,75,,,percent of total billed charges,75% of total billed charges,9.04,85,,,percent of total billed charges,85% of total billed charges,4.04,9.9,
Zinc Oxide 13% topical ointment,ZINC1312012,CDM,250,RC,,,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Azithromycin 250 mg oral tablet,ZIT1003065,CDM,637,RC,A9270,HCPCS,outpatient,,,10.44,7.83,,9.4,90,,,percent of total billed charges,90% of total billed charges,9.71,93,,,percent of total billed charges,93% of total billed charges,3.97,38,,,percent of total billed charges,38% of total billed charges,3.97,38,,,percent of total billed charges,38% of total billed charges,8.87,85,,,percent of total billed charges,85% of total billed charges,3.97,38,,,percent of total billed charges,38% of total billed charges,8.5,81.4,,,percent of total billed charges,81.4% of total billed charges,9.4,90,,,percent of total billed charges,90% of total billed charges,9.4,90,,,percent of total billed charges,90% of total billed charges,3.97,38,,,percent of total billed charges,38% of total billed charges,3.97,38,,,percent of total billed charges,38% of total billed charges,3.97,38,,,percent of total billed charges,38% of total billed charges,7.83,75,,,percent of total billed charges,75% of total billed charges,8.87,85,,,percent of total billed charges,85% of total billed charges,3.97,9.71,
Azithromycin 100 mg/5 mL oral liquid,ZIT1003066,CDM,637,RC,A9270,HCPCS,outpatient,,,16.4,12.3,,14.76,90,,,percent of total billed charges,90% of total billed charges,15.25,93,,,percent of total billed charges,93% of total billed charges,6.23,38,,,percent of total billed charges,38% of total billed charges,6.23,38,,,percent of total billed charges,38% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,6.23,38,,,percent of total billed charges,38% of total billed charges,13.35,81.4,,,percent of total billed charges,81.4% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,6.23,38,,,percent of total billed charges,38% of total billed charges,6.23,38,,,percent of total billed charges,38% of total billed charges,6.23,38,,,percent of total billed charges,38% of total billed charges,12.3,75,,,percent of total billed charges,75% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,6.23,15.25,
Azithromycin IV 500 mg intravenous injection,ZIT1003067,CDM,250,RC,27447-P,HCPCS,outpatient,,,29.03,21.77,,26.13,90,,,percent of total billed charges,90% of total billed charges,27,93,,,percent of total billed charges,93% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,23.63,81.4,,,percent of total billed charges,81.4% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,21.77,75,,,percent of total billed charges,75% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,27,
Azithromycin IV 500 mg intravenous injection,ZIT1003067,CDM,636,RC,J0456,HCPCS,outpatient,,,29.03,21.77,,26.13,90,,,percent of total billed charges,90% of total billed charges,27,93,,,percent of total billed charges,93% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,23.63,81.4,,,percent of total billed charges,81.4% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,21.77,75,,,percent of total billed charges,75% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,27,
Azithromycin IV 500 mg intravenous injection,ZIT1003067,CDM,250,RC,J0456,HCPCS,outpatient,,,29.03,21.77,,26.13,90,,,percent of total billed charges,90% of total billed charges,27,93,,,percent of total billed charges,93% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,23.63,81.4,,,percent of total billed charges,81.4% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,21.77,75,,,percent of total billed charges,75% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,27,
Azithromycin IV 500 mg intravenous injection,ZIT1003067,CDM,636,RC,27447-P,HCPCS,outpatient,,,29.03,21.77,,26.13,90,,,percent of total billed charges,90% of total billed charges,27,93,,,percent of total billed charges,93% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,23.63,81.4,,,percent of total billed charges,81.4% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,26.13,90,,,percent of total billed charges,90% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,11.03,38,,,percent of total billed charges,38% of total billed charges,21.77,75,,,percent of total billed charges,75% of total billed charges,24.68,85,,,percent of total billed charges,85% of total billed charges,11.03,27,
Simvastatin 20 mg oral tablet,ZOC1003228,CDM,637,RC,A9270,HCPCS,outpatient,,,3.24,2.43,,2.92,90,,,percent of total billed charges,90% of total billed charges,3.01,93,,,percent of total billed charges,93% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.64,81.4,,,percent of total billed charges,81.4% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,2.92,90,,,percent of total billed charges,90% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,1.23,38,,,percent of total billed charges,38% of total billed charges,2.43,75,,,percent of total billed charges,75% of total billed charges,2.75,85,,,percent of total billed charges,85% of total billed charges,1.23,3.01,
Ondansetron (Zofran) 2 mg/mL injectable solution,ZOF1003244,CDM,636,RC,J2405,HCPCS,outpatient,,,34.81,26.11,,31.33,90,,,percent of total billed charges,90% of total billed charges,32.37,93,,,percent of total billed charges,93% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,29.59,85,,,percent of total billed charges,85% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,28.34,81.4,,,percent of total billed charges,81.4% of total billed charges,31.33,90,,,percent of total billed charges,90% of total billed charges,31.33,90,,,percent of total billed charges,90% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,26.11,75,,,percent of total billed charges,75% of total billed charges,29.59,85,,,percent of total billed charges,85% of total billed charges,13.23,32.37,
Ondansetron (Zofran) 2 mg/mL injectable solution,ZOF1003244,CDM,250,RC,J2405,HCPCS,outpatient,,,34.81,26.11,,31.33,90,,,percent of total billed charges,90% of total billed charges,32.37,93,,,percent of total billed charges,93% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,29.59,85,,,percent of total billed charges,85% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,28.34,81.4,,,percent of total billed charges,81.4% of total billed charges,31.33,90,,,percent of total billed charges,90% of total billed charges,31.33,90,,,percent of total billed charges,90% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,13.23,38,,,percent of total billed charges,38% of total billed charges,26.11,75,,,percent of total billed charges,75% of total billed charges,29.59,85,,,percent of total billed charges,85% of total billed charges,13.23,32.37,
"Ondansetron (Zofran) ODT 4 mg oral tablet, disintegrating",ZOF5369,CDM,250,RC,,,outpatient,,,31.15,23.36,,28.04,90,,,percent of total billed charges,90% of total billed charges,28.97,93,,,percent of total billed charges,93% of total billed charges,11.84,38,,,percent of total billed charges,38% of total billed charges,11.84,38,,,percent of total billed charges,38% of total billed charges,26.48,85,,,percent of total billed charges,85% of total billed charges,11.84,38,,,percent of total billed charges,38% of total billed charges,25.36,81.4,,,percent of total billed charges,81.4% of total billed charges,28.04,90,,,percent of total billed charges,90% of total billed charges,28.04,90,,,percent of total billed charges,90% of total billed charges,11.84,38,,,percent of total billed charges,38% of total billed charges,11.84,38,,,percent of total billed charges,38% of total billed charges,11.84,38,,,percent of total billed charges,38% of total billed charges,23.36,75,,,percent of total billed charges,75% of total billed charges,26.48,85,,,percent of total billed charges,85% of total billed charges,11.84,28.97,
Sertraline 50 mg oral tablet,ZOL1003245,CDM,637,RC,A9270,HCPCS,outpatient,,,1.16,0.87,,1.04,90,,,percent of total billed charges,90% of total billed charges,1.08,93,,,percent of total billed charges,93% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.94,81.4,,,percent of total billed charges,81.4% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,1.04,90,,,percent of total billed charges,90% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.44,38,,,percent of total billed charges,38% of total billed charges,0.87,75,,,percent of total billed charges,75% of total billed charges,0.99,85,,,percent of total billed charges,85% of total billed charges,0.44,1.08,
Piperacillin-tazobactam (Zosyn) 3.375 g IV,ZOS1003302,CDM,636,RC,J2543,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
Piperacillin-tazobactam (Zosyn) 3.375 g IV,ZOS1003302,CDM,250,RC,J2543,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
Piperacillin-tazobactam (Zosyn) 4.5 g IV,ZOS8845,CDM,250,RC,J2543,HCPCS,outpatient,,,84.37,63.28,,75.93,90,,,percent of total billed charges,90% of total billed charges,78.46,93,,,percent of total billed charges,93% of total billed charges,32.06,38,,,percent of total billed charges,38% of total billed charges,32.06,38,,,percent of total billed charges,38% of total billed charges,71.71,85,,,percent of total billed charges,85% of total billed charges,32.06,38,,,percent of total billed charges,38% of total billed charges,68.68,81.4,,,percent of total billed charges,81.4% of total billed charges,75.93,90,,,percent of total billed charges,90% of total billed charges,75.93,90,,,percent of total billed charges,90% of total billed charges,32.06,38,,,percent of total billed charges,38% of total billed charges,32.06,38,,,percent of total billed charges,38% of total billed charges,32.06,38,,,percent of total billed charges,38% of total billed charges,63.28,75,,,percent of total billed charges,75% of total billed charges,71.71,85,,,percent of total billed charges,85% of total billed charges,32.06,78.46,
Piperacillin-tazobactam (Zosyn) 2.25 g IV solution,ZOS8855,CDM,636,RC,J2543,HCPCS,outpatient,,,28.12,21.09,,25.31,90,,,percent of total billed charges,90% of total billed charges,26.15,93,,,percent of total billed charges,93% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,22.89,81.4,,,percent of total billed charges,81.4% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,25.31,90,,,percent of total billed charges,90% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,10.69,38,,,percent of total billed charges,38% of total billed charges,21.09,75,,,percent of total billed charges,75% of total billed charges,23.9,85,,,percent of total billed charges,85% of total billed charges,10.69,26.15,
OLANZapine 10 mg intramuscular injection,zyp1312012,CDM,636,RC,J2358,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
OLANZapine 10 mg intramuscular injection,zyp1312012,CDM,250,RC,J2358,HCPCS,outpatient,,,56.24,42.18,,50.62,90,,,percent of total billed charges,90% of total billed charges,52.3,93,,,percent of total billed charges,93% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,45.78,81.4,,,percent of total billed charges,81.4% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,50.62,90,,,percent of total billed charges,90% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,21.37,38,,,percent of total billed charges,38% of total billed charges,42.18,75,,,percent of total billed charges,75% of total billed charges,47.8,85,,,percent of total billed charges,85% of total billed charges,21.37,52.3,
Cetirizine (ZyrTEC) 10 mg oral tablet,ZYR1003350,CDM,637,RC,A9270,HCPCS,outpatient,,,4.32,3.24,,3.89,90,,,percent of total billed charges,90% of total billed charges,4.02,93,,,percent of total billed charges,93% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.67,85,,,percent of total billed charges,85% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.52,81.4,,,percent of total billed charges,81.4% of total billed charges,3.89,90,,,percent of total billed charges,90% of total billed charges,3.89,90,,,percent of total billed charges,90% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,1.64,38,,,percent of total billed charges,38% of total billed charges,3.24,75,,,percent of total billed charges,75% of total billed charges,3.67,85,,,percent of total billed charges,85% of total billed charges,1.64,4.02,